Flu Shot Ethics

 

 

Photo Credit – CDC PHIL

# 5866

 

This week I’ll stop by my local pharmacy and get my seasonal flu shot. No, I don’t particularly like taking the time, or spending the $30 (my insurance doesn’t cover it), to do this every year.

 

And I usually end up with a sore arm for a couple of days.

 

But I get the shot not only to protect my own health, I do it to protect those around me; family, friends, and even casual contacts I might meet.

 

People like my Dad, who will be 87 in November.

 

Last year he contracted an ILI (influenza-like-illness) over the Christmas holidays which evolved into pneumonia, and we almost lost him. 

 

I don’t know for sure that his flu-cum-pneumonia was vaccine preventable (for reasons why, see BMC Study: A Crowded Viral Field), but when the stakes are this high, I consider it my duty to try to reduce the risks as much as I possibly can.

 

While I can’t do much (beyond practicing good flu hygiene) about catching the various adenoviruses, rhinoviruses, coronaviruses, Parainfluenzas, or Human metapneumoviruses out there, I can significantly reduce my odds of catching . . . and spreading the flu.

 

And yes, Dad got the flu vaccine last year.  But at the age of 86, his immune system doesn’t mount as robust of a response to the vaccine as would a younger person.

 

          *       *       *      *      *      *      *

Earlier this year, NFID - the National Foundation for Infectious Diseases - convened a panel of experts to address the issues of influenza and the elderly that included such familiar names in public health as Arnold Monto, MD; Kristin Nichol, MD, MPH; H. Keipp Talbot, MD, MPH; and William Schaffner, MD.

 

From that panel a 5-page brief has emerged, called: Understanding the Challenges and Opportunities in Protecting Older Adults from Influenza.

 

Although the elderly generally see less protection from the flu vaccine, older individuals may still mount a robust immune response. In populations 65 and older, the brief points out that:

 

• Hospitalization rates for influenza and pneumonia are lower in community-dwelling adults who received the seasonal influenza vaccine.
• Immunization is associated with reduced hospitalization of older patients for cardiac, respiratory, and cerebrovascular diseases.

 

While the goal of vaccinating the younger population is to prevent infection, the authors point out that:

 

. . . the goal in older adults is to prevent severe illness, including exacerbation of underlying conditions, hospitalization, and mortality.

 

In other words, even if the vaccine doesn’t always prevent infection in the elderly, studies suggest that the vaccine may blunt the seriousness of the illness in those over 65.

          *       *       *      *      *      *      *

 

 

But it isn’t just the elderly (and myself) that my flu shot helps to protect. 

 

By denying the virus a susceptible host, I help limit its ability to spread in my community. And that means I’m helping to protect younger adults, children, and even infants (who, under 6 mos. of age can’t be vaccinated). 

 

Unfortunately, based on the most recent flu vaccination numbers published by the CDC’s MMWR (see FluVaxView Report ), last year only a little over 1/3rd of the residents in my state took it upon themselves to do the responsible thing and get vaccinated.

 

 

Even in the top five states (Maryland, Hawaii, Massachusetts, Rhode Island, and South Dakota) coverage was less than 60%.

 

And among healthcare workers (HCWs) – who have the opportunity to spread the flu to the most vulnerable members of our society – uptake of the vaccine in the United States last year was reported recently to have been just over 60%.

 

Despite resistance from some HCWs, calls for mandatory flu vaccination among health care workers have been coming from many directions. Earlier this year, the following editorial opinion appeared in The Lancet.

 

The Lancet, Volume 378, Issue 9788, Pages 310 - 311, 23 July 2011

doi:10.1016/S0140-6736(11)61156-2

Time to mandate influenza vaccination in health-care workers

 

 

While strongly advocating HCW influenza vaccination, the CDC has stopped short of mandating them. I blogged on this back on June 23rd, 2010  in  CDC: Proposed Influenza Infection Control Guidance.

 

Numerous professional medical organizations, however, have adopted policies calling for mandatory vaccination of HCWs.  A few earlier blogs on that include:

 

APIC Calls For Mandatory Flu Vaccination For HCWs

AAP: Recommends Mandatory Flu Vaccinations For HCWs

SHEA: Mandatory Vaccination Of Health Care Workers

IDSA Urges Mandatory Flu Vaccinations For Healthcare Workers

 

Today, with another flu season approaching, Katherine Harmon writing for Scientific American asks a number of infectious disease experts:

 

Are Health Care Workers Who Decline Flu Shots Irresponsible?

More than a third of U.S. health care employees were not vaccinated last flu season. Research shows that the unvaccinated staff have a decent chance of getting sick--and passing that infection on to at-risk patients

 

 

While the answers vary in terms of diplomacy, the consensus is that HCWs who do not get vaccinated against influenza are putting their patients at unreasonable (and unnecessary) risk.

 

Which is why – despite protests from some employees – an increasing number of hospitals and medical offices are making flu vaccination mandatory this year. A few recent headlines illustrating this growing trend include:

 

Mandatory Flu Shots For Children's Medical Center Employees

Hospital's 'Cocoon Strategy' Aimed At Protecting Young Patients

 

Local health system mandates flu vaccine for upcoming season

 

Hospitals Making Flu Vaccine Mandatory for Employees

 

 

Increasingly, hospitals are looking at this as both a liability and an economic issue, on top of their concerns over patient welfare. 

 

But no matter your job description, unless you live alone in a cave somewhere, you have the potential to spread the serious – and sometimes life-threatening – influenza virus.

 

Getting a flu shot every year can significantly reduce (but not completely eliminate) that risk.

 

That, and practicing good flu hygiene (covering coughs, sneezes, washing hands, staying home when sick), can literally save lives.

 

Which makes getting the flu shot not only smart in terms of protecting your own health, but it also makes it, without a doubt, the ethical thing do do. 

»» Read More

NPM11: The Ethics Of Preparation

 

 

 

Note: This is day 3 of National Preparedness Month.  Follow this year’s campaign on Twitter by searching for the #NPM11 hash tag.

This month, as part of NPM11, I’ll be rerunning some edited and updated older preparedness essays, along with some new ones.

 

 

 

# 5810

 

 

Over the years - when talking about emergency preparedness - a few people I’ve met have felt that it was somehow unfair, or even unethical, for those with greater financial means to prepare for disasters while those with fewer resources are be unable to do so.

 

A noble and egalitarian sounding idea, I suppose.

 

But the reality is that when more people are prepared before a crisis, fewer people will be competing for finite and sometimes slow-to-arrive emergency assistance in the days following a disaster.

 

And when you as an individual, family, or business are prepared, you are in a better position to offer help to friends, neighbors, relatives, or your community.

 

Which makes prepping not only ethical, but extremely practical as well.  

 

And it isn’t just me saying that.

 

In October, 2008 I wrote a blog which highlighted the John's Hopkins Study entitled Ethics and Severe Pandemic Influenza: Maintaining Essential Functions through a Fair and Considered Response.

 

It included the following snippet from the summary provided on  the Johns Hopkins Berman Institute of Bioethics website.

 

. . .  individuals and families who can afford it should do their best to prepare for any disaster. The paper notes, the more initiative the general public exercises in stockpiling several weeks' worth of food, water, paper goods, batteries medicines, and other needed supplies, the less vulnerable they will be to a break in the supply chain.

 

It is important for leaders to communicate to the middle class and the wealthy that it is their responsibility to prepare for self-sufficiency in order to free up scarce supplies and allow first responders to direct their attention towards those too poor or vulnerable to prepare themselves.

 

While this may not have been the main thrust of this paper's message, it is a powerful component. One that bloggers such as myself have been trying to promote for several years.

 

As long as our supply chains are intact, grocery store shelves are full and capable of being restocked, and no major shortages exist it is not hoarding, selfish, or unethical to be stockpiling a reasonable amount of emergency supplies for you, your family, and others you might be able to assist during a disaster.

 

During a crisis, relief agencies will have their hands full trying to help those who were unable to prepare, or who lost their preps due to a disaster.

 

By being prepared in advance, you take some of that burden off these agencies, which will allow them to concentrate their efforts on helping those less able to help themselves.

 

And by being prepared, you are in a better position to help others as well.

 

And that’s a win-win situation. For you, your family, and your whole community.

 

The American Red Cross sponsors a Do More Than Cross Your Fingers preparedness campaign. Spokesperson Jamie Lee Curtis has made a video that can get you started. 

You can also follow the Red Cross on Twitter by subscribing to @RedCross.

 

While 72 hours is considered the minimum amount of  time for which you and your family should be prepared, there is nothing that says you shouldn’t strive to do better than that.

 

A week or more of emergency supplies is a laudable, and easily obtainable, goal. 

 

The Red Cross isn’t alone in promoting disaster preparedness. Over the past decade, personal and community preparedness has become a national goal.

 

For more information, visit:

 

FEMA http://www.fema.gov/index.shtm

READY.GOV http://www.ready.gov/

 

It’s really the ethical thing to do.

»» Read More

Referral: The Economics Of Citizen Preparedness

 

 

# 4899

 

 

One of the best things about being a blogger in the Preparedness/Flublogia arena is the company I get to keep. 

 

Terrific and insightful writers like Scott McPherson, Crawford Kilian, Indigo Girl, Jimmy Jazz at Break Glass, Maryn McKenna, Ian York, John Solomon and others make every day a veritable treat for this humble blogger.

 

Perhaps the nicest part is that we feel free to work off each others posts, enlarging on (and often improving upon) each other’s thoughts and presentations. 

 

John, Scott, Indigo, or Crof will often write on a topic and that will spark an idea in me, that I will then write about in my blog.  And I’m happy to say, every once in awhile something I write serves as a muse for one of their blogs.

 

Which brings me to today’s post by John Solomon on his In Case of Emergency Blog that builds upon something I wrote about last week.

 

I’m not surprised that John – whose expertise in citizen preparedness far exceeds mine - adds considerable value to the topic.

 

Read:

 

The Economics Of Citizen Preparedness: Should Government Officials More Openly Acknowledge Its Readiness Messaging Is Financially, Socially Tiered?

September 14th, 2010 

 

Highly Recommended.

And if you aren’t already a regular visitor to John’s blog, you should be.

»» Read More

NPM10: The Ethics Of Prepping

 

 

Note: This is day 3 of National Preparedness Month.  Follow this campaign on Twitter by searching for the #NPM10 hash tag.

 

# 4863

 

 

 

There are some who believe that it is unfair, or somehow unethical, to ask those with greater financial means to prepare for disasters while some with fewer resources may be unable to do so.

 

A noble idea, I suppose.

 

But the reality is that the more people who are prepared before a crisis, the fewer people that will need emergency assistance later.

 

And by being prepared, you are in a better position to offer help to a friend, a neighbor, a relative, or your community.

 

Prepping is ethical.   And it isn’t just me saying that.

 

In October, 2008 I wrote a blog which highlighted the John's Hopkins Study entitled Ethics and Severe Pandemic Influenza: Maintaining Essential Functions through a Fair and Considered Response. 

 

It included the following snippet from the summary provided on  the Johns Hopkins Berman Institute of Bioethics website.

 

. . .  individuals and families who can afford it should do their best to prepare for any disaster. The paper notes, the more initiative the general public exercises in stockpiling several weeks' worth of food, water, paper goods, batteries medicines, and other needed supplies, the less vulnerable they will be to a break in the supply chain.

 

It is important for leaders to communicate to the middle class and the wealthy that it is their responsibility to prepare for self-sufficiency in order to free up scarce supplies and allow first responders to direct their attention towards those too poor or vulnerable to prepare themselves.

 

 

While this may not have been the main thrust of this paper's message, it is a powerful component.    One that bloggers such as myself have been trying to promote for several years.

 

As long as our supply chains are intact, grocery store shelves are full and capable of being restocked, and no major shortages exist it is not hoarding, selfish, or unethical to be stockpiling a reasonable amount of emergency supplies for you, your family, and others you might be able to assist during a disaster.

 

During a crisis relief agencies will have their hands full trying to help those who were unable to prepare, or who lost their preps due to a disaster.

 

By being prepared in advance, you take some of the burden off these agencies, which will allow them to concentrate their efforts on helping those less able to help themselves.

 

And by being prepared, you are in a better position to help others.

 

 

And that’s a win-win situation. For you, your family, and your community.

 

The American Red Cross sponsors a Do More Than Cross Your Fingers preparedness campaign, with spokesperson Jamie Lee Curtis that can get you started. 

 

 

You’ll find scores of other Red Cross videos on the RED CROSS YOUTUBE CHANNEL.  You can also follow the Red Cross on Twitter by subscribing to @RedCross.

While 72 hours is considered the minimum amount of  time you and your family should be prepared for, there is nothing that says you shouldn’t strive to do better than that. 

 

A week or more of emergency supplies is a laudable goal.

 

And of course, the Red Cross isn’t alone in promoting disaster preparedness. For more information, you’ll want to visit.

 

FEMA http://www.fema.gov/index.shtm

READY.GOV http://www.ready.gov/

 

It’s the ethical thing to do.

»» Read More