Vaccines are real science for real health threats

Austin American-Statesman, January 19, 2010

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Vaccines represent the greatest success story in public health — the triumph of human achievement over disease. But as the incidence of infectious diseases has declined over 60 years, many people are less interested in the horrific consequences of preventable illnesses like polio, diphtheria and the like and more concerned about vaccine risks. And there's no reasoning with them.

Vaccines represent the greatest success story in public health — the triumph of human achievement over disease. But as the incidence of infectious diseases has declined over 60 years, many people are less interested in the horrific consequences of preventable illnesses like polio, diphtheria and the like and more concerned about vaccine risks. And there’s no reasoning with them.

Recently, the American-Statesman published a story of a nurse working in surgical recovery at at the Seton Family of Hospitals who, after an initial suspension, was fired for refusing to wear a mask after she refused the seasonal and H1N1 flu vaccines.

It’s hard for me to understand this war on vaccines in the lay public. But it’s impossible for me to understand it among health care professionals who were educated in the sciences to earn the right to sit for their licensure exams.

Were the sciences real to them while in school — but not now?

I wonder if people are aware that between April and mid-November, 50 million Americans (one in six) became infected with H1N1, and 10,000 died, according to the U.S. Centers of Disease Control and Prevention. As opposed to the elderly, whom the seasonal flu affects the most, more than 75 percent of H1N1 deaths were people between 18 and 64.

Closely following the scientific knowledge and practical recommendations about the H1N1 virus from the World Health Organization and the CDC, the Seton Family of Hospitals required its employees to receive the flu vaccines or wear surgical masks while on the job.

For a business and health care ministry in eminent danger of becoming crippled by the first flu pandemic in 41 years, it was the right decision. The CDC reported 213,000 hospitalizations in the same time period. The virus did not discriminate on the basis of insurance coverage, leaving hospitals nationwide financially vulnerable.

Since Seton announced the requirement in September, I’ve been surprised at how many of my health care co-workers from many disciplines are wearing masks. So I asked them why they didn’t get the vaccine.

“I got the flu vaccine one year and got the flu.” Impossible. The vaccine is a killed virus, unable to cause active infection.

“I’ve never gotten the flu shot and never gotten the flu.” You’ve been lucky. If you’ve never had a head-on collision, do you still wear a seat belt?

“I would go home if I were sick.” Flu is highly contagious, with as many as 50 percent of contacts with infected individuals catching the flu. How can you know exactly when you’re contagious?

“I don’t like to be told what to do or for my employer to limit my freedom of choice.” Should food-service workers have the freedom not to wash their hands after visiting the restroom?

Health care workers who choose not to get vaccines serve as potential vectors of disease transmission to unsuspecting patients, especially to immuno-suppressed children and adults who cannot receive vaccine.

H1N1 infection rates are waning, but typical of flu pandemics, health experts are predicting a third wave, which might bring new strains of virus. Officials warn not to relax vaccination programs, as H1N1 vaccine is still the most potent countermeasure for any human flu.

Control of communicable diseases like H1N1 relies on “herd” (population) immunity. That means simply that everyone gets vaccinated.

For health care workers, whether to get vaccines is not a power play nor a question of freedom. It’s a matter of public health. Maintaining community health is a job for all of us, not for some of us.

Toni Inglis, MSN, RN CNS (retired), FAAN, a lifelong Austin resident and retired neonatal intensive care nurse and editor of NursingNews, writes a monthly opinion column for the Austin American-Statesman editorial page.