U.S. Hospitals illegally firing workers who do not take the flu shot

Note: Hospitals and other healthcare facilities use vaccination “policies”, not laws, to force workers to take the shots. That is because forcing someone to take a vaccine is illegal, therefore no law exists to truly mandate vaccinations.

By LINDSEY TANNER | AP | JANUARY 14, 2013

Patients can refuse a flu shot. Should doctors and nurses have that right, too? That is the thorny question surfacing as U.S. hospitals increasingly crack down on employees who won’t get flu shots, with some workers losing their jobs over their refusal.

“Where does it say that I am no longer a patient if I’m a nurse,” wondered Carrie Calhoun, a longtime critical care nurse in suburban Chicago who was fired last month after she refused a flu shot.

Hospitals’ get-tougher measures coincide with an earlier-than-usual flu season hitting harder than in recent mild seasons. Flu is widespread in most states, and at least 20 children have died.

Most doctors and nurses do get flu shots. But in the past two months, at least 15 nurses and other hospital staffers in four states have been fired for refusing, and several others have resigned, according to affected workers, hospital authorities and published reports.

In Rhode Island, one of three states with tough penalties behind a mandatory vaccine policy for health care workers, more than 1,000 workers recently signed a petition opposing the policy, according to a labor union that has filed suit to end the regulation.

Why would people whose job is to protect sick patients refuse a flu shot? The reasons vary: allergies to flu vaccine, which are rare; religious objections; and skepticism about whether vaccinating health workers will prevent flu in patients.

Dr. Carolyn Bridges, associate director for adult immunization at the federal Centers for Disease Control and Prevention, says the strongest evidence is from studies in nursing homes, linking flu vaccination among health care workers with fewer patient deaths from all causes.

“We would all like to see stronger data,” she said. But other evidence shows flu vaccination “significantly decreases” flu cases, she said. “It should work the same in a health care worker versus somebody out in the community.”

Cancer nurse Joyce Gingerich is among the skeptics and says her decision to avoid the shot is mostly “a personal thing.” She’s among seven employees at IU Health Goshen Hospital in northern Indiana who were recently fired for refusing flu shots. Gingerich said she gets other vaccinations but thinks it should be a choice. She opposes “the injustice of being forced to put something in my body.”

Medical ethicist Art Caplan says health care workers’ ethical obligation to protect patients trumps their individual rights.

“If you don’t want to do it, you shouldn’t work in that environment,” said Caplan, medical ethics chief at New York University’s Langone Medical Center. “Patients should demand that their health care provider gets flu shots — and they should ask them.”

For some people, flu causes only mild symptoms. But it can also lead to pneumonia, and there are thousands of hospitalizations and deaths each year. The number of deaths has varied in recent decades from about 3,000 to 49,000.

A survey by CDC researchers found that in 2011, more than 400 U.S. hospitals required flu vaccinations for their employees and 29 hospitals fired unvaccinated employees.

At Calhoun’s hospital, Alexian Brothers Medical Center in Elk Grove Village, Ill., unvaccinated workers granted exemptions must wear masks and tell patients, “I’m wearing the mask for your safety,” Calhoun says. She says that’s discriminatory and may make patients want to avoid “the dirty nurse” with the mask.

The hospital justified its vaccination policy in an email, citing the CDC’s warning that this year’s flu outbreak was “expected to be among the worst in a decade” and noted that Illinois has already been hit especially hard. The mandatory vaccine policy “is consistent with our health system’s mission to provide the safest environment possible.”

The government recommends flu shots for nearly everyone, starting at age 6 months. Vaccination rates among the general public are generally lower than among health care workers.

According to the most recent federal data, about 63 percent of U.S. health care workers had flu shots as of November. That’s up from previous years, but the government wants 90 percent coverage of health care workers by 2020.

The highest rate, about 88 percent, was among pharmacists, followed by doctors at 84 percent, and nurses, 82 percent. Fewer than half of nursing assistants and aides are vaccinated, Bridges said.

Some hospitals have achieved 90 percent but many fall short. A government health advisory panel has urged those below 90 percent to consider a mandatory program.

Also, the accreditation body over hospitals requires them to offer flu vaccines to workers, and those failing to do that and improve vaccination rates could lose accreditation.

Starting this year, the government’s Centers for Medicare & Medicaid Services is requiring hospitals to report employees’ flu vaccination rates as a means to boost the rates, the CDC’s Bridges said. Eventually the data will be posted on the agency’s “Hospital Compare” website.

Several leading doctor groups support mandatory flu shots for workers. And the American Medical Association in November endorsed mandatory shots for those with direct patient contact in nursing homes; elderly patients are particularly vulnerable to flu-related complications. The American Nurses Association supports mandates if they’re adopted at the state level and affect all hospitals, but also says exceptions should be allowed for medical or religious reasons.

Mandates for vaccinating health care workers against other diseases, including measles, mumps and hepatitis, are widely accepted. But some workers have less faith that flu shots work — partly because there are several types of flu virus that often differ each season and manufacturers must reformulate vaccines to try and match the circulating strains.

While not 100 percent effective, this year’s vaccine is a good match, the CDC’s Bridges said.

Several states have laws or regulations requiring flu vaccination for health care workers but only three — Arkansas, Maine and Rhode Island — spell out penalties for those who refuse, according to Alexandra Stewart, a George Washington University expert in immunization policy and co-author of a study appearing this month in the journal Vaccine.

Rhode Island’s regulation, enacted in December, may be the toughest and is being challenged in court by a health workers union. The rule allows exemptions for religious or medical reasons, but requires unvaccinated workers in contact with patients to wear face masks during flu season. Employees who refuse the masks can be fined $100 and may face a complaint or reprimand for unprofessional conduct that could result in losing their professional license.

Some Rhode Island hospitals post signs announcing that workers wearing masks have not received flu shots. Opponents say the masks violate their health privacy.

“We really strongly support the goal of increasing vaccination rates among health care workers and among the population as a whole,” but it should be voluntary, said SEIU Healthcare Employees Union spokesman Chas Walker.

Supporters of health care worker mandates note that to protect public health, courts have endorsed forced vaccination laws affecting the general population during disease outbreaks, and have upheld vaccination requirements for schoolchildren.

Cases involving flu vaccine mandates for health workers have had less success. A 2009 New York state regulation mandating health care worker vaccinations for swine flu and seasonal flu was challenged in court but was later rescinded because of a vaccine shortage. And labor unions have challenged individual hospital mandates enacted without collective bargaining; an appeals court upheld that argument in 2007 in a widely cited case involving Virginia Mason Hospital in Seattle.

Calhoun, the Illinois nurse, says she is unsure of her options.

“Most of the hospitals in my area are all implementing these policies,” she said. “This conflict could end the career I have dedicated myself to.”

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Cowardly World Leaders Hide from the Public

Barack Obama changes G8 Summit Location from Chicago to Camp David

Associated Press
March 5, 2012

The White House abruptly announced Monday that it had scuttled plans to hold the upcoming G-8 economic summit in Chicago, and would instead host world leaders at the presidential retreat at Camp David in Maryland.

It was an unusually late location change for a large and highly scripted international summit and came with little explanation from the White House. Chicago Mayor Rahm Emanuel — the former White House chief of staff who personally lobbied President Barack Obama to hold the summit in Chicago — was informed only hours before the official announcement.

White House national security spokesman Tommy Vietor simply said that Camp David, the rustic retreat in the mountains of Maryland, was a setting that would allow for more intimate discussions among the G-8 leaders. He said security and the possibility of protests were not factors in the decision, noting that Obama would still host the NATO summit in his hometown of Chicago from May 20-21.

The White House said the G-8 summit would take place May 18-19.

The White House announced plans last summer to hold both summits back-to-back in Chicago, giving the president a high-profile opportunity to tout his foreign policy and diplomatic credentials on his home turf in an election year.

The idea of moving the G-8 to Camp David was raised to the president a few weeks ago, a senior administration official said, adding that the president was intrigued by the novelty of the idea and asked staff whether they could pull off the change.

The official who spoke on condition of anonymity about internal White House thinking.

Adding to the curious nature of the White House announcement was the fact that Obama rarely spends time at his presidential retreat. And unlike many of his predecessors, Obama has never hosted a world leader at Camp David.

Monday’s announcement appeared to catch many in Chicago by surprise.

A spokeswoman for Emanuel said the Chicago mayor was informed about the location change in a Monday phone call from a White House official.

Chris Johnson, spokesman for the Chicagoland Chamber of Commerce, said his organization was “just as surprised about the announcement as anybody else.”

The world’s eight largest economies are represented in the G-8 and hosting duties for the annual summit are rotated among the member countries. The summits have become a target for large, and sometimes violent, protests in recent years, making security costs a concern for host cities.

At least one protest group heralded the news as a major victory. But Joe Iosbaker of the United National Antiwar Committee in Chicago said protests would still go on during the NATO summit.

Chicago officials began planning for the summits last summer, with city officials predicting it would give the city a chance to shine internationally, while the police rank-and-file worryied whether they would be prepared to handle the thousands of protesters expected to converge downtown.

Elizabeth Sherwood-Randall, Obama’s senior director for European affairs, said recently that the president was confident his hometown could put on a “great show” and that its police department was up to the task of providing security.

The city’s host committee had estimated it could cost $40 million to $65 million to stage the events, including the costs for security.

Gordon Johndroe, who served as National Security Council spokesman for President George W. Bush, said the immense logistics involved in setting up an international gathering like the G-8 would make it difficult to split the summits at such a late date.

“It is very complicated to set these things up, and even more complicated to move them that quickly,” said Johndroe.

Leaders from Canada, France, Germany, Italy, Japan, Russia, the United Kingdom, as well as the European Union, are expected to attend this year’s gathering.

U.S. Administration Supports Indecent Vatican’s Paedophilia Immunity

AFP

The Obama administration in a brief to the Supreme Court has backed theVatican’s claim of immunity from lawsuits arising from cases of sexual abuse by priests in the United States.

The Supreme Court is considering an appeal by the Vatican of an appellate court ruling that lifted its immunity in the case of an alleged pedophile priest from Oregon.

In a filing on Friday, the solicitor general’s office argued that the Ninth Circuit court of appeals erred in allowing the lawsuit brought by a man who claims he was sexually abused in the 1960s by the Oregon priest.

The unnamed plaintiff, who cited the Holy See and several other parties as defendants, argued the Vatican should be held responsible for transferring the priest to Oregon and letting him serve there despite previous accusations he had abused children in Chicago and in Ireland.

The solicitor general’s office, which defends the position of President Barack Obama’s administration before the Supreme Court, said the Ninth Circuit improperly found the case to be an exception to the Foreign Sovereign Immunities Act, a 1976 federal law that sets limits on when other countries can face lawsuits in US courts.

“Although the decision does not conflict with any decision of another court of appeals, the Court may wish to grant the petition, vacate the judgement of the court of appeals and remand to that court for further consideration”.

The case, which was filed in 2002, does not directly address questions raised in a separate lawsuit in Kentucky alleging that US bishops are employees of the Holy See.

But the Vatican plans to argue that Catholic dioceses are run as separate entities from the Holy See, and that the only authority that the pontiff has over bishops around the world is a religious one, according to Jeffrey Lena, theVatican’s US attorney.

In recent months, large-scale pedophilia scandals have rocked the Roman Catholic Church in a number of countries, including Austria, Ireland, Pope Benedict XVI’s native Germany and the United States.

Senior clerics have been accused of protecting the priests involved by moving them to other parishes — where they sometimes offended again — instead of handing them over to civil authorities for prosecution.

The pope, who has himself faced allegations implicating him in the scandal, has repeatedly said priests and religious workers guilty of child abuse should answer for their crimes in courts of law.