Labor Unions Oppose Mandatory Flu Shots As AMA Cherry-Picks Ethics to Endorse Vaccine Mandates

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Labor Unions Oppose Mandatory Flu Shots as AMA Cherry-Picks Ethics to

Endorse Vaccine Mandates

Posted: 8/21/2012 5:51:57 PM | with

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By Theresa Wrangham, NVIC Executive Director

In February

I reported on the National Vaccine Program Office’s (NVPO) federal

advisory committee, the National Vaccine Advisory Committee (NVAC), and

their recommendation that health care facilities consider mandatory

flu shot policies as a condition of employment for health care

professionals in order to meet Healthy People 2020 goals. NVIC is on

record as opposing the NVAC’s recommendation due to the absence of

flexible medical, religious and personal/philosophical/conscientious

belief exemptions in the recommendation.

Long-awaited Response from NVPO

Immediately after the February NVAC meeting I requested copies of the

organizational written public comments submitted to the NVAC on this

matter and received those comments last week. The comments, which by law

must be made available to the public, may be obtained from our website

here, or can be requested from NVPO by

email with the understanding that the available files are currently

not in compliance with the US Rehabilitation Act.

I can now report to our readers the gist of these comments and say that

our health care professionals are not alone in their fight for autonomy

and respect. NVIC is in good company in defending the informed consent

ethic for health care professionals facing workplace influenza vaccine

mandates.

AMA's Medical Code of Ethics SUPPORT Exemption Provisions

There were a few surprises that caused me to raise an eyebrow when

reading the organizational public comments. A statement contained in the

Service Employees International Union (SEIU) public comment is stunning.

For those not familiar with the SEIU, they are the largest U.S.

organization representing health care professionals hailing from a

variety of health care settings, to the tune of over 1 million strong.

Below is the comment that caught my eye:

“The breath of organizations that strongly support flu vaccination,

but are on record concurring with SEIU in opposing a flu vaccine employer

requirement in the absence a basic philosophic or personal exemption for

healthcare workers include: OSHA, CDC's NIOSH, the EEOC, the AFL-CIO, the

AMA (15), the ANA, ACOEM (the largest organization of occupational

health physicians), and the Association of Occupational Health

Professionals in Healthcare (AOHP), the California Nurses

Association {CNA), Leading Edge (the trade association for the non-profit

long term care industry), National Nurses United {NNU), the New York

State Public Employees Federation {PEF), and the New York State Chapter

of the American Civil Liberties Union {ACLU). "

Did you note the bolded AMA? Yes, I was a little surprised too,

because the American Medical Association (AMA) also submitted a written

public comment to the NVAC, which stated:

“The AMA believes that as professionals committed to promoting the

welfare of individual patients and the health of the public, and to

safeguarding their own and their colleagues’ well-being, physicians have

an ethical responsibility to take appropriate measures to prevent the

spread of infectious disease in healthcare settings. Thus, AMA ethical

policy states that physicians have an obligation to accept immunization

absent medical contraindication, as recommended by the medical

staff leadership or healthcare institution. This is consistent with the

subgroup’s recommendation that facilities that are unable to achieve the

Healthy People goal of 90 percent influenza vaccination coverage of

healthcare personnel in an efficient and timely manner consider an

employer requirement for influenza immunization.”

The red, italicized, bolded section of the quote above is admittedly my

doing, as I found this portion of the AMA statement to be contradictory

to SEIU’s statement. Thankfully, the SEIU cited their statement on the

AMA and I was directed to AMA’s Code of Medical Ethics. Below is the most

current policy posted on the AMA's website - in its entirety. Again, I

highlight the most interesting part:

AMA Code of Medical Ethics - Opinion 9.133 Routine Universal Immunization

of Physicians: As professionals committed to promoting the

welfare of individual patients and the health of the public and to

safeguarding their own and their colleagues’ well-being, physicians have

an ethical responsibility to take appropriate measures to prevent the

spread of infectious disease in health care settings. Conscientious

participation in routine infection control practices, such as hand

washing and respiratory precautions is a basic expectation of the

profession. In some situations, however, routine infection control is not

sufficient to protect the interests of patients, the public, and fellow

health care workers.

In the context of a highly transmissible disease that poses

significant medical risk for vulnerable patients or colleagues, or

threatens the availability of the health care workforce, particularly a

disease that has potential to become epidemic or pandemic, and for which

there is an available, safe, and effective vaccine, physicians have an

obligation to:

(a) Accept immunization absent a recognized medical, religious, or

philosophic reason to not be immunized.

( Accept a decision of the medical staff leadership or health care

institution, or other appropriate authority to adjust practice activities

if not immunized (e.g., wear masks or refrain from direct patient

care). It may be appropriate in some circumstances to inform

patients about immunization status. (I, II)

Issued June 2011 based on the report

" Routine Universal Immunization of Physicians for

Vaccine-Preventable

Disease,

" adopted November 2010.

It appears that SEIU is correct and that the AMA cherry-picked their

own ethics policy by neglecting to mention the scope of exemptions within

their policy when responding to the NVAC request for public comment.

If this is the AMA’s most current policy, I have to ask myself, is there

a secret handshake allowing private exemption to those in the know? I ask

because

this

organization appears to publicly discourage individuals from

exercising the same exemption options for school entry. If these

exemptions are good enough for AMA members, shouldn’t they be good enough

for everyone else?

Informed Consent Support from Other Career Fields of Organized Labor

While I could summarize what organizations opposing vaccine mandates

submitted to the NVAC, it simply wouldn't do these brave organizations

justice. Below are additional quotes I have chosen to highlight taken

from the written public comments submitted to the NVAC by organizations

opposing influenza vaccine mandates for health care professionals and

which support informed consent and/or medical, religious and

personal/philosophical/conscientious belief exemptions.

American Federation of Labor and Congress of Industrial Organizations

(AFL-CIO) representing 9 million workers: “The Healthy People 2020

Objective of 90 Percent Seasonal Influenza Vaccination Among Health Care

Personnel Is A Goal Rather Than a Mandatory Requirement”

“Unilateral Implementation Of Mandatory Seasonal Influenza Vaccination

Programs In Unionized Healthcare Facilities Is A Violation Of The

National Labor Relations Act - NVAC Should Not Endorse Illegal Acts By

Employers”

“Healthcare workers must be permitted to refuse the annual seasonal

influenza vaccination without fear of reprisal for medical, religious, or

personal reasons.” American Federation of State, County and Municipal Employees (AFSCME)

representing 1.6 million members: “… cannot endorse

Recommendation # 4 urging that employers require influenza vaccination

without allowance for medical, religious and philosophical exemptions” American Federation of Teachers (AFT) representing 1.5 million

members: “The mandate should be the adoption of a comprehensive

standard similar to OSHA blood-borne pathogen standard with requirements

for training, voluntary immunization and declination after

education. "

“The AFT believes that establishing a mandatory seasonal influenza

program is a change to the terms and conditions of employment. Therefore

those healthcare employers with unionized workforces cannot unilaterally

implement mandatory influenza programs with the consequence of discipline

or discharge for those unwilling to do so without negotiating with the

union should the union wish to do so. The National Labor Relations Board

(NLRB) recently upheld that right in its decision in the Virginia Mason

Hospital and Washington State Nurses Association, Case 19-CA-30154,

August 23, 2011.”

Association of Flight Attendants-Communications Workers of America

(AFA) representing 60,000 flight attendants at 23 airlines: “AFA does

not support making influenza vaccination a condition of employment for

HCP. As stated in the draft report, this is a controversial and hotly

debated recommendation. It is also one that if adopted will have

significant, career-altering consequences for workers who object strongly

(for whatever reason) to influenza vaccination.” Association of American Physicians and Surgeons: “The Association

of American Physicians and Surgeons (AAPS), a national organization of

physicians in all specialties founded in 1943 to preserve the sanctity of

the patient-physician relationship, objects strenuously to any coercion

of healthcare personnel to receive influenza immunization.”

“It is a fundamental human right not to be subjected to medical

interventions without fully informed consent.”

National Nurses United (NNU) representing 170,000 members across all

states is the largest professional association and labor organization of

director care registered nurses: “…we cannot support mandatory

vaccination policies, because, rather than being educated on the

importance of vaccination, employees are instead coerced into accepting

the vaccine, or risk being punished, retaliated against, and, in some

cases, fired by their employer. Mandatory flu vaccination programs

engender distrust and resistance among employees; offer a disincentive to

providing vaccination education to employees, and raise ethical and legal

questions about the personal employment rights of employees. This is not

the way to protect public health.” The Coalition of Kaiser Permanente Unions representing 28 local

unions with 95,000 frontline employees: " Employee relations and

public health are not well served by the use of coercion to achieve flu

vaccination ends. And it is not consisted with our national values

openness, respect, and informed consent around medical treatments we

receive.” The Occupational Safety and Health Administration (OSHA): “OSHA

is a strong supporter of appropriate education, ready access and signed

declination statements for HCP vaccinations. OSHA's bloodborne pathogen

standard regarding Hepatitis B education and vaccination is a

best-practice model. Influenza vaccination exemptions should be allowed

for HCP with valid medical contraindications to vaccinations, or

religious and/or personal objections.” United Steel, Paper and Forestry, Rubber, Manufacturing, Energy,

Allied Industrial and Service Workers International Union is among

the first unions in the United States to organize health care workers and

represents 30,000 members throughout the health care sector:

" The USW supports effective, voluntary programs for influenza

vaccination ofhealthcare workers... " “Employers are prohibited

by the National Labor Relations Act, and other labor laws with similar

provisions, from making unilateral changes in conditions of employment

including health and safety. A mandatory vaccination policy would

certainly fall within this category... "

" In conclusion, we urge NVAC to drop the recommendation for

mandatory vaccination as a condition of employment for healthcare

workers...”

Some of the above comments are from organizations not limited to

representing health care professionals. Perhaps these organizations can

see the writing on the wall; that if health care professionals can be

bullied and coerced into vaccination against their will, then what

profession is next? Teachers, daycare workers, government employees and

public transit employees?

For myself, I have to ask, how long will it be before those not bowing to

the recommended schedule will be forced to wear a scarlet letter

announcing their vaccination status? What other areas of medicine will

informed consent be deemed too inconvenient to be followed and the

consumer told that they have no say in matters of their health?

The line drawn in the sand by the organizations opposing flu shot

mandates without comprehensive exemption provisons has far reaching

implications and it would appear that their words are fighting

words.

Adult Influenza Vaccine Injury Claims Increasing

In light of the aggressive push by government and medical trade

associations like the AMA to mandate influenza vaccine for all health

care workers in the U.S., it is interesting to note that adult influenza

vaccine injury claims are now leading all vaccine injury claims submitted

to the federal Vaccine Injury Compensation Program (VICP). Many health

care workers have expressed concern about mercury preservatives in

influenza vaccines they are being forced to get as a condition of

employment.

Most influenza vaccines licensed in the U.S. are distributed in

multi-dose vials and contain 25 mcg of the mercury preservative,

Thimerosal, in amounts above EPA safety guidelines for one-day exposures

to mercury. Thimerosal-free influenza vaccines are also available

in the U.S. in limited quantities (about 4 million doses are made

available every year by vaccine manufacturers) but most of these

mercury-free vaccines distributed in single dose vials are reserved for

children and pregnant women. However, adult health care workers may be

able to ask vaccine providers to administer a mercury-free influenza

vaccine, if stocks are available.

Click here to access the

Vaccine Ingredient Calculator (VIC) to determine which vaccines are

Thimerosal free and visit NVIC’s influenza webpage to access the latest

vaccine manufacturer product inserts and learn more about staying well

during the flu season.

Scheduled Meetings of Vaccine Related Federal Advisory

Committees

Federal advisory committees meet throughout the year and NVIC continues

to monitor and inform our readers of their activities and continues to

stand up for informed consent during public comment and engagement. These

meetings are open to the public and participation is often offered via

teleconference on toll-free phone lines.

The next NVAC meeting is September 11-12 and

pre-registration is required. The agenda for this meeting has

not yet been published and that information is made available two weeks

before the meeting and can be found

here.

The Advisory Commission on Childhood Vaccines (ACCV), which is

currently considering the expansion of the Vaccine Injury Table used for

vaccine injury compensation, will hold its next meeting on September 6-7

and meeting information may be found

here. The agenda is not yet available.

Tell Your Story on

NVIC’s Vaccine Freedom Wall

If you have been threatened or coerced by a doctor, nurse or employer

for attempting to exercise informed consent to vaccination for yourself

or your child, you can share your experience on

NVIC’s Vaccine Freedom Wall. The stories posted on the Vaccine

Freedom Wall give powerful evidence for why the legal right to make

voluntary vaccine choices in America is worth defending. Please share

your story and help inform and empower others to stand up for their

parental and informed consent rights.

Join NVIC’s Advocacy Portal User Community

In the past few years, NVIC Vaccine E-News readers know that non-medical

exemptions to vaccination for children to attend school, which include

those for sincerely held religious, conscientious and philosophical

beliefs, have come under attack by lobbyists representing drug companies,

medical trade associations and public health officials working in

government health agencies. Washington and Vermont have passed laws

restricting the right to obtain a non-medical exemption and legislation

is pending in California to do the same.

NVIC’s Advocacy Portal is a

free online communications and state advocacy network that provides users

with email Action Alerts when state legislation is introduced that

threatens vaccine exemptions. You will be put in immediate contact with

your own state legislators with the touch of an I-phone screen or click

of a computer mouse so you can make your voice heard! Sign up today and

stand up for your rights.

MedAlerts Adds “Wayback”

Feature For Vaccine Reaction Searches

MedAlerts is a powerful database search engine that makes it easy to

search and review vaccine adverse events reported to the federal Vaccine

Adverse Events Reporting System (VAERS) by vaccine, symptoms of

reactions, dates, places and more. Developed and managed by computer

scientist Rubin, PhD., who is NVIC’s volunteer Director of Vaccine

Research Analytics, MedAlerts has been a special feature on NVIC.org for

nearly a decade. This week, Dr. Rubin has announced an enhancement of

MedAlerts that allows visitors to analyze VAERS information and changes

made to VAERS data dating back to 2003.

Dr. Rubin also writes a MedAlerts Blog that features monthly analyses of

trends in VAERS reports. This month's

MedAlerts Blog

introduces MedAlerts “VAERS Wayback Machine. "

MedAlerts was the first online search engine designed to offer the public

an easy way to access and search the VAERS database. Visit NVIC’s

vaccine reactions

webpage to learn more about reporting vaccine reactions and how to

search for vaccine reaction reports made to VAERS using

MedAlerts.

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