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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 14 comments

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. 
(b) 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 Steven 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.

Join NVIC on Facebook

Stay up to date on what is happening day to day with breaking vaccine news by becoming a fan on NVIC’s Facebook page.

NVIC Calendar Notes
Aug. 31 & Sep. 7, 2012 on Lifetime Network: "The Balancing Act" will broadcast their annual "Back to School" special that will feature a segment on vaccination and preventive health with celebrity Mom, Julie Moran, who interviews Barbara Loe Fisher and Vicky Debold, RN, PhD., NVIC's Director of Research and Patient Safety. The segment will be shown between 7-8 a.m. ET/PT.
Oct. 13, 2012 in Chicago, IL9th Annual Natural Living Conference sponsored by Holistic Moms Network (HMN). Keynote speaker Barbara Loe Fisher will speak about "Vaccines & Chronic Illness: Staying Well in the New Epidemic." HMN recently sent an email blast to its readers honoring Barbara. Click The Power of One Mom: Honoring 30 Years of Vaccination Choice to view HMN's email blast.
In The News

Families sue DHHR over required vaccines
, Daily Mail (Charleston, WVA), Aug. 10, 2012
Local parents question state vaccination policies, Daily Comet (LA), Aug. 11, 2012

Posted: 8/21/2012 5:51:57 PM | with 14 comments


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