Should taking a drug or a vaccination be made a mandatory condition for coming to work? What about for front-line workers in health care? The issue re-emerged last month when a group of paramedics in the Kingston, Ont., area were sent home for not having a flu shot during an influenza outbreak.
Steve Hampton, a paramedic working in the counties of Leeds and Grenville, was among the group of 20 paramedics told at the end of January they couldn’t provide patient care when Kingston, Frontenac and Lennox & Addington Public Health declared it had an outbreak.
Of those, 14 returned to work after agreeing to take either the flu shot or the anti-viral drug Tamiflu, and six remained off work, said Terry Baker, president of Local 462 of the Ontario Public Service Employees Union (OPSEU).
Hampton is allergic to flu shots, he told
Canadian HR Reporter
, and his only option is to take Tamiflu.
But his physician would only give him one prescription. What his doctor’s office told him was people take it inappropriately, and that people should take the drug only when they’re exposed to someone with influenza.
“Somewhere, somebody has said it’s okay to use prophylactically. My physician said, the problem is you’re only supposed to take it when you’re exposed to someone with the flu, but even then, someone says they’ve got the flu and what they’ve really got is a common cold.”
As a result, Hampton described himself as “stuck in this bureaucratic thing where I don’t have a choice. I’m supposed to take Tamiflu or I’m suspended.”
Jamie Ramage, chair of the ambulance group at OPSEU, said the flu shot issue has been a concern for paramedics for years. At the beginning of the decade, the issue was more heated when the province amended the Ambulance Act to require paramedics to take a number of vaccinations, including the flu shot. The three unions representing paramedics in the province, including OPSEU, the Canadian Union of Public Employees and the Service Employees International Union, lobbied the government and succeeded in having the flu shot removed.
But what remained in the act is “if you didn’t have a flu shot and you entered a facility that had a declared outbreak, then you would have to wear personal protection equipment — masks, gloves, gowns, that sort of thing,” said Ramage.
However, Ontario’s Ministry of Health and Long-term Care takes a different view. According to ministry spokesperson A.G. Klei, the province’s “communicable disease standards under the Ambulance Act do not allow paramedics to provide patient care when a local area has an outbreak, unless that individual has chosen to take antiviral medication.”
The paramedics’ concern with flu shots centres mainly around their ineffectiveness in preventing the flu, said Ramage.
“It’s proven to be beneficial to certain age groups: the elderly, the infirm, the sick and the young. It doesn’t prevent the flu. It just helps reduce the symptoms. And it’s of no benefit to healthy individuals,” said Ramage. “We understand the purpose of preventing the spread but there are other avenues. We can wear masks. We can wear gloves. Proper hand washing techniques, proper cleaning of equipment after each patient contact — all reduce the chance of transmission.”
Ramage said other health professionals aren’t required to have a flu shot and, even if they are, the fact it’s not mandatory for the general population casts doubt on its effectiveness. He added that the union isn’t opposed to other vaccinations such as those for Hepatitis A, Hepatitis B and polio, which are still required in the act.
But at the ministry of health, Klei said the protocol around providing patient care during an outbreak applies equally to the other health professions. At the Ontario Association of Non-Profit Homes and Services for Seniors, CEO Donna Rubin confirmed this protocol. She said staff at the long-term care facilities understand that those who haven’t taken a flu shot must take the anti-viral drug in an outbreak or they’ll be reassigned. If an entire facility is affected, they’ll have to stay home without pay, she added.
Doris Grinspun, executive director of the Registered Nurses’ Association of Ontario, said the paramedics’ concern around the flu shot demonstrates the need for a better awareness campaign around its effectiveness, including campaigns aimed at health workers.
“There is no question that the flu shot is the best, most effective strategy to prevent the spread of the flu. We fully support and encourage nurses to get a flu shot, but that’s different from saying we support making it mandatory,” said Grinspun. “As a whole, we have not done a stellar job in educating health-care professionals. If you were to mandate us, you would have health-care professionals getting the flu shot but saying to others, ‘I did it because I was obliged,’ rather than ‘I got it because it’s the single most effective protection.’”
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