Columns, Patient Care

EMS Has a Responsibility to Be Vaccinated Against Influenza

Issue 9 and Volume 41.

The Research

Moser A, Mabire C, Hugli O, et al. Vaccination against seasonal or pandemic influenza in emergency medical services. Prehosp Disaster Med. 2016;31(2):1–8.


The Science

This study comes from Switzerland, where the authors attempted to determine whether or not EMS providers were more likely to obtain an influenza vaccine in the context of a pandemic influenza (PI) outbreak as compared to the seasonal influenza (SI).

 

They used a survey of EMS providers in a single city with a population of 130,000. Sixty-six of the town’s 69 EMS providers responded. The survey was sent one year after the 2009 influenza pandemic, at which time the protocol instructed EMS providers to be vaccinated. Those refusing were required to wear a surgical mask during patient care for the duration of the influenza season.

Vaccination rates were 40% for both PI and SI, 19% for PI only, 1.6% for SI only, and 39% refusing vaccination against either PI and SI. Of those receiving both vaccines, 92% had been vaccinated in the previous three years; however, 30% indicated they wouldn’t get the vaccination in next season. During the pandemic, vaccination increased from 26% to 42% of providers.

Altruism (for the good of the community) and discomfort from wearing the surgical mask were the main motivations for getting vaccinated against pandemic influenza. However, the option of wearing the mask, avoidance of medications, fear of adverse effects, and concerns of the effectiveness of the vaccine were the primary reasons for not being vaccinated.

Doc Wesley Comments

This report joins many others confirming that EMS providers, along with the majority of healthcare workers, refuse to be vaccinated against influenza. Frankly, I’m not surprised. It reflects the pervasive and cavalier attitude toward the use of personal protective equipment down to the very simple act of hand washing. It’s ironic that the first words stated during every scenario testing is “Scene safe, BSI,” yet few understand what those words mean.

I don’t want to get into a political discussion of civil rights and personal autonomy. We’ve accepted the role of healthcare provider and with that comes the responsibility to follow the recommendations of experts. The Centers for Disease Control and Prevention (CDC) has identified through rigorous research that getting yearly influenza vaccinations is the single most important thing we can do to protect not only ourselves but the welfare of our patients.

Why should our patients, many of whom are immunocompromised, be subjected to the risk of dying from influenza, caught from our runny nose, simply because we thought we knew better than the CDC? Yes, there are some valid reasons for not getting vaccinated. But they’re few and the list is getting shorter every year.

I’m proud to say that at HealthEast Medical Transportation, 98% of my EMTs and medics elected to be vaccinated last year. Those who didn’t were required to wear a mask. It was 91% the previous year, but only 72% the year prior to that when the mask wasn’t required. In our hospital system, physicians are required to either be vaccinated or wear a mask during rounds. We decided that if that was the standard for physicians then it should be our standard as well.

Medic Wesley Comments

Since I totally agree that providers need to be vaccinated, for grins, I’ll play the devil’s advocate.

It’s easy to say that all EMS providers, other than those with allergies, should be vaccinated against influenza. Although you imply the CDC is all-knowing about disease, immunizations, etc., they’ve been wrong on a lot of things. What happened to the Ebola epidemic we were told to prepare for? Why should I be forced to have a foreign substance injected into my body, when there’s a risk that I could become disabled or die from it?

Isn’t it enough that we as providers go out and care for the sick and injured, often putting ourselves in harm’s way? Let’s face it: EMS is in no real danger of falling into the “wealthy” tax bracket on the wages we make. And now we’re told we have to also give up our right to refuse medical care?

Your point, Doc, is that we may put others at risk by not being vaccinated. We are put at risk every day of contracting something from our patients. That’s the chance we take. And if I’m sick with the flu, I’m not coming to work anyway. So the patients are safe.

OK, I felt totally ridiculous saying all of the above. So get vaccinated!