All-Staff Forum follow-up questions: Immunization: Fact vs Fiction

Dr Réka Gustafson was our key note speaker at the September 13 All-Staff Forum. She gave an interesting and informative presentation on the what and why of immunization, which led to further discussion with our panel who answered questions from “Which current vaccine do you think will completely change the face of disease in the future?” to “Why is it important that staff get a flu shot?” If you missed it but would still like to view this informative session, please click here to see the webcast.

We ran out of time to get to all of the questions; so, here are a few follow-up questions:

Question 1

My question is about diet.  What is the correlation between the communication a health provider gives a client about what a person eats and their health to getting a vaccination and believing they will be cured/saved/protected by a shot?  If an individual is eating an acidic based diet (i.e, McDonalds, pre-pared foods at home, junk food etc.) then band aiding their health with a vaccination can dramatically increase their chances for disease or illness verses a person whose diet is Alkaline based enriched with whole foods like raw fruits/veggies, natural proteins like nuts and legumes and providing their cells and building blocks of natural flora growth to protect their immunities from illness and disease. I don’t hear much communication about how important diet is to protecting your body from illness but rather “Get a vaccination so you don’t become ill”.  Our bodies are built to fight things off but it is pushed too much that vaccinations are the answer.

Answer: While good nutritional status can support overall wellbeing, the specific immune responses that help us fight specific pathogens are not stimulated by choosing certain foods over others. We also have evidence that Vitamin A deficiency leads to worse outcomes for children who get measles. But in general, we do not have evidence that good nutritional status will prevent infections that are preventable with vaccines.  We support healthy eating as essential for reducing rates of chronic disease AND we support immunizations that help prepare the adaptive immune system to respond rapidly and strongly when we are confronted with a pathogen that could do us and our patients harm.

Question 2

If one develops urticaria on day three after Fluviral vaccine (& urticaria lasted for four days), can that person still have flu vaccine this season?

Answer: Yes. Only anaphylaxis is a contraindication to any vaccination. Urticaria, three days after influenza vaccination are due to another co-incidental cause rather than vaccination. Allergy testing is only indicated when urticaria occur within two hours of vaccination; delayed urticaria that are associated with other allergy symptoms may require an allergy assessment. These reactions should be reported to public health for clinical assessment and recommendation regarding follow up care.

Question 3

I am just wondering about food sensitivities/allergies. We are usually asked about allergy to eggs when taking the flu vaccine. I have developed a strong sensitivity to eggs and other foods. Would it be safe for me to have the flu vaccine this year? I am aware sensitivity and allergies are two different things, but I have gotten slightly ill the last couple of years after being vaccinated for the flu.  I am debating about receiving the vaccine this year.

Answer: Egg sensitivity, even significant egg allergy, are not contraindications to the influenza vaccine.  You can safely receive the influenza vaccine this year.

Question 4

For Hep B, if you non reactive X 6 what does it mean and what needs to be done?

Answer: A small proportion of vaccine recipients (less than 5%) do not respond to the hep b vaccine; these individuals are called ‘non-responders’. You or your patients are likely non-responders to the Hepatitis B vaccine.  If there is an exposure to Hepatitis B, it will be important to seek immediate post-exposure prophylaxis with Hepatitis B immune globulin.

Question 5

Why would you like very healthy individuals, such as myself, to get an injection that is repeatedly said to be less than 50% effective at preventing the flu?  Why not only give the vaccine to sick and immune deficient people.  Why punish healthy folks for being healthy?

Answer: This question is rooted in some misperceptions on the severity of the flu. If someone told us that we could get a vaccine that would reduce our risk of cancer by 50%, most people would think that was worth getting.  Influenza is a major source of morbidity and mortality, and a 50% reduction in any infection and a greater reduction in serious complications of infection is a good outcome.  Also, as health care workers, a 50% reduction in the likelihood that we transmit an infection to our patients that can cause significant morbidity and disability is very much worthwhile. As a bonus, this vaccine keeps us well and the efficacy in preventing illness in healthy adults – such as health care workers – is much higher.

Question 6

A nurse friend stated that the majority of nurses they work with in their department indicate they have received the flu vaccine on the self-reporting tool when they do not get the yearly vaccine.  If this is one department in the hospital is this common throughout VCH?  I do not get the vaccine because I am healthy….but I do indicate so on the tool….what repercussions will I incur?

Answer: Health care workers are professionals, with a code of conduct that includes being truthful.  We rely on health care workers professionalism in this regard, and trust that most health care workers behave accordingly. Thank you for reporting honestly. The health care worker policy has two choices: vaccine or mask. If you choose to not be immunized, you are required to wear the surgical mask in patient care areas. If management is aware of staff who falsely report vaccination status, VCH can investigate further including asking staff to produce a record of their vaccination. Staff who intentionally report false information (i.e., claiming they were vaccinated when they were not) will be subject to discipline consequences and would not be eligible to work until they receive the vaccine or wear a mask in patient care areas.

A copy of the policy: Influenza Prevention Policy.


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