Tuesday, October 3, 2023

Should Healthcare Workers Be Vaccinated

I Have Been Called In To A Healthcare Facility For An Emergency But I Am Not Fully Vaccinated Can I Enter The Facility

California to require state employees, health care workers be vaccinated

An unvaccinated healthcare worker may be permitted to enter a healthcare facility to respond to an emergency. They must use Personal Protective Equipment required by the PPE guideline and abide by the COVID-safe plan and practices of the healthcare facility.

Where you enter the healthcare setting for an emergency response, you must also notify your employer and the responsible person at the healthcare facility that you have done so and are unvaccinated.

% Of Physicians Vaccinated

The AMA, the American Hospital Association and the American Nurses Association have repeatedly called on health professionals to get their COVID-19 vaccination. So far, the reception among doctors has been robust: a recent AMA survey found that more than 96% of physicians reported receiving the vaccine.

Its good to see that the great majority of my colleagues are setting an important example and practicing what weve been preaching, said Dr. Kao.

Ethics policy adopted at the says that physicians have an ethical duty to get immunized against pandemic disease when a safe and effective vaccine becomes available, and if there are no medical contraindications.

Full Fda Approval A Game

The three vaccines now available in the U.S.those made by Pfizer-BioNTech, Moderna and Johnson & Johnsonhave been granted emergency use authorization by the FDA. These vaccines have demonstrated strong, real-world efficacy and safety data, said Dr. Kao.

Weve given COVID vaccines to nearly 70% of the U.S. adult population. Safety and efficacy are holding up well, even against the variants that have emerged, he said.

The FDA is expected to grant full approval to the Pfizer and Moderna vaccines in the coming weeks and months. Having this full approval should help to get some people who are currently on the fence get vaccinated, said Dr. Kao.

As individual facilities weigh their options, physicians and health systems should continue to get the message out that COVID-19 vaccines save lives, Dr. Kao advised.

Can you imagine where we would be in this country if we did not have safe and effective COVID-19 vaccines? he said.

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Providing Evidence Of Vaccination

You should provide evidence of meeting the vaccination requirements as soon as reasonably possible after each dose you receive of a COVID-19 vaccine to your employer, and any other nominated responsible person for keeping records of COVID-19 vaccination for workers at the healthcare facility.

There are 3 different types of proof available that you can get for free:

  • a COVID-19 digital certificate
  • your immunisation history statement
  • an International COVID-19 Vaccination Certificate for overseas travel.

The COVID-19 Digital Certificate or IHS can be viewed and/or printed through:

  • Medicare Online via MyGov

Workers in healthcare exempt from getting the COVID-19 vaccination are those:

  • with a medical contraindication
  • participating in a COVID-19 vaccine trial.

Youll need a medical certificate from a registered medical practitioner stating the medical contraindication, or confirming you are participating in a Phase 3 or Phase 4 clinical trial for the COVID-19 vaccine and have received at least one active dose. As soon as practical after your participation in the trial ends, you must notify the responsible person in your workplace. If your medical contraindication is temporary, your medical certificate will also need to state the time period it applies for, and youll need a new medical certificate if your contraindication continues beyond that date.

Students undertaking educational placement must be fully vaccinated and exceptions do not apply.

Return To Work Criteria For Hcp Who Were Exposed To Individuals With Confirmed Sars

Pfizer

Data are limited for the definition of close contact. For this guidance it is defined as: a) being within 6 feet of a person with confirmed SARS-CoV-2 infection or b) having unprotected direct contact with infectious secretions or excretions of the person with confirmed SARS-CoV-2 infection. Distances of more than 6 feet might also be of concern, particularly when exposures occur over long periods of time in indoor areas with poor ventilation. When close contact occurs, factors that can reduce risk for transmission include, but are not limited to: correct use of personal protective equipment by HCP, use of well-fitting source control by the individual with SARS-CoV-2 infection, whether the HCP and/or the individual with SARS-CoV-2 infection are up to date with all recommended COVID-19 vaccine doses. All these factors should be considered when evaluating an exposure.

The framework presented in the Table is considered the conventional and recommended return to work strategy for healthcare settings. Contingency and crisis strategies are described in the Strategies to Mitigate Healthcare Personnel Staffing Shortages

Recommended Work Restrictions for HCP Based on Vaccination Status and Type of Exposure

Exposure

Personal Protective Equipment used

Work Restriction for HCP who are are up to date with all recommended COVID-19 vaccine doses or who have recovered from SARS-CoV-2 infection in the prior 90 days

Exposure

Personal Protective Equipment used

Option 1:

Option 2:

Exposure

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These People Should Be Required To Get Vaccinated

Cases are surging. We need to maximize the number of inoculated frontline workers and students.

By Ezekiel J. Emanuel, Aaron Glickman and Amaya Diana

Dr. Emanuel is a professor of medical ethics and health policy at the University of Pennsylvania, where Mr. Glickman and Ms. Diana are researchers.

The next coronavirus surge seems to be underway. Maryland, Michigan, Minnesota and Wisconsin are among the states with rising cases, hospitalizations and intensive care occupancy, and hospitalization rates among younger people are increasing nationally. The causes of this pronounced rush of cases the spread of a more infectious B.1.1.7 variant and lockdown fatigue are not going away.

We need to sharply reduce coronavirus infections to turn the tide and quell the pandemic. The best hope is to maximize the number of people vaccinated, especially among those who interact with many others and are likely to transmit the virus.

How can we increase vaccinations? Mandates.

Vaccines should be required for health care workers and for all students who plan to attend in-person classes this fall including younger children once the vaccine is authorized for them by the Food and Drug Administration.

Mandates are the fastest way to get to herd immunity. Frontline workers should be at the start of the line.

Healthcare Workers Likely To Be First In Line For Coronavirus Vaccination

Within months, three massive trials in the U.S. could show whether a group of experimental coronavirus vaccines can prevent COVID-19. Even if all of them succeed, however, early supply of those shots will be limited, which is why it’s fallen on public health authorities to figure out who will get access first.

The latest to weigh in on the issue is a committee from the National Academies of Sciences, Engineering, and Medicine, which on Tuesday for the distribution of coronavirus vaccines.

Though several advisory groups and panels have made recommendations thus far, the committee’s opinion carries significant weight because it will support the work being done by the Advisory Committee on Immunization Practices, or ACIP, which works with the Centers for Disease Control and Prevention. ACIP is currently developing a priority list that the U.S. may follow once a vaccine becomes available.

According to guidelines the National Academies committee posted Tuesday, healthcare workers and first responders, particularly those who have direct contact with COVID-19 patients, appear likely to be first in line. Workers in critical occupations and people who have medical conditions that make them particularly vulnerable to COVID-19 are also at the top of the list, followed, in succession, by broader groups who are at lower risk of contracting the disease or having serious complications.

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Can I Continue To Work If I Am Not Fully Vaccinated By 16 December 2021

From 17 December 2021, you can only work in a healthcare setting if you are not fully vaccinated because of a medical contraindication or if you are participating in a COVID-19 vaccine trial, and you provide a medical certificate from your doctor. You must also comply with the following requirements:

  • use personal protective equipment consistent with the Personal Protective equipment guideline and COVID safe plans
  • produce a daily negative COVID-19 polymerase chain reaction test result before each work shift.

There are very limited medical contraindications that prevent someone from receiving a COVID-19 vaccine. Guidance published by the Australian Technical Advisory Group on Immunisation provides information about contraindications in relation to the use of a particular COVID-19 vaccine.

The timeframe for the vaccine trial medical certificate is temporary and must include an expiry date.

Why Wont Some Health Care Workers Get Vaccinated

California Vaccine Mandate: Some vaccinated healthcare workers protest vaccine mandate

Editors note:On August 23, 2021, the FDA granted full approval to the Pfizer/BioNTech COVID-19 vaccine for people ages 16 and older. Children ages 12 to 15 can continue to receive this vaccine under emergency use authorization as more data is collected.

Many Americans cannot wait to get the COVID-19 vaccine. They call hotline numbers. They search online for vaccine clinics. They wait for hours in line. Yet, others with ready access to the vaccine have declined it in large numbers. Staff in long-term care facilities were prioritized to receive the vaccine, but many are choosing not to get vaccinated. Why?

Nobody is more familiar with the impact of COVID-19 than staff at nursing homes and assisted living facilities that have been ground zero for the pandemic. Large numbers of residents and staff have contracted the virus. Nearly 40% of the COVID deaths in the US have occurred among residents of these facilities. Over 1,500 nursing home staff have also died from COVID, making nursing home caregiver the most dangerous job in America.

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Was I Setting The Bar Too High

Was I setting the bar too high for healthcare workers? I had assumed they would all rush to get their hands on these vaccines, especially given their disproportionately high infection rate in 2020.

The majority of healthcare workers in this country have done just that but there is a rump of resistance that concerns the Australian Medical Association, some hospital administrators and their bewildered colleagues.

Is it right to demand a higher level of social responsibility and compliance from one section of the community?

If reaction on my program is any guide, then yes. If the reaction from the other healthcare workers who called in, horrified, is any guide then hell yes.

Natalie was furious. She had texted me the day before asking why, with so many fellow registered nurses and registered midwives around her refusing to get vaccinated, she had to run the risk of working with unvaccinated colleagues?

“I have to work with potentially positive patients, but why should my colleagues also be a potential hazard to me?”

Good question.

Danny Hill and other union representatives are supportive of vaccination and publicly back the national program. But what draws me up short is not what’s said by these important industrial figures, but what’s not said. When I hear Danny Hill or ACTU leader Sally McManus speak about workers being required to be vaccinated — there’s something missing.

What Happens If I Test Positive

If your test result is positive, you should notify your employer, stay away from the workplace and self-isolate. You will receive a call from our public health unit advising you on what to do next.

If youre well enough to take care of yourself, you will need to stay in self-isolation until you recover. If your symptoms worsen, you may be admitted to hospital. Our public health unit will closely monitor your situation and wellbeing.

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Attempts At Promoting Voluntary Vaccine Compliance

Hospitals have tried numerous techniques to increase voluntary immunization among their patient-care staffs. Some hospitals use roving carts that bring vaccines to nursing stations, or vaccines might be brought to staff meetings. In some facilities, vaccine decliners must sign statements acknowledging the risk they are assuming for themselves and for their patients, or they might have to wear surgical masks during flu season. The goal of all these measures is to make vaccination as convenientand avoidance of vaccination as inconvenientas possible.

Unfortunately, while these efforts to achieve voluntary compliance tend to increase vaccine uptake somewhat, they still leave vaccination rates below 50%. The only approach that has generated near-total compliance is mandatory vaccination consisting of an ultimatum to health care workers that they either receive a vaccine or lose their job. Limited exceptions are permitted for individuals known to be at heightened risk for side effects, such as allergies to vaccines, and for those with clear religious objections.

Right To Refuse Vaccines

Health workers should be top priority for vaccines ...

According to an Ipsos poll conducted exclusively for Global News in April 2021, 69 per cent of Canadians said they were in favour of making the COVID-19 inoculations compulsory.

Mandatory vaccines is a controversial topic in Canada and there are some legal barriers to enforcing it.

Under the Section 7 of the Canadian Charter of Rights and Freedoms, Canadians have a right to refuse medical treatment and to make reasonable medical choices without the threat of criminal prosecution.

From an ethical standpoint, Kerry Bowman, a professor of bioethics and global health at University of Toronto, argued that the safety and well-being of patients takes precedence over the rights of healthcare workers.

But he added that more information was needed about the percentage of unvaccinated healthcare workers and their reasons before coming out with a blunt requirement.

Were really not in a position at this point to do mandatory because we havent fully defined the problem yet, Bowman said.

In an open letter to the provincial government dated July 20, Ontarios Registered Nurses Association also stressed the importance of mandatory vaccination for all health-care workers.

But Ontario Premier Doug Ford has previously said that his government is not considering making COVID-19 vaccinations mandatory for health-care workers, saying it is their constitutional right to decide whether or not they want to get the shot.

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Federal Judge Oks Hospital Mandate

Vaccine mandates arent new to health care facilities, but the health care sector has seen its share of legal challenges against these requirements, and the COVID-19 vaccine is no exception.

Dr. Kao mentioned a high-profile lawsuit in Texas, in which 100 hospital employees claimed wrongful termination for being put on leave without pay for refusing a hospital-supplied vaccination. A federal judge recently ruled in favor of the hospital, noting that if hospital’s employees didn’t want to receive a COVID-19 shot, they were free to work elsewhere, said Dr. Kao.

Meanwhile, at least six have enacted new laws limiting mandatory COVID-19 shots.

Fortunately, many of these states have not prohibited employers from requiring workers to get a vaccine but do carve out an exception for health care and public health workers, Dr. Kao noted. These new laws, however, only further contribute to politicizing a public health emergency that should not be a red versus blue or a left versus right issue.

Related Coverage

Why Health Care Workers Should Be Vaccinated

Why Healthcare workers should have all their vaccinations.

Because of their contact with patients or infective material from patients, many healthcare workers are at risk for exposure to and possible transmission of vaccine-preventable diseases. Maintenance of immunity is therefore an essential part of prevention for HCWs.

Healthcare Personnel Vaccination Recommendations

Hepatitis A, typhoid and polio vaccines are not routinely recommended for Healthcare Personnel who may have on the job exposure to fecal material.

As a Healthcare Professional, are you protected? For more information on immunizations visit www.immunize.org or www.vaccineinformation.org also visit the Centers for Disease Control and Prevention web site .

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Tell Us About Your Vaccination Experience

Ezekiel J. Emanuel is the vice provost of global initiatives and a professor of medical ethics and health policy at the University of Pennsylvania. Aaron Glickman and Amaya Diana are researchers in the department of medical ethics and health policy at the university.

The Times is committed to publishing a diversity of letters to the editor. Wed like to hear what you think about this or any of our articles. Here are some tips. And heres our email: .

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An Information Problem Or A Trust Problem

Should your doctor be vaccinated? Frontline workers face calls for mandatory inoculation

Many experts attribute low vaccination rates among staff to an information problem. Indeed, a recent survey of nursing home caregivers suggests many staff worry about vaccine safety and side effects. Yet, major information campaigns including well-crafted toolkits and fact sheets have not been sufficient. The problem isnt just a lack of information, but also who delivers this information. Direct caregivers in long-term care may lack information about the vaccine, but they also lack trust in facility leadership.

We have historically undervalued the work of caregivers in long-term care facilities. They perform a difficult job for pay at or near minimum wage, with few benefits like health insurance or paid sick leave. They often work at multiple facilities in order to earn a living wage. Many facilities are understaffed with high turnover. The vast majority of caregivers are women, and many are people of color and recent immigrants. They may be treated poorly while being asked to work long hours at low pay.

Since the start of the pandemic, this workforce has been further exploited. They have often had to work in facilities that were severely short-staffed, without adequate personal protective equipment or rapid COVID testing. Many staff did not receive hazard or hero pay despite working in the most dangerous of conditions. Not surprisingly, many staff do not trust management at the facilities where they work.

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