Pregnant nurse: I was fired for refusing flu vaccine

[The Straight Story]

A pregnant nurse tells CNN she was fired from her job after she refused to get a flu shot for fear of miscarrying.

"I'm a healthy person. I take care of my body. For me, the potential risk was not worth it," Dreonna Breton told CNN Sunday. "I'm not gonna be the one percent of people that has a problem."

Breton, 29, worked as a nurse at Horizons Healthcare Services in Lancaster, Pennsylvania, when she was told that all employees were required to get a flu shot. The Centers of Disease Control and Prevention advises that all health care professionals get vaccinated annually.

She told her employers that she would not get the vaccine after she explained that there were very limited studies of the effects on pregnant women.

Breton came to the decision with her family after three miscarriages.

http://www.cnn.com/2013/12/29/health/pregnant-nurse-flu-vaccine-refusal/index.html?hpt=hp_t2

[FarPoint]

1. At the very worst....a suspension

from active employment during the flu season would seem acceptable. I do support the right for someone to choose what medication they will take during a pregnancy.

[loli phabay]

2. problem is flu season runs a long time, not sure where i stand on this

i am all for personal choice in all matters but this may cross the line of being a danger to others in her care.

[FarPoint]

6. I understand the management of cross-infection.

That is why a job suspension would be a fair negotiation. It's the termination that really bothers me....I am too old school I guess...valued employees are a day of the past.

[Locut0s]

8. This. She may have been a fantastic nurse for all we know..

Except for this poor decision she may have been an amazing nurse.

[FarPoint]

17. Her decision was based upon fear.

I heard on the news that she has a history of having 2 miscarriages. Valid or not, her fear is real.

[Lost_Count]

10. How does that work?

Nurse A gets suspended and Nurse B,C and D have to cover down on her work

or

Nurse A gets suspended and Nurse E gets hired but then canned when A comes back.

[FarPoint]

16. Most facilities already have "as needed" staffing.

These nurses choose to work as needed....typically for extra cash. It's not rocket science to have an employer practice staff retention.

[Gormy Cuss]

66. A requirement that the nurse use proper infection control is how it's handled in some places.

Wearing a mask and gloves when handling patients, changing gloves and scrubbing more frequently are the protocols used in a facility where a friend of mine is a nurse.

[darkangel218]

3. Hmm.. thats a lil too drastic.

Last edited Mon Dec 30, 2013, 08:16 AM - Edit history (1)

There are plenty of healthcare workers who refuse the flu vaccine and all they have to do is wear a surgical mask when coming in contact/proximity with a patient .

Gah...

[AngryOldDem]

4. I think some kind of exception should be made in extenuating circumstances.

But that is the policy at a lot of hospitals: get the shot or get fired.

I totally understand her reluctance not to take any chance of jeopardizing her pregnancy, and if you can prove that the risks of the shot outweigh the benefits in your particular case, then that should be considered by your employer.

[Spider Jerusalem]

5. Good

The CDC also advises that pregnant women get the seasonal flu vaccine. I don't have a problem with mandatory vaccination for healthcare workers during flu season.

[Locut0s]

7. Too harsh but she's making a bad choice too...

In this day and age losing your job means a lot. This was too harsh, especially over a personal decision like this.

Having said that getting the flu while pregnant could be very dangerous for both mother and child, certainly likely much more dangerous than the vaccine for which there doesn't appear to be much evidence of harm.

Then there is the fact that as a practising nurse you run the risk of infecting others in your care for whom getting the flu could be deadly. It's not always 100% clear you have the flu from the point you start to become infectious.

[idwiyo]

9. She is a nurse. Vaccination is done to protect her patients, not just her.

Drastic but necessary response.

[Hassin Bin Sober]

11. Good.

[B Calm]

12. I say good too!

[Hekate]

13. Certainly she's entitled to do what she wants with herself,but she's NOT entitled to expose patients

... with weakened immune systems (and in some cases no immune system at all) to a deadly disease. She has no way of predicting whether or not she's going to catch the flu from someone coughing in her face in the grocery store, on the bus, or in the hospital itself. She's a health care worker and must put protection of her patients above a lot of other considerations.

While I have a great deal of sympathy for her three miscarriages, they don't speak well of her own health situation. She might have been better off had she made the decision to stop working for the duration -- that is, by applying for a medical leave of absence until she and her doctor were sure this pregnancy would endure, rather than getting stuck in a no-win battle over an important part of her job.

Yes, it is a terrible financial strain to quit work, and it takes an emotional toll too. But I know at least one woman who had to literally go on bed rest for half of each of her pregnancies because of medical complications. There are no easy decisions in these situations.

[Android3.14]

14. Appropriate

She is a menace to herself, her baby and her patients.

[demwing]

100. OMG the OUTRAGE!

Menace to herself and her baby?

Lighten the fuck up...

[intaglio]

15. Fired too much, suspended - yes

If you are a nurse you go with the full suite of vaccinations because you are working amongst vulnerable people many of whom have compromised immune systems.

[SidDithers]

18. Good...

Health care professionals shouldn't become carriers for diseases that could be potentially fatal to their patients.

Maybe she should go work for a naturopath.

Sid

[LeftyMom]

19. Aside from the risk of exposing her patients, it calls into question her competence.

I suspect the latter has more to do with her firing. Of course we'll never know because the hospital isn't allowed to say.

[FarPoint]

20. That is a bit of a stretch....

but not unheard of these days.

[LeftyMom]

22. She thinks a flu shot might cause her to miscarry.

That's... scarily uninformed. Having a history of miscarriage myself I understand her reluctance to do ANYTHING out of the ordinary, but there's no reason to believe that a flu shot is a miscarriage risk at all. Fevers do pose a slight risk to pregnancy, so if anything what she needs to avoid is the flu.

ACOG recommends the flu shot to pregnant women for this reason. I also suspect she'd have been in the clear if she'd had an excuse note from a doctor (as people with egg allergies would get, for example) and the fact that she apparently didn't should clear up the validity of her fears regarding miscarriage from the flu vaccine.

My suspicion is that her attempt to get out of the shot involved a bunch of internet sourced nutjobbery, and that had as much to do with her firing as the shot itself.

[kcr]

37. That was my thought, too. n/t

[Vashta Nerada]

75. That was my first thought as well.

[snooper2]

21. Per CDC she made the list twice, must be a lazy news day CNN eh?

Who should get vaccinated this season?

People who are at high risk of developing serious complications (like pneumonia) if they get sick with the flu.
People who have certain medical conditions including asthma, diabetes, and chronic lung disease.
Pregnant women.
People younger than 5 years (and especially those younger than 2), and people 65 years and older.
A complete list is available at People Who Are at High Risk of Developing Flu-Related Complications.
People who live with or care for others who are at high risk of developing serious complications (see list above).
Household contacts and caregivers of people with certain medical conditions including asthma, diabetes, and chronic lung disease.
Household contacts and caregivers of infants less than 6 months old.
Health care personnel.

[MineralMan]

23. Justified firing. As a nurse, if she catches the flu,

she will be infectious even before she knows she is sick. As a nurse, she comes in close contact with sick people, who are especially vulnerable to the flu, which can be fatal for someone already ill enough to be in a place that has nursing care.

She has an absolute right not to take the flu vaccination, but she has no particular right to endanger the patients she works with. The vaccination rule for healthcare workers is sensible and protects very vulnerable people. Her right not to be vaccinated does not outweigh her patients' right not to be endangered.

Decisions have consequences. After her child is born, she can be vaccinated and return to working as a nurse. As someone with 89 year old parents and an 85 year old mother-in-law, I'm very aware of the risks they face when they are hospitalized. They need no unnecessary risks added to that.

[gerogie2]

24. I agree with firing

She signed an employment contract to get vaccines to protect patients. She broke her contract so she should be fired. She can find a job with an employer that doesn't require a vaccination against disease.

[arikara]

70. Where did you hear that?

The article didn't say anything about her contract.

[Ms. Toad]

25. Some nice knee-jerkery going on in this thread.

Here are some facts:

• The hospital she works at allows nurses who do not vaccinate for religious reasons the option of wearing masks during flu season. She offered to do the same, and was rejected because her reason was medical rather than religious.
  
  
• Her obstetrician and primary care doctor supported her decision, based on their assessment of her specific medical circumstances.
  
  
• She is correct about the state of research about the impact of vaccination on miscarriage. It is insufficient - and there are peer reviewed studies which support both sides (and studies which acknowledge design problems with existing studies which bias some of the existing studies against even being able to answer the question).
  
  
  "There was some evidence of an increased HR for preterm delivery following pH1N1-influenza vaccine exposure; however the decrease in gestational age on average was approximately three days." http://www.ncbi.nlm.nih.gov/pubmed/24016809
  
  "Vaccination was associated with an increased adverse composite outcome in pregnant women without identified co-morbidity but not those with co-morbidities." (The co-morbidities included prior preterm births.) http://www.ncbi.nlm.nih.gov/pubmed/23406444
  
  "The unadjusted fetal-loss report rates for the three consecutive influenza seasons beginning 2008/2009 were 6.8 (95% CI: 0.1-13.1), 77.8 (95% CI: 66.3-89.4), and 12.6 (95% CI: 7.2-18.0) cases per million pregnant women vaccinated, respectively. The observed reporting bias was too low to explain the magnitude increase in fetal-demise reporting rates in the VAERS database relative to the reported annual trends. Thus, a synergistic fetal toxicity likely resulted from the administration of both the pandemic (A-H1N1) and seasonal influenza vaccines during the 2009/2010 season." http://www.ncbi.nlm.nih.gov/pubmed/23023030
  
  And - because of how the studies have been conducted and when miscarriages occur, they are likely to be biased against being able to reveal a link because both the vaccination and the risk period during the pregnancy must be captured in the study window, and many women are recruited after one or both - which needs to be taken into account in the design of future studies. http://www.ncbi.nlm.nih.gov/pubmed/22674821
  
  


Note: I am not claiming that the above studies are all that is out there. There are also studies which suggest there is no increase in risk. My point is that many in this thread (as is unfortunately typical in any discussion on vaccination both on DU and in real life) jumped to the immediate conclusion that her decision was based on "internet nutjobbery," or that she was "scarily uninformed." "a menace to herself, her baby," or incompetent.

These conversations would be a lot more productive if people would take the time to read the underlying article (which - in this case provided the first two facts above - including that the hospital does not automatically fire nurses merely for refusing a vaccination, and that two medical doctors who know her personally and are well versed in her particular health history support her decision) and would do a little research to see if there are valid concerns out there (or - as in this case - not enough research to address the narrow concerns raised - in this case whether the influenza vaccine increases the risk of miscarriage in the population of women with a history of miscarriage).

[redqueen]

29. Agreed.

This part makes me think there was something else going on:

The hospital she works at allows nurses who do not vaccinate for religious reasons the option of wearing masks during flu season. She offered to do the same, and was rejected because her reason was medical rather than religious.

[cinnabonbon]

123. I was thinking the hospital was right in firing her (because it would protect patients)

until I read the part where it says they allow nurses not to vaccinate on religious grounds. WTF. Firing her serves no purpose at all.

[stevenleser]

31. Good research. That changes things entirely.

I hope she can retire from the litigation.

[Ms. Toad]

93. Thanks. n/t

[kcr]

36. I still say the hospital was right to fire her.

Her claim wasn't valid. She wasn't claiming a religious reason. She was claiming a medical reason, and it wasn't valid. She still refused. So they fired her for not getting the shot.

[Ms. Toad]

41. So you know more than her obstetrician? and her primary care doctor?

Who know her medical history, who are actively treating her, and who support the medical decision not to vaccinate as appropriate for her ?

Did you read the peer-reviewed research information at the links I posted (which indicate that - on this particular question the jury is still out (the impact of vaccination on pregnancy in women who have previously miscarried))?

Do you really think that a person who is unvaccinated for medical reasons is more of a health threat than one who is unvaccinated for religious reasons? If not, then please provide the health based justification for (1) a blanket policy which overrides the individual medical decision of treating physicians (2) refusing to allow her to use the same mechanisms for preventing disease transmission that the hospital has already deemed are medically adequate for people who assert they have a religious objection to the vaccination (I say "assert," because I have been in discussions with a number of people who - at least in the context of admission to school - feel free to say they have religious objections when their objections are based in generalized and irrational fear of all vaccines)?

[kcr]

42. I don't have to know more than they do

Hospitals have the right to fire people for not following policy. Your links do not show that flu vaccines harm pregnant women. They certainly do not show that they're a greater risk than flu itself.

[Ms. Toad]

48. You're setting up straw men and batting them down.

Have fun arguing with yourself.

I'll be glad to have a conversation with you about the points I actually made, or about any response you might have to the question I asked about why the procedures put into place to protect the hospital's patients from being infected by a nurse who refuses to be vaccinated for religious reasons are not sufficient to protect those same patients from infection by a nurse who declines vaccination for medical reasons.

But I have no interest in battling over points I didn't make in the first place.

[kcr]

50. I don't think you know what a strawman is

Because I'm doing no such thing. I'm stating that they don't have to grant her the same exemptions they do for those on religious grounds. They have good reason for doing so. They don't have to allow every single employee to throw on a mask simply because they don't wanna get a vaccination, they're scared. They have good reason to limit the number of employees they allow to do so. They don't want half their staff running around with masks on. Her exemption is not religious.

[Ms. Toad]

59. Did I say they had to grant her the same exemptions?

No. That's why it is a strawman. Responding to an argument I didn't make (they have to grant her an exemption) as if it was an argument I did make is creating and batting down a strawman.

I was addressing (1) the general responses (including yours) which rejected out of hand the possibility of real medical risks on the assumption that her concerns are just "internet nutjobbery" - without reading the article to learn that her doctors support her decision and without bothering to check and see if there might be some evidence to support her concerns and (2) whether a medical waiver should be treated any differently than a religious waiver.

And your further response is a little closer, but still a strawman.

This is a single woman, with a history of multiple miscarriages, whose treating physicians have made the medical decision that it is inappropriate for her to be vaccinated - who is also citing the lack of research about the safety of vaccinations in a very small group of employees (some of which I pointed you to, which indicates that (1) there may well be a risk as two studies found and (2) because of defects in how many studies are populated they miss the population which includes this nurse.

That population (taking all similarly situated employees) is not "half their staff." That population is not "every single employee." That population is not someone who generically "don't wanna get a vaccination, (because) they're scared)" - it is a limited population which has heightened risk for miscarriage anyway and whose decision is supported by the doctors caring for them.

Beyond that (just in terms of evidence and logic), you haven't cited any medical reason why they should want to limit the number of employees wearing masks - you just made a conclusory statement that "they have good reason to." If the institution has determined that a mask is medically sufficient to prevent disease transmission for one person, it does not inherently become insufficient merely because there are 10, or 100 wearing masks - that implicit contradiction (a sufficiently effective individual disease transmission method when used by 1 becomes ineffective when used by many) needs to be supported by evidence and reasoning. I'm not saying it couldn't be done - but you didn't even bother to try.

But even giving you that point - that it would be unreasonable for the hospital to grant unlimited exemptions - nothing I said even hinted that I thought that they should make the vaccination policy optional for all employees (i.e. not limit the number of employees). When you respond as if that was the argument I made, you are battling strawmen of your own creation.

The specific group of employees I was discussing are those who (1) are pregnant, (2) have a history of multiple prior miscarriages, and (3) decline immunization for medical reasons during a specific pregnancy under the care of their obstetrician (and in this case GP), in the face of inconclusive research about the risks of vaccination in view of a history of prior miscarriages (including some studies which have found an increased risk). That is a very limited group of employees - likely far fewer than those currently claiming religious exemption.

Personally, I think it would be reasonable to expand the exemption to any pregnant employee whose doctor recommends she not receive the vaccine until there is more conclusive research. (But even that larger expansion is not the argument I made.)

[kcr]

61. Well, forgive me for misunderstanding then

because I don't understand then how it's relevant that they allow employees with religious exemptions to wear masks. And you did bring that up. I assumed the reason for that is that you thought they should allow her to have that exemption as well.

What medical reason do I need to cite for having the exemption you are now saying you weren't claiming she should have? I'm really getting confused now, but okay. The flu is bad. The patients shouldn't catch it. I'm sure it's pretty easy to find sources on the internet.

Yes, she's pregnant and scared she'll have a miscarriage but her fears aren't based in reality. The flu would be far worse for her than the flu vaccine.

[Ms. Toad]

64. Her doctors disagree with you

that her fears aren't based in reality. They are treating her. They know her unique history. They may have information about what led to her previous miscarriages that you don't have (there are many different reasons for repeated miscarriages). Some of those may raise more concerns about the risk of vaccination than others. Whatever the concern is, her doctors are in the best position to evaluate her health and the current research and to decide whether the risks to her are greater to have the influenza vaccine v. influenza. Certainly they are in a better position than you, I, or her employer.

As for your disease transmission argument - this is just analysis of your argument, and an explanation of why I challenged it - you can't just jump from 1 person wearing a mask is perfectly fine - to letting everyone wear masks is bad. The logical extension of "1 is perfectly fine" is that "everyone" is also perfectly fine - unless you explain why there is a difference between 1 (or a handful) and everyone. The reality of disease transmission is obviously a lot more complex - and there probably are valid reasons to limit the number of people allowed to opt out and wear masks - but you didn't make that argument.

So - accepting your position that there needs to be a limit (for the sake of argument) - where should we draw the line?

Don't we get cranky when when employers try to inject themselves into the medical decisions made by their female employees (for example, abortions, working while pregnant, or access to birth control)? It isn't precisely the same issue - but it is very similar since this woman isn't just someone who doesn't feel like getting vaccinated because she heard on the internets that it causes autism. This woman is acting on the advice of (or at least with the support of) her obstetrician.

From my perspective, if the employer has decided that wearing a mask is an acceptable alternative for any group of employees who has opted out of vaccinations (in this case for religious reasons), it should offer the same option to this woman (and the small group of others similarly situated) - so she doesn't have to choose between following her doctor's medical advice and her job.

[kcr]

65. The bottom line is her employer doesn't agree with her doctor

And the fact is the flu is more dangerous than the vaccine. I'm sorry, but I just don't agree. I think it's more than reasonable for health care employers to mandate the flu shot for their employees and limit the types of exemptions they allow.

[Ms. Toad]

67. Her employers are not privy to her specific medical condition.

Neither are you. Her doctors are.

You have no idea whether the flu is more dangerous to her than the vaccine. All of the research on vaccination risks is general. On average, the risk of influenza is greater than the risk of the vaccination. There are individuals, however, for whom vaccination is riskier. The only person qualified to make that assessment is the physician who is caring for that individual and knows her medical history - and employers should not force their employees to choose between following medical advice and their jobs.

And - you're also back to strawmen - arguing as if I said employers should not be able to limit vaccine exemptions at all. Suggesting that employers should permit exemptions to allow individuals to follow the medical advice of their doctors (in addition to the current religious based exemptions) is not even close to suggesting that employers should not be able to place any limits on exemptions.

[kcr]

68. No, we aren't

But if her doctors don't provide proof that the vaccine is more dangerous to her than the vaccine, then too bad. The article states they support her decision. It doesn't state the claimed the vaccine was dangerous for her. Yeah, we don't know that she's isn't some special rare case. But she hasn't provided any evidence that she is. Her employer has the right to implement this policy.

[Ms. Toad]

84. You know - it is really none of your business

or her employers (think HIPAA) why her doctors made the recommendation they did. She has documentation from the obstetrician treating her that that she should be excused from the vaccination for medical reasons. That should be sufficient - it is intrusive into a relationship progressives normally work hard to protect (the doctor patient relationship) to suggest that not only should the doctor have to make a medical determination with his patient about what is in her best interest, but should also be required to prove to the employer that the decision was a valid one.

[kcr]

85. Where does it say her doctor excused her?

It said they supported her decision. That's not the same thing. I'm sure most doctors support their patient's personal decision on whether or not to get a flu shot. I'm sorry, but that isn't sufficient. So, HIPPA laws should effectively mean people have the right to spread flu germs to patients? I don't think so. I think a doctor's note should actually state a valid medical reason. If she wants to keep that medical reason private? Get the flu shot.

[Ms. Toad]

89. You're demanding way too much detail from a short news article.

And you're adding new conditions which really aren't relevant to the discussion - since her employer's position is that medical waivers aren't permitted (it doesn't say that medical waivers aren't permitted unless she provides a "valid medical reason" or "proof that the vaccine is more dangerous to her than the vaccine" - it says they rejected her request for a medical waiver which was supported by letters from two doctors who are treating her ("The mother of one submitted letters from her obstetrician and primary care doctor supporting her decision.&quot

The medical reasoning beyond the letters they chose to send to her employer is none of my business, your business, or her employers. If a mask protects against spreading flu germs by employees who are granted religious waivers, it will also protect against spreading flu germs by employees whose doctors believe they should not be vaccinated.

[kcr]

92. No, not really.

I'm not adding new conditions. I'm stating what the article says. I was countering your 'none of our business' argument. It's not adding new conditions to state that any old note from a doctor, regardless of what it states, doesn't have to be automatically be accepted by employers. Gee, wouldn't that be a neat thing? Imagine what you could do with that? No, I don't accept that she should be able to flaunt a policy that protects both herself and her patients, and spread flu germs when there's no basis for it.

[Ms. Toad]

94. You are not her doctor.

You actually don't have a clue whether the policy protects her - or instead puts her at risk. Her doctor does.

[kcr]

97. No, but I can certainly read the article

She states she's afraid the vaccine will cause a miscarriage. The vaccine doesn't cause miscarriages. Nowhere in the article does does she state she has any condition that precludes her from getting the vaccine. Nothing is even hinted at. That's a clue.

[Ms. Toad]

102. Do a little research, please.

Even if all you do is read the links I posted in the first post you responded to.

There are medical studies which show a link between influenza vaccine and miscarriages - particularly in women with a history of miscarriage. I provided links to two of those. There are also flaws in some of the studies which meant the patient pool was biased in such a way that it would have missed the relevant population. So your assertion that the vaccine does not cause miscarriages is not supported by the evidence. That research is still actively going on, and we won't know the answer for some time.

There are also theoretical reasons which explain why repeated miscarriages may be linked to vaccinations. Vaccines contain adjuvants - agents which are designed to alter the body's immune response to the virus or bacteria being immunized against. The are added because (generally) the quantity of viral or bacterial material in a single immunization is not sufficient to provoke an immune response that will create immunity. Adjuvants have been linked to the expression of autoimmune disorders (an increasingly prevalent group of disorders which are generally thought to be expressed as a result of a genetic predisposition and an environmental trigger - like an adjuvant). (Just one article - there are plenty more articles out there from reputable sources.) Some autoimmune disorders cause repeated miscarriages - so that is one possible explanation for the statistical link some studies have found between vaccines and miscarriage in women with a history of miscarriage.

I don't know what her doctor's thinking is. I don't know the cause of her repeated miscarriages. It's really none of my business - or her employer's. That is between her and her doctor.

What I do know is that the concern she expressed is in an area of current and ongoing research, and even though the research is not complete at this point there are already both statistical and theoretical reasons to support her concerns. That is enough for me to say that if her doctor believes she shouldn't have the vaccination, her employer shouldn't require her to choose between following her doctor's advice and her job.

[kcr]

108. Sorry

But doing a little research will only conclude that flu vaccines aren't harmful to pregnant women. I saw your links. I'm sticking to all the links from the reputable sources that say that it is safe. Like the Mayo Clinic. The CDC. Flu.gov. When this subject is researched, the evidence overwhelmingly points to safe. More than safe. Getting the flu while pregnant on the other hand is risky for a pregnancy.

You're entitled to think it's none of your business. Her employer thinks otherwise and I'm on their side, because the flu in health care settings is nothing to take lightly.

[OwnedByCats]

71. I agree with you. If her doctors want her to skip the vaccination,

I don't care what medically is going on. Her doctor says no, it should be granted as an exemption for medical reasons, period. If someone can bow out for religious reasons, than a woman's doctor who wants her to be exempt should be granted a medical exception without fear of losing one's job.


I don't understand where the confusion is, do you?

[kcr]

77. "I don't care what medically is going on."

Her employer does. They have a good reason for this policy. Being able to talk her doctor into supporting her decision just because she's scared doesn't cut it IMO, and it didn't for her employer either.

[OwnedByCats]

113. I don't know that she talked her doctor into anything

I feel however that if you can refuse for religious reasons, you should be able to refuse for medical reasons if you have a doctor or doctors saying that employee should not have it. Whether it's an allergy to the vac, or a high risk pregnancy - she has doctors backing her up. Now in an ideal world she should get some kind of medical leave (with pay) if this presents a problem, if her wearing a mask is not good enough, if she can't be given work where she's not dealing with patients who have a high risk for complications of the flu. Although I would hope that any patients they do care for that are high risk would have had vacs themselves because they could pick up the flu from anywhere, not just from this nurse. My father has a nurse visit him a couple times a week to change his bandages, she actually told us she doesn't get the vac, but I'm not too worried as my father got his flu shot.

I just don't agree with firing her. Medical leave, or changing her job description until flu season is over would have been more preferable.

[kcr]

114. Generally, I don't disagree with that.

I just don't think she had a valid doctor's note backing her up. If she did, a note outright stating a vaccine would harm her, I doubt she would have been fired. Flu vaccines are highly recommended for pregnant women. Unless she had an outright quack for a doctor, I have a hard time believing her doctor backed up her claim she shouldn't have one. I note the wording in the story, which said it backed up her decision. Not the same thing. If her employer wanted to place her on leave, I wouldn't have a problem with that. There may be more to the story behind her firing.

[OwnedByCats]

117. You're right

There are things we may not know about the story, some of this is conjecture. I know generally speaking a pregnant woman can have the vac, but not being a doctor myself, I can't discount her doctor may have had a good reason, or that he could be a complete quack or just went along to shut her up. I think this is hard. On one hand I don't think one should be forced to have anything injected into their body, especially when one is pregnant ... on the other hand, it's a risk to the patients and herself and baby not to have it, if in fact the vac would not harm the unborn baby.

I think with anything, there is always a risk for some people. The risks are sometimes very rare, but can occur. Not everybody can tolerate all drugs etc,. What works well for one, does not for another.

[Ms. Toad]

81. Unfortunately - yes.

People have made this debate into a black and white one, and most people who see shades of grey have learned not to open their mouths.

I regularly get called both an anti-science whack job AND a shill for big pharma because I believe that there are some gray areas we haven't yet figured out - and that there are individuals for whom vaccination is more harmful than the risk associated with the combined likelihood of exposure to the disease + consequences of the disease if acquired. The area in this discussion (pregnant women with a history of miscarriage) is one of those areas. Individuals with autoimmune disorders is another (the dominant emerging theory for autoimmune disorders is that expression of an autoimmune disorder is a combination of genetic predisposition + environmental trigger. Adjuvants - included in most vaccines for the purpose of altering the immune response could be the environmental trigger (there are some studies linking adjuvants to the manifestation of autoimmune disorders - http://www.ncbi.nlm.nih.gov/pubmed/24238833 ). (This add on is pure speculation - but some people who chronically miscarry do so because of certain autoimmune disorders - so that is a potential explanation for a connection between history of miscarriage an vaccinations.)

But - particularly the side which likes to paint any suggestion that vaccinations can be risky for certain individuals as "woo" can't tolerate any gray in the discussion. So I get jumped on anytime I suggest any minor exception to the mandatory regimented vaccination - which I almost always link to peer reviewed research - with (1) the kneejerk response that any challenge to vaccines is based on "internet nutjobbery" or anti-science (you see that in this thread) and (2) - as happened in this subthread - dire predictions about how dangerous it would be to make all vaccinations voluntary (often including calling me a baby murderer) when I my suggestion was to make small changes to the universally mandatory nature of the current regimen.

This thread is actually a pleasant exception to the rule, and gives me a little hope. And, for the most part, when I pointed out the facts in the article and provided some research, people actually responded thoughtfully.

[Jester Messiah]

52. You know something, I've been disagreeing with you lately...

But you're dead-on right in this.

[uppityperson]

44. She works with a company that does in-home nutritional and infusion therapy, NOT a hospital

They go into people's homes and help them there, NOT a hospital. http://www.horizonhealthcareservices.com/

The business offers employees who don't want to get the flu shot the ability to wear a mask and there is no way they would say "sorry, not for religious reasons you are fired". I do not trust that part of this report at all and won't until I read confirmation from another source.

[kcr]

45. I don't see what the difference is.

I don't care if I'm receiving care at home or in the hospital, i wouldn't want a nurse who refused a shot giving me care. Why wouldn't they say "sorry, not for religious reasons?" If her request isn't a valid reason, they should fire her. Personally, I don't think religious grounds should be a valid reason either.

[uppityperson]

46. I agree, just clearing up that it isn't a hospital. nt

[kcr]

47. okay

I'm glad you cleared it up. I think it's even more important in this case. People who need this sort of care really don't need to be catching the flu.

[Ms. Toad]

49. I was citing the article when I identified where she worked as a hospital

"Breton offered to wear a face mask at work, a practice that is used if employees are exempted for religious reasons. The hospital did not approve, according to Breton."

And if you click through the link you provided to "career opportunities" you are linked to the Lancaster General Health (a hospital) website - so I don't know that her work setting is entirely clear. She did say (or at least the paper reported) that she worked in a hospital.

[uppityperson]

53. It could be they are linked with a hospital, I looked them up directly.

[Ms. Toad]

60. I just clicked on their career options

Last edited Mon Dec 30, 2013, 11:36 PM - Edit history (1)

to see if they provided services exclusively in the home setting, and was sent directly to the hospital page.

[uppityperson]

62. Our local conglomerate healthcare business started with hospital, then they added support

services like home health, then they absorbed different clinics. When I apply to the clinic, it sends me to the hospital to apply, and since I am on their shit list for some reason, alas, more clinics are out of my ability to work at.

So it may be true that the hospital is the hiring place, the business place, etc, but the whateveritwas is in home stuff.

[lunasun]

54. +1 & - I agree with you

Including that the hospital does not automatically fire nurses merely for refusing a vaccination, and that two medical doctors who know her personally and are well versed in her particular health history support her decision

I think they didnt want her startin something...precedent wise
..and individual belief is not the same as an established religious exemption so she could go.

[Ms. Toad]

90. Thanks.

I don't know what their reasoning was - but it troubles me when employers decide they have the right to second guess doctors with a direct relationship to the patient.

What I do know is that on DU, allowing for the possibility that there may be people for whom certain vaccines are more harmful than the risks associated with disease exposure is instant qualification for the "woo" tar and feather brush. So most people who believe there should be some exceptions to a mandatory vaccination regimen, for a variety of well founded reasons (including, as here, their doctor's advice) have just opted out of the conversations.

[Hekate]

82. Thank you for the input, Ms. Toad

It adds some needed depth to the discussion.

[Ms. Toad]

91. You're welcome. n/t

[mainer]

26. She shouldn't be working as a nurse if she's pregnant and unvaccinated

She's going to be working with flu patients. She's going to be exposed, and stands a chance of losing her baby BECAUSE she refused to be vaccinated. Maybe her employer didn't want to be held liable for the loss of her baby.

[HERVEPA]

27. Fired is totally correct

Exposing patients to this is not acceptable.
Mask is not foolproof. Anyone refusing the shot should be fired. Should be no exception for religion.
You don't take the job if you're willing to put vulnerable patients at extra risk.

[ananda]

28. So why didn't she say it was for religious reasons, I wonder.

Then all she would have to do is wear a mask.

[ScreamingMeemie]

79. Because she was raised to be honest, perhaps?

[Savannahmann]

30. I do not get the flu shot, and have not for nearly twenty years.

Whenever I would get it, I would get sick within a day, and stay sick for at least three. I never got sick off of other vaccinations, and no, I am not opposed to vaccination. I am opposed to coming up with a one size fits all policy that everyone must accept. For some reason, the flu shot hits me in a way the other don't, and I can't explain it, and the Medical personnel were casual about it. "Well, that happens sometimes."

So if I get the shot, I am nearly 100% certain to get sick. If I don't get the shot, I will probably, but not definitely, get sick. If I get the shot, there is no guarantee that I won't end up with the flu anyway. If I don't get the shot, there is no guarantee that I will get the flu.

So I stopped taking the shot. It was a personal choice that was considered and no, it wasn't a single episode. For the first few years, I wrote it off as coincidence. The last time I took the shot, I started a stopwatch. Twenty hours later I was bowing to the porcelain god. My fever was 101, and I felt like I'd been run over by a truck. That was the eighth time in a row for that response, now when the shot comes to work, I just pass the line and head on out to the jobsite.

[Phentex]

33. I read somewhere recently that the shot does cause a reaction in some.

I know many places denied that before but with it happening to so many people, it can't be just a coincidence.

We are a split household. My husband got the flu shot last year for the first time simply because the doctor recommended it. My husband never gets sick so I didn't really understand why he got the shot. One of my sons gets a flu shot because he works with young kids throughout the year and I think he's had the flu a couple of times in the past few years.

I don't get a flu shot and my other son doesn't either. He's 18 so I leave it up to him. He's never sick and I am rarely sick. I have no real objection to it. I'm just lazy.

[jeff47]

34. And that's fine when it's only you involved

But a nurse is going to be treating a lot of people who have other medical problems. If these folks catch the flu, it will be far more dangerous than the population at large.

[Savannahmann]

35. And the reactions to the shot could get worse

Allergic responses, if in fact that was what I experienced, tend to get more severe. People affected with bee sting allergies for example. The first response is usually bad, but gives the people enough time to seek medical treatment. The next episode usually takes less time, and then less time still for subsequent responses.

Are you comfortable declaring that anyone who has an allergy to such inoculations be prohibited from ever working in the medical field? Because I'm not sure, but I think that may well be a violation of the Americans with Disabilities Act. Certainly the court case would argue that it is such a violation.

But lets for the sake of argument say that my response is not an allergic reaction. Are you suggesting that I must endure three days of violent illness every year, at least three days, if I worked in the medical field?

[jeff47]

38. You're taking what I said far too far.

Allergic responses are a reason to not get the shot, regardless of profession.

"Someone on the Internet says it's dangerous to pregnant women" is not.

[Savannahmann]

39. The woman in question had three miscarriages

That means she is almost certain to have a difficult and complicated pregnancy. There aren't a lot of studies about the effects. If her Doctor advised her not to get the shot, that should be the end of it. But it isn't. The fact that she was fired, for following the doctors advise, the doctor who is hoping to see her safely and successfully through this pregnancy, is outrageous.

IMO, her Doctor sending a letter should have been the end of it.

[jeff47]

40. The doctor would have to back that up with something.

Saying "Don't get the shot if you have the option to skip it" is a possible risk reduction. With nothing to back up that advice, it doesn't outweigh the obvious benefit to the patients she will be exposed to.

Though the flu is much more likely to cause a miscarriage, making it pretty shitty advice. Especially when the woman's job is going to expose her to the flu.

[demigoddess]

63. some people don't get the flu

until I was 16 I thought it was a fake disease. Never had it, siblings never had it, and my children never had it. and I am in my 60s and my kids in 30s and 40s. I always thought it was kitchen hygiene but not terrible fanatical about germs. Example, I never use those hand sanitizers.

[Hekate]

98. Report to the research lab: science wants a look at your family's DNA!

I hope by now you have discovered that influenza is a serious disease for the rest of us. But I do applaud your good health.

When I was younger I used to only get it about every 5 years. It's not that way now that I'm in my 60s, have asthma, and live with a husband who is on an immuno-suppressant medication. We don't mess around pretending it won't hurt us.

[demigoddess]

118. mid sixties now and still haven't had it

do not know why. But if I came down with it, I wouldn't run around in public spreading it.

[libodem]

32. I think part of it has to do

With institutions not wanting to pay for sick days. You get treated like a sherker if you are out for a week. Even if its viral you have to send $80.00 for a Dr.'s excuse to stay home, saying you were really sick. Half the time the vaccine doesn't actually cover what is out there. And some stoic folks will work sick or not, because the have the strong work ethic.

I was always guilted into it by our staff doctor. I did respect him. And I cared about not infecting fragile patients. I never liked it. I haven't gotten one since. I'd rather have a few cases of flu and build up my immunity.

Pretty sure I have a mild respiratory virus right now. Staying home, drinking plenty of fluids, little cough syrup, ibuprofen, you know the drill. Thank the Goddess, I can stay home!!!

[uppityperson]

43. There must be more to this story. Period. No kneejerking until all the info is out.

First off, Horizons Healthcare Services is an in-home care business.
http://www.horizonhealthcareservices.com/

Horizon Healthcare Services offers patients and their families the special coordinated care they need in the comfort and security of the home environment.

They work with brittle people, people with health issues that could very easily catch a virus and die.
http://www.horizonhealthcareservices.com/infusion.htm

Secondly, they allow people to wear face masks rather than get the flu shot.

Yes, this story says she wasn't allowed to do that, even though they offer it and I do not trust this story as they would not not allow her to if it is their policy to allow it.

No, I do not trust this story and will not kneejerk react until it is confirmed. I recommend this to others also as first reports are often inaccurate.

[bonzaga]

51. When did it become OK for a corporation to force someone to inject something into their bodies?

This is a human rights issue. This is not some pharmacist refusing to sell a pill on religious grounds. This is a woman who should not have to fear losing her livelihood because her employer, who has all the power in this case, mind you, is forcing her to inject something into her own body.

Not only should she be reinstated, but she ought to sue and win punitive damages as well. Nobody, especially not employers, has any right to force anybody to put something into their bloodstream, period.

[uppityperson]

56. Most places let you wear a mask instead and limit your involvement with brittle or acute patients

This story says they offer that but not to her, which is really odd and I do not believe.

[darkangel218]

78. +1

In our hospital anyone who will not or can not receive a flu shot ( some people are alergic to it ) has to wear a mask when 6 feet and less from a patient.

[SoCalDem]

58. when corporations sign your paycheck and write the rules

This corporation probably decided they did not want lawsuits when some family member sued them for infecting their aged relative with the flu. The corporation protects itself by insuring that their workers are NOT likely to infect anyone with anything that a vaccination can prevent.

[SoCalDem]

55. If you work at a healthcare facility where flu shots are required, you have to accept

the consequences if you refuse to comply. It sucks, but it is what it is.

Having had three miscarriages, she might have been better off to ask for medical leave and remove herself from nursing for a while.

I always worry about nurses & doctors being exposed to all kinds of things, & I expect that all facilities have requirements in place to protect them.

[nadinbrzezinski]

57. Of course she does know the cdc recommends pregnant women

Get vaccinated too.

[hunter]

69. This is fucked up.

We need a gentle economic system.

One that could let her take leave when she is pregnant or nursing her baby and then invite her back when she's ready to work again.

I get flu shots because I don't want to be the 145 pound 6'4" skeleton-man in a hospital bed ever again. Nobody wants to see me at my worst. I'm pretty gross and disgusting in a hospital bed and I get mean and unreasonable too. Not so bad as my grandma, but that's not saying much. She'd rip out her IV's, bite people, and run out into the hospital parking lot naked. One of my brothers threw a hospital mattress out the window during the worst phase of his cancer treatments. Yet he lives today. They cured him, removing a few parts, poisoning him with toxic chemicals that made his hair fall out and his ass bleed. It was a wild ride.

As an occasional health care worker I get the flu shots because I don't want to pass any flu on to anyone else, not if I can help it, especially someone in worse shape than I happen to be in. (My hyperactive asthmatic lungs can be serious assholes when infected.)

There ought to be some accommodations made for pregnant women with concerns, "realistic" concerns or not.

One of my silly kids is home from college this Christmas break, in the other room, with the flu. Did not get the shot, not free, not even a thirty dollar grocery store pharmacy shot I would have gladly paid for.

It's not random shit, just semi-random shit. But our society ought to accommodate much more random shit than it does.

A pregnant woman with a history of miscarriages who doesn't want to get a flu shot ought to be be a person our society can deal with without much fuss, without any harsh judgments.

[Humanist_Activist]

72. That's unrealistic, she's a health care worker, and should be expected...

to do the bare minimum that her employer requires to maintain patient health and safety. If she can't do that much, based on, apparently, medical ignorance, then she's in the wrong profession.

[hunter]

73. Welcome to Capitalist paradise!

Land of the disposable worker, where "Productivity" is god.

[Humanist_Activist]

74. Actually no, even if she was working for a NHS or other type of public system here...

I'd still support a policy of mandatory vaccinations barring real medical reasons, and penalties up to termination for refusing.

[hunter]

88. Are you sure you are a "Humanist?"

The perspective "penalties up to termination for refusing" sounds authoritarian, not humanist.

Her fears are still her fears, even if they seem unreasonable to others.

Firing her from her job seems extreme because our society's "social safety nets" are poor, and a woman who is pregnant may have great difficulty finding another job.

In a humane society losing a job would never have catastrophic consequences, but we do not live in a humane society.

The anti-vaccination crowd is dangerous, but so is the economic system that forces people to go to work when they are spewing viruses. The "work ethic" that demands perfect attendance in school or work is a much greater danger to patients than a frightened woman who has suffered two miscarriages.

[Humanist_Activist]

95. I'm more concerned about an immuno-compromised patient of hers getting influenza and...

dying due to complications of it versus her hurt feelings.

She could have said yes to the vaccine, we cannot, as a society, coddle every unreasonable fear people may have, if she actually has a pathological phobia, then it should be treated, otherwise she should have gotten the damned shot.

[NoOneMan]

76. Unless she is a religious wing-nut

Why the double standard?

[Humanist_Activist]

87. Because religion has a privileged place in society, I don't agree with it, I just acknowledge it...

and frankly, if I were the employer, that double standard would not exist.

[Ms. Toad]

86. Your assumption that it is based on medical ignorance is misplaced.

She is correct that there is not enough evidence currently about vaccinations for pregnant women who have had repeated miscarriages. There is currently research going on on this issue, and the results are mixed - and some of the studies, at least, were flawed in how they obtained a patient base in a way which would have biased them against obtaining accurate information in this particular population. I linked to some of the research above.

The obstetrician treating her has provided documentation supporting a medical waiver for her.

Her employer has already determined that some waivers are permitted, and that for those individuals wearing masks provides sufficient protection for the patient population. If waivers are permitted for any reason, employees seeking a waiver for medical reasons should not be forced to choose between following their doctor's advice and their job.

[Humanist_Activist]

96. So basically its inconclusive and her doctor is trying for the "better safe than sorry" approach...

OK, fine, then she should have been suspended, without pay, until influenza is no longer a threat.

ON EDIT: Just to be clear, the idea that the flu vaccine is in any way a risk to pregnant women is what I'm saying is inconclusive, or better yet, unproven, and there's quite a bit of evidence against the idea. For fuck's sake, women are recommended to get the vaccine when pregnant.

[Ms. Toad]

106. Just because there is a general recommendation for women to be vaccinated

Does not mean it is safe for this specific woman, with her medical history. There is statistical data supporting her concern, and at least one theory I can articulate which would explain the statistical data - based on my research into autoimmmune disorders and vaccination.

Whether it is safe for that particular woman is a decision for her doctor to make - and apparently both her obstetrician and her primary care doctor have decided it is not. Since the hospital has already decided masks are an appropriate disease prevention mechanism for people with a religious exemption to vaccinations, that same precaution should be sufficient for individuals whose doctors have decided that vaccination is not appropriate.

[kcr]

115. Most statistical data, taken as a whole, do not support her concern

It is not apparent that her obstetrician and primary care physician decided it wasn't. Why would her employer allow exemptions for religious reasons but not medical ones? That doesn't make sense. That's why I think it's more likely they didn't, and that's why her claim for exemption was rejected.

[Ms. Toad]

116. So you don't like the story as reported, so you just change it.

They must not allow for religious exemptions - because it isn't reasonable for them to allow religious but not medical ones. Frankly that's the point I've been making - but I'm not rejecting the facts reported in the story to get the outcome I want.

And - in large part one of the main points I have been making is that general statistics are not a good fit for everyone. When doctors evaluate a situation in light of the particular details of an individual's health, and determine that the statistical model isn't a good fit, they recommend a different path. That is how doctors work, and it is presumptuous of you to assume her doctors didn't do that merely because you disagree with the conclusion they reached.

[kcr]

119. What did I change about the story?

I'm not rejecting a single thing from the story. I agree with you. I don't think it would be reasonable for them to allow religious medical exemptions but not medical ones. That's exactly why I think she's not presenting a valid medical exemption.

[Ms. Toad]

120. The story, as reported, is that they do allow religious exemptions.

And that they don't allow medical ones. Nothing in the story suggested the problem was that her medical excuse wasn't good enough. As the story is written, the problem is solely that it is a medical exemption rather than a religious one.

[kcr]

122. Where does it say they do not allow medical exemptions.

Edit it doesn't. And here's another article that states they do. It also states exactly what I suspected. That her own doctor said the shots were safe:
http://www.usatoday.com/story/news/nation/2013/12/30/newser-pregnant-nurse-flu-shot/4248615/

Her employer rightfully saw no medical reason to exempt her and put her patients in danger.

[kcr]

99. When even the Huffington Post says it's safe

http://www.huffingtonpost.com/2013/01/16/flu-vaccine-safe-in-pregnancy_n_2490683.html

That has to be some kind of reassuring. But seriously. It's not true there is not enough evidence. There is plenty of evidence it is safe.

[Ms. Toad]

104. Seriously?

I'm linking you to peer reviewed articles in medical journals and you are countering with Huffington Post articles?

Safe, on average - even for the average pregnant woman - does not mean safe for everyone.

There is current research which supports her concern - which is not that it is generally unsafe, or even that is is generally unsafe for pregnant women - but that for at least some women with a history of miscarriages it may increase the risk of miscarriage.

[kcr]

110. Right, because that's the only source. Geeze.

I'm sorry you didn't get the joke. Not everyone gets my humor.

Anyway, if she can prove to her employer it isn't safe for her, no problem. But "I'm afraid" isn't good enough.

[Ms. Toad]

111. I doubt that's what the communication from her doctor said.

And the black/white insistence that "I'm afraid" isn't good enough - without any understanding that there are populations which are more vulnerable than others to the risks associated with immunizations - has the potential to put people I care about at greater risk. It isn't a joking matter to me.

The decision about whether to exempt people from otherwise applicable vaccination requirements should reside with the treating physician, who has the ability based on research and personal health history, to determine whether a patient's concern has a basis in reality. You have neither the medical background, nor access to her personal history to make that call. And neither does her employer.

[kcr]

112. Why is the flu a joking matter?

It's not black and white. Patient safety is at stake, and I'm not choosing to ignore the dangers of the flu. Nor am I placing too much importance on single conflicting studies while ignoring the fact that they've been accepted as safe.

As to your second paragraph, I don't agree in the case of medical providers particular in this instance. If the employer isn't satisfied then I think they can decide not to grant the exemption. They do not have to disregard the safety of the patients or the other employees.

[jeff47]

101. Catching the flu is far more likely to cause a miscarriage than the shot

And her profession means she will be exposed to a lot of people with the flu.

If she was a bookkeeper locked away from most public contact, she might try risking a flu season. She's not. No vaccination means she will catch the flu.

employees seeking a waiver for medical reasons

Except she isn't. She's seeking a waiver for medical guesses. Given that the flu shot is routinely prescribed for pregnant women, you'd think we'd see a significant increase in miscarriages after the shot if it was a problem. Making it a poor medical guess.

[Ms. Toad]

103. I suspect from your response that you responded

without bothering reading the links to studies which have shown a statistical link between the influenza vaccine and miscarriage in women with a history of miscarriage.

It is an area of current research, in which the answer is not yet clear - but there is both statistical data and theoretical explanations which support her concern. Her doctors (who provided letters to her employer) are treating her, and likely have a lot better idea than you do about whether she is in a population which should avoid the influenza vaccine.

So yes, she is seeking a waiver for medical reasons - reasons you simply don't have enough information to evaluate, because you apparently haven't read the research and you don't know her personal medical history. Her doctors do.

[jeff47]

105. Except their advice, and yours, utterly ignores the danger caused by the flu itself.

Again, the flu induces miscarriages at a much higher rate than proposed danger from the flu vaccine.

Again, if she were employed in a non-healthcare setting isolated from the public, she could avoid the flu this year. But she's not. She's in a healthcare setting, and works with the public. No vaccine means she is extremely likely to get the flu. And that is far more likely to cause a miscarriage.

without bothering reading the links to studies which have shown a statistical link between the influenza vaccine and miscarriage in women with a history of miscarriage.

Except there's other studies showing no link (you kinda skipped those). If the vaccine were so likely to cause a miscarriage, there would not be conflicting studies. So there's either a slight link or no link.

Deciding to avoid air travel because a plane crash will be fatal is fine. Deciding to drive in a car instead is not. Because you are far more likely to die in a car crash (common) than in a plane crash (extremely rare).

This is a similar situation. She's avoiding the unlikely, but flashy, danger in order to waltz right up to the much larger danger.

[Ms. Toad]

107. You're making assumptions you don't have the information to support

about the risks posed by her medical condition(s). For her, given her particular medical condition(s) - the risk of miscarriage because of the vaccination may well be greater than the risk of miscarriage because of the flu. That is why her doctors (rather than you, or her employer) are in the best position to decide what is riskier for her - the vaccine or influenza.

As to the links - I was countering the accusations in the thread at the time I posted it that her fears were based on "internet nutjobbery," etc. by providing links to current studies in peer reviewed medical journals which demonstrate they are realistic concerns with scientific support. I explicitly said there were studies which showed no increased risk - and that (overall) the studies at this point were inconclusive. It is kind of slimy to pretend I didn't.

As to the risk to others, the hospital already allows exemptions and has decided wearing masks is appropriate protection for the public. That same mask will protect the public from this woman (or others whose doctors determine should not be vaccinated). As long as they are making exceptions for anyone, they ought to make an exception for those whose doctors advise against vaccination.

[jeff47]

109. No, I'm not.

you don't have the information to support about the risks posed by her medical condition(s). For her, given her particular medical condition(s) - the risk of miscarriage because of the vaccination may well be greater than the risk of miscarriage because of the flu.

If that were true, we wouldn't have conflicting studies. If there was a significant increase in risk we'd see it in all studies. Since we have conflicting studies, it's either a minor risk or a non-existent risk.

That is why her doctors (rather than you, or her employer) are in the best position to decide what is riskier for her - the vaccine or influenza.

I can easily pressure a doctor into agreeing to do whatever I find on the Internet as long as it's not obviously massively dangerous. Just because one doctor said "well, you don't have to get it" doesn't make it automatically right.

I explicitly said there were studies which showed no increased risk - and that (overall) the studies at this point were inconclusive.

Which is why I brought it up again down here, where you appear to be saying the risk is established.

As to the risk to others

I'm not talking about the risk to others. I'm talking about the risk to her and her baby.

The high fever of the flu causes miscarriages. If the mother works with the public, she's likely to catch the flu, and thus have a high fever. If the mother works in a healthcare setting with the public, she's very likely to catch the flu and thus have a high fever. And she works in a healthcare setting with the public.

Again, I am saying we have an unproven, but must be small, risk from the vaccine. We have a very large risk from the disease itself. Avoiding the small, unproven risk that is flashy in favor of the large, proven risk is really dumb.

That assessment is utterly independent of her employer's decisions on the subject.

[backscatter712]

80. I would have fired her too.

She chose to put her patients at unnecessary risk.

[pnwmom]

121. This poor woman has had 3 miscarriages, and she's desperate

to keep this baby.

I would have offered some compassion.

[Nikia]

83. If her doctor writes her an excuse that should be the end of it

It isn't up to her employer to question it, just like it isn't up to an employer to say "Lifting heavy weights doesn't cause miscarriage or preterm delivery, now go lift that 80 lb bag of salt, despite the fact that you have a doctor's note for a 10 lb weight restriction". Actually I have heard such conversations about people (but not to people) and the employer realizes that they have to consider the doctor's note valid regardless of what they think personally.