By - aapsonline.org
(Association of American Physicians and Surgeons)
In a letter to Colorado public health
officials, the Association of American Physicians and Surgeons (AAPS)
opposes a rule requiring workers in health care facilities to have an
annual influenza vaccination or lose their jobs. Workers who had a rare
religious or medical exemption would be required to wear a mask in
patient care areas from November through March.
The religious exemption is too narrowly
drawn, AAPS writes, and should be a philosophical exemption, as accepted
in many states, to “to avoid inquisitions into matters of faith.” The
mask requirement “seems to be nothing more than a punitive retaliation
against those who decline the vaccine” and should be dropped, the AAPS
letter states, as both immunized and nonimmunized individuals can
transmit influenza or other illnesses.
The New Mexico study cited in support of
the policy shows a tiny effect: an adjusted odds ratio of only 0.97 for
confirmed influenza “outbreaks” (at least one case) in residents of
long-term care facilities where 60% of direct-care workers were
immunized compared with facilities with a 51% immunization rate. This
means that in facilities where more workers were immunized, residents
were still 97% as likely to get influenza. “Many other factors could
account for the small difference,” states AAPS executive director Jane
Orient, M.D.
In the age of “evidence-based medicine,”
AAPS notes that there is surprisingly little evidence supporting the
efficacy of influenza vaccine, and evidence of safety is also scant.
According to a 2006 article in the British Medical Journal by Tom
Jefferson http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1626345/,
the coordinator of the vaccines section of the Cochrane Collaboration,
safety data are reported in only five randomized studies with 2,963
observations. Many repeated doses of similar vaccines likely increase
the risk of allergic reactions, and no data exist on the safety of a
large number of doses, states Dr. Orient, citing a 2006 article in the
Journal of American Physicians and Surgeons. http://www.jpands.org/vol11no3/geier.pdf
Immunizations and pertinent information
should be made conveniently available to all workers in medical
facilities, states AAPS. But the judgment of medical professionals
should be respected; more than half choose to decline the annual shot.
The letter to Colorado officials is available. http://www.aapsonline.org
AAPS, a national organization of
physicians in all specialties, was founded in 1943 to preserve and
promote the practice of private medicine and the sanctity of the
patient-physician
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