Some thoughts on mandatory influenza prophylaxis

This month marks a year since I got a demyelinating spinal cord disorder a week after getting the same flu shot I had received every year for at least 20 years. This one happened to be the one that liked me spinal cord better than the virus. It is very slowly improving but definitely still there.

Both of my lower legs are on fire 24 hours a day. Just like both legs immersed in a bath of hot water. Both hands are the same. It appears to be completely sensory in nature but now maybe not. My personal gym trainer noticed that all my muscle groups are consistently tight, then nagged me for months to have a massage therapist check it out. So I finally relented and had one bend my bones for an hour, She said every muscle group was tighter than a turkey’s ass, especially the muscles of my feet and lower legs and that was unusual. So there may be some long-term motor stuff as well.

Neurologist says it might go as long as two years but if it goes longer; I’m probably stuck with it. I’ve learned to live with it and it rarely interferes with my daily life.

I DO believe in immunizations, especially as it pertains to children. I fervently believe Jenny McCarthy, who made a career as a dumb blond really is one as it pertains to children’s immunization and she has all the credibility of Sarah Palin.

And that said, I hope the efficacy of flu immunizations are at least better than chance for adults. If so,then complications such as mine for a few are collateral damage that must be accepted to gain the benefit of many. But there are some problems as it pertains to mandatory injections for all health care workers.

First, I would like to see more convincing evidence that the flu shot actually works. People get the shot every year and are relived that they didn’t get the flu. I have elephant repellant in my back yard and I’ve never seen an elephant back there. Does that mean the repellant works? What if they do get the flu after accepting the shot? Is it the old Christian paradox, if you have good luck, its God’s working in your life. If you have bad luck, it’s still good, you just don’t understand the big picture of God’s will. If I am to accept the bad luck component for me, I’d like a little more evidence that the flu shot has a better than chance potential for mass benefit.

Second is the consent issue. I can assure you after going through this that there is NO informed consent involving potential complications of the flu shot. Anyone who asks is told that the occasional complication may occur but it’s minuscule compared to the benefit for all so don’t worry abut it. If asked specifically about the potential for Guillian-Barre, they are told this possibility is shown in the literature to be about the same as chance. BTW, this year I had a woman with Guillian-Barre that developed a week after her flu shot in my ICU. That’s two cases in this hospital this year.

So, everyone lining up for the shots are overwhelmed by good news and any potential for bad news buried. Fine. But we are a society that runs on informed consent, so much so that it frequently gets ridiculous. So should everyone in line be told that there have been two potentially serious complications of the flu shot this year in this hospital (that we know of).

But that implies they have the option to decline the shot, an option that is rapidly disappearing. The crushing wave of optimism for an injection containing various iterations of virus has now reached the point where the issue of informed consent is crushed with it. The prevailing opinion that darts thrown at a list of a thousand potential damaging viruses will hit the right ones has obliterated the issue of options.

In New York, a law is being considered, and will probably pass, that will create incentive for getting the flu shot by punitive measures. If anyone opts out, they must wear a “surgical mask” everywhere in the hospital. Now the wave of optimism for flu shots turns into a gun to the head.

This is straight up coercion with an empty gesture. There is NO evidence in any world literature that suggests ANY efficacy for surgical masks preventing spread of virus or anything else. When the ‘bird flu” came along a few years ago, I attended a mandatory lecture and fitting of a “real” effective mask we would be wearing. It was bulky, heavy and incredibly uncomfortable. The audience was told in no uncertain terms that surgical masks were worthless and no one would be wearing one.

So the mandatory wearing of a surgical mask to prevent spread of virus is not to prevent spread of virus. It’s to provide an incentive to avoid having to wear a mask everywhere. We’ve now entered theater of the bizarre.

I continue to be conflicted. On one end, I do believe in immunizations and I support them, even accepting the occasional complication. On the other end, I’m not so sure about FORCING health care workers to line up and get with the program in the face of weak evidence and known life threatening complications, however rare.

Patients, prospective or otherwise, are said to have a right to determine medical treatment on the basis of informed consent. Every other hospitalized patient can, and frequently does refuse treatment even when informed the benefit greatly exceeds the marginal risk. And they do so with total impunity. Are we now suspending that societal maxim for the flu shots because our optimism exceeds theirs?

So, I will be watching all this unfold from the sofa of fraternity rejects of “Animal House”.

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