I’ve sort of decided to have the H1N1 jab mainly because I suffer with Asthma, and chronic fatigue which effects my immunity. I actually more concerned about catching swine flu rather then passing it on to others as I believe the result could be quite serious
On a bit of a tangent I’m the swine flu lead for our team so get to go to lots of tedious meetings about this – the DOH and trusts are not seeing this as a clinical threat (lots of dead bodies) but a threat to service with High numbers of staff off sick and the failure of service
Yup BSP that's the biggest reason behind immunising NHS workers against it, not because some guy on here selected a few articles of the net and thinks we not are allowed freedom.
sorry my handwashing argument was a bit lame.....
frontline NHS staff should have the vaccine because it should help reduce the spread of the disease to at risk groups, this should be reason enough.
Your job is to help make people better not infect them further.
Then of course there is the argument that the NHS is screwed enough without you getting ill because you didnt have the vaccine.
Finally, it makes sense on such a basic statistical level.... you'd be stupid not to.
Not really no, a carrier of a virus suffers no symptoms but can very easily spread a virus. Making your whole argument worthless.
why do I know more about this than a NHS professional?
whilst a non symptomatic carrier of a Virus can spread the disease without symptoms, the handwashing all you guys do after repeatedly should take care of this?
If a frontline NHS staff member becomes symptomatic then goes into work coughing and sneezing everywhere the chance of infection increases exponentially.
So yes, front line NHS Swine flu vaccination should be mandatory (ideally at gunpoint) as unfortunately common sense and basic intelligence arent.
[i]why do I know more about this than a NHS professional?[/i]
You don't really though, you think you do by trying to manipulate other peoples postings.
[i]So yes, front line NHS Swine flu vaccination should be mandatory (ideally at gunpoint) as unfortunately common sense and basic intelligence arent. [/i]
And thus with this line any further postings you make will be ignored as clearly your a bit special.
Not really no, a carrier of a virus suffers no symptoms but can very easily spread a virus. Making your whole argument worthless.
Drac, I'm not sure what your qualifications are but:
1. Define what you mean by carrier? If you have been immunised with a live virus, then yes you may still shed virus particles for a period while your immune system is building up immunity. This is a moot point as I believe the UK vaccines are attenuated.
2. If you mean you can still 'carry' the virus on your skin or clothing then you should already be following the proper precautions to prevent this sort of thing like washing your hands?
My point was that H1N1 is a respiratory virus easily spread by coughing and sneezing, if you aren't coughing and sneezing and are taking care when physically contacting patients, then you aren't going to be spreading it are you?
Again, I've already linked to published articles proving that vaccination of healthcare workers prevents deaths due to flu. I've still to see any evidence for not taking the vaccine other than reasons like TJ mentioned.
1) A carrier is a person who carries he virus but shows no symptoms. They are immune yes but doesn't stop them carrying the virus.
2) See 1.
[i]My point was that H1N1 is a respiratory virus easily spread by coughing and sneezing, if you aren't coughing and sneezing and are taking care when physically contacting patients, then you aren't going to be spreading it are you?[/i]
Yes it's spread a lot easier by that but can still be spread with out them. People can cough and sneeze anyway without having a cold or flu.
Drac is a highly skilled top of the range paramedic IIRC - as he don't want to say his qualifications - with a clear understand of research and the morals of this sort of issue.
Forcing NHS professionals to have an immunisation that carries its own risks is simply not on.
Immunising the staff will not have a huge effect on the spread of the disease.
[i]Drac is a highly skilled top of the range paramedic IIRC[/i]
lol as qualified as can be.
[i]as he don't want to say his qualifications - with a clear understand of research and the morals of this sort of issue.[/i]
Spread of viruses was very limited subject that I don't think is even covered any more. I still have morals though and the minute it becomes compulsory for me to take some sort of vaccine to do my job then it'll be time to look at my career options.
1) A carrier is a person who carries he virus but shows no symptoms. They are immune yes but doesn't stop them carrying the virus.
Spread of viruses was very limited subject that I don't think is even covered any more
I'm presuming that you've covered at least basic immunology then?
I believe the R(0) of [url= http://science.samxxzy.ns02.info/cgi/content/abstract/324/5934/1557 ]H1N1 is low enough[/url] that if enough people in a group were to be vaccinated then the theoretical presence of Immune Carriers would be irrelevant, but then I'm not an immunologist either. However, I do believe that there are a few working for the WHO, CDC etc. who seem to be recommending that health care workers are immunised.
Forcing NHS professionals to have an immunisation that carries its own risks is simply not on.
TJ - I've presented my side of the argument, backed up by published peer reviewed journal articles, I'm hoping you can complete your side of the argument by pointing me toward published evidence of these risks you have mentioned?
drac - you have offered me advice regarding my missus in the past and i am sorry if i have caused offence, this thread struck a real chord with me.
to give you an example though:
My wife was having her infusion of antibodies this week, and the nurse sorting out her canular had a streaming nose, chesty cough and was flushed.
FFS, how basic a failing is this?
not being funny mate but i have made it my business to find out as much as i possibly can regarding swine flu, as it is clearly the biggest threat to my missus and the NHS in the coming months.
If frontline NHS staff do not know the reasons why a vaccination process is vital to reduce impact on the NHS, to save lives etc etc, then frankly something needs to change.
sorry again if my tone was a bit off in my posts, but this is a really important issue for my imediate family.
Don't know anout your regulatory bodies but as a doc i was researching this for a job interview yesterday
http://www.gmc-uk.org/guidance/good_medical_practice/health.asp
It seems us docs don't have a choice!! Thanks GMC!!
Nursing culture (for the most part) is that you carry on working to almost the point of death – yes you would think we know better – however the fact remains that Nurses are the worst when it come to their own health (and by implication their patients) most units I’ve worked on colleges from nursing and ither profession are derided for going of sick at the drop of hat
I don’t see a mere virus putting many off
[i]drac - you have offered me advice regarding my missus in the past and i am sorry if i have caused offence, this thread struck a real chord with me.[/i]
Accepted and hope my advice was good.
I understand the personal side it but that's how it is for us. Any medical professional with common sense would not come to work if they showed signs of flu, the same as goes for the Rotavirus.
[i]If frontline NHS staff do not know the reasons why a vaccination process is vital to reduce impact on the NHS, to save lives etc etc, then frankly something needs to change.[/i]
We do, I'm prepared to have the vaccine but only because I don't want flu again, it's not impossible I'm immune as been introduced to on about 4 occasions now. There's the risk that I then passed it on later in the day but I took all precautions I possibly could to reduce the chances.
[i], I'm hoping you can complete your side of the argument by pointing me toward published evidence of these risks you have mentioned? [/i]
The BMJ provides evidence for this too.
Dr nick that sucks, as of yet the HPC haven't implemented this.
Any medical professional with common sense would not come to work if they showed signs of flu
but are you not infectious for a couple of days before you start getting symptoms?
And are the initial symptoms not just a fairly mild cold? In fact that's all some people suffer.
So will you not be coming in as soon as you sense that you may develop a sniffle ?
I wish I could have mine sooner than later! As a diabetic with asthma as well and having had a history of bad bronchial and other chest infections I am geniunely concerned that I am well in the at risk group. The normal flu jab for the past two years has made me feel rough for 24 hrs a couple of days after but nowhere as ill as the rest of the family were say last year when they caught full blown flu and were in bed for days.
On the other issue discussed within the thread I feel that there is a moral and ethical obligation for all NHS workers (and essential services personel) to protect not just themselves but others who may be cpompromised in the meantime till they recieve their jabs. In certain occupations we are subject to some rules that whilst they may irritate and annoy by restrictions that they cause us but the rules are there for a reason. Why should one person be judge and jury to a large number of immune suppressed/other high risk group individuals?
The BMJ provides evidence for this too.
Such as?
I'm just 'a guy who has selected a few articles on the net' and you are just a paramedic who has confessed to having limited knowledge of immunology. Nobody is saying that they want to take away your right to a choice, but I've provided loads of evidence as to why frontline medical staff should be taking it - evidence that fits with potentially saving the lives of others and hence the reason for being involved in the medical profession. Can anyone else see the irony?
I've still to see a reasoned argument as to why you wouldn't take the vaccine? At the end of the day I'm not out to force people to take it, I just want all those who opt out to tell me why and justify it, 60 posts in and I'm still waiting for one.
[i]So will you not be coming in as soon as you sense that you may develop a sniffle ? [/i]
There's more to that then diagnosing it so no.
[i]but are you not infectious for a couple of days before you start getting symptoms?[/i]
Yup.
[i]At the end of the day I'm not out to force people to take it, I just want all those who opt out to tell me why and justify it, 60 posts in and I'm still waiting for one.[/i]
Your waiting for one to please you.
[i]Such as?[/i]
Take a look lazy bones.
All vaccinations have risk attached to them - flu ones more than many.
When giving flu vaccinations you need adrenaline injections to hand due to the very rare incidence of anaphalactic shock afterwards.
many folk get a reaction to the vaccinations - I am one. this is common knowledge - want detailed studies and so on you can google for them. this is common knowledge and established fact
Your waiting for one to please you.
Lol, thats rich coming from somebody so high up on their moral high horse.
Take a look lazy bones.
Believe it or not, when constructing an argument I look for sources to counter my point of view, I've done a search of BMJ articles, haven't found one mentioning panic about the current H1N1 vaccine, but I'm willing to be proven wrong unlike you who is a adopting a hands in your ears 'La la la I can't hear you approach'.
You quite clearly have never had somebody publicly challenge your medical opinion because of your current job role and its obvious you don't have an academic background either as I've yet to see any reasoned argument.
Its a shame really, because there are a probably a lot of people who read this forum who respect you and admire you and will ultimately be swayed by your viewpoint because of partial relevance of your job.
Again I'll state that I don't want anybody to feel forced to be vaccinated against their will, but when it comes to potentially risking the health of others because you've not made an informed opinion, thats on your conscience not mine.
Feel free to prove me wrong.
There's more to that then diagnosing it so no.
doesn't the diagnostic test take 2 days, which is why they gave up try to use it before prescribing Tamiflu?
but are you not infectious for a couple of days before you start getting symptoms?Yup.
So even if you did immediately figure out you have swine flu the moment your symptoms appear and don't come to work from then, you've still exposed 2 days worth of folk and now your service is a paramedic down.
It's a really interesting issue I think. I absolutely agree that you have a right to free choice about what goes into your body.
But I'm also fairly persuaded that the interests and safety of patients is best served by you having the jag.
Watching with interest to see how it plays out.
http://www.cdc.gov/vaccines/vac-gen/side-effects.htm#h1n1
This is standard and well known as I stated earlier.
[i]You quite clearly have never had somebody publicly challenge your medical opinion because of your current job role and its obvious you don't have an academic background either as I've yet to see any reasoned argument.[/i]
You really are wrong there it's challenged on a regular occurrence, I could give you an example now but as it's not currently public knowledge I'd risk my job by discussing it on a forum. I will say it's in front of a medcial panel not some guy posting links they've googled. Academic background, I'm afraid again your assumptions are wrong again I hold a BHSc and a mentor degree this is helped me greatly in supporting my case mentioned. I've appeared in the High Courts through my work answering questions from defence and prosecution lawyers about my role and decisions so please don't think your any threat.
The evidence is there on the BMJ site and posting links to it is far from classed as research now is it, so even if I did it proves nothing more than and still won't sway your opinion.
Glad you don't think I should be forced to have it, eventually. I have made an informed decision and decided the risk posed by having one are small for me and as mentioned already will take the chance to have it. Not to protect my clients but as I don't want flu again and it will reduce the chance of me being of work through flu allowing me to continue my profession.
At the end of the day I'm not out to force people to take it, I just want all those who opt out to tell me why and justify it, 60 posts in and I'm still waiting for one.
At the end of the day everybody has the right to opt in or out of medical interventions, and they do not have to justify this to anyone but themselves. I am struggling to understand why you believe frontline NHS staff should not share this basic human right, and why they have to justify themselves to you.
[i]So even if you did immediately figure out you have swine flu the moment your symptoms appear and don't come to work from then, you've still exposed 2 days worth of folk and now your service is a paramedic down.[/i]
2 days worth that is no higher than a carrier having flu and no symptoms.
It is choice, we have the choice and should be allowed to choose not forced to take it.
Interesting that you (TJ) had to go to a US based site for the info !
The potential adverse affects listed look far less severe than those associated with many of the medicines commonly prescribed - so I can't see any reason not to have the vaccine, other than the usual medics 'do as I say, not as I do' and 'doctor knows best' philosophy 😉
Looks like we'll have the situation of (some) medics advocating and giving vaccines they are not prepared to take themselves - nice example to set eh.......
[i]Looks like we'll have the situation of (some) medics advocating and giving vaccines they are not prepared to take themselves - nice example to set eh...[/i]
A great example to set the freedom of choice. No one is forcing those receiving the injection to have it.
I've appeared in the High Courts through my work answering questions from defence and prosecution lawyers about my role and decisions so please don't think your any threat.
Just because you are a paramedic with a degree called to court and be questioned by lawyers (who will have limited medical experience themselves) doesn't make you capable of a reasoned argument on immunology any more than it does me as I too am not an immunologist. Am I wrong to say that these court cases were related to accidents and not the spread of viral illnesses through populations? If I am then accept my apologies.
The evidence is there on the BMJ site and posting links to it is far from classed as research now is it, so even if I did it proves nothing more than and still won't sway your opinion.
Nope this isn't really the forum for proper research based arguments is it, but I'm still intrigued to see these links, like I said the majority of papers in the BMJ present the case [b]for[/b] vaccination of healthworkers. As for swaying my opinion, I am open minded, but I base my opinion on facts not hearsay or conjecture.
Not to protect my clients
There was me thinking that to be in frontline medical care you'd have to be selfless, clearly I'm wrong (again). I've always said from the beginning of this thread that is the individuals choice, but it should be based on informed opinion, and you will have to live with the moral consequences of your actions not me.
TJ, what you've linked to is a list of mild side effects (unless you have an allergy), not really a comparison to medical journal articles stating quite clearly that there is evidence to suggest not vaccinating healthcare workers could lead to a higher incidence of flu related deaths.
theboatman - when I said all, I meant all in this forum, they've publicly stated their opinion which may influence others who read this thread, but they've given no justification to base their opinion on at least I've tried. Nobody has to answer to me, only themselves.
I'm off to bed now, but if all I do is make at least one person think more deeply about whether or not they should get vaccinated then I'll be happy even if they decide not to.
Good night everybody.
[i]Just because you are a paramedic with a degree called to court and be questioned by lawyers (who will have limited medical experience themselves)[/i]
Where do you think they source they info from to argue with me, it's not Google. They use medical professionals to argue their case against me, people far more qualified than me in some aspects. They also find the smallest of things to try and win. Times, doses, patients responses mentally, physically and the situation they were under. All this I have to be prepared for able to answer with confidence and knowledge, often on the spot of there's something my solicitor has missed.
[i]Am I wrong to say that these court cases were related to accidents and not the spread of viral illnesses through populations?[/i]
Irrelevant as your point was I had never been challenged.
[i]There was me thinking that to be in frontline medical care you'd have to be selfless, clearly I'm wrong (again).[/i]
Rule 101 is we are taught self preservation first.
[i]Nope this isn't really the forum for proper research based arguments is it, but I'm still intrigued to see these links, [/i]
They're there.
[i]I've always said from the beginning of this thread that is the individuals choice, but it should be based on informed opinion, and you will have to live with the moral consequences of your actions not me.[/i]
Something again I do on a regular bases is live with the possible consequences of my actions.
Hagi - you are being unnesassarily offensive now.
I will say it again. I am not in a high risk category myself, nor are teh people I care for.
medical journal articles stating quite clearly that there is [i]evidence to suggest[/i] not vaccinating healthcare workers [i]could [/i]lead to a higher incidence of flu related deaths.
That is really conclusive is it not?
I am quite happy that I have made an informed choice and I am quite happy to live with the consequences of my actions.
the reason I posted the list of side effects is earlier you said there was no evidence of side effects.
How effect if the vacine? Most flu vaccines are around 70% effective IIRC.
I have looked at teh official advice from my employer about this - it is advising not requesting or requireing vaccination and clearly the main thrust is about preventing manpower shortage rather than infective risk to patients.
find one case of a healthcare worker transmitting the disease?
tricky one, say no and you can claim a week or two off riding on the sick on the swine flu tab. im selfish and will always follow this route for a few sunny winter days riding of my choice.
not been tested "enough" yet but swine flu should only be kicking about for the next year or so. bit of a gamble as to what is the risk of you catching it and passing it on and the risk of there being something nasty in the vaccine. the overall health benefits to society will prob be on the side of getting the vaccine being fine.
my moms oncology specialist at the hosp has told her he wont be having it and will not question staff or family members of high risk folk that follow the same route. his reason is just it hasnt been tested thoroughly???
vaccination of healthcare workers is to stop these workers taking time off especially during times of epidemics not to stop said workers passing anything on.
vaccination made me ill? i'll check again but thought that was a myth, my BcG gave me TB but just for a day or two etc; an excuse used by soft kids to get a day on the couch watching richard and judy,(or out on the bike :wink:)
could anyone save me the trouble and post the evidence that vaccinations make people ill, or vise versa.
Doh - mild "flu like symptoms" are a recognised and common side efffect of flu vaccines. Its there all over the place - I have a link to this further up on this thread
Ok But I know Doctors and Pharmacys and you tell me why they Dont and most wont Have the Jab !!
Having too and common sence is not the correct answer I am looking for
and is not the answer to why they wont have the vaccine
I remember years back one winter and the company doctor offered
a flu jab and I had never felt so bad
Hagi - you are being unnesassarily offensive now.
Really? Apologies, that wasn't my intention. All I'm trying to do is fill in the clearly large gap in my knowledge that all these 'informed' NHS workers seem to have.
TJ, I've said all along that I have no problem with people opting not to have it if they have a genuine reason, you've already stated that you have a reason, thats more than good enough to me.
That is really conclusive is it not?
Nope its the beginnings of an argument based on evidence based reasoning, you should try it sometime.
find one case of a healthcare worker transmitting the disease?
Very amusing, but if you read my earlier posts I link to published studies in contained healthcare environments which show a statistically significant decrease in flu related deaths when healthcare workers have been immunised against seasonal flu. If you search you can find plenty of similar papers.
Rule 101 is we are taught self preservation first.
Whilst I respect your Paramedic skills and knowledge, I'm pretty sure the rule of self preservation don't really apply here now does it? But again, I'm willing to be proven wrong when you show me some evidence of high probability of morbidity or mortality caused by seasonal flu vaccinations. This should be pretty easy to find if it exists given that since 2002 tens of millions of doses have been administered annually.
They're there.
Really? The solitary article I could find was based on German concerns of squalene being used as adjuvant (although technically it isn't an adjuvant, but thats beyond this discussion). Given that Squalene has been used in vaccinations since 1997, doesn't really make it untested does it?
Not only that, but only one of the two sets of vaccine the UK gov. has ordered has an adjuvant so its still a pretty weak argument.
I'm sorry, but you've given me no evidence of an 'informed opinion', and that really riles me up, I've met too many NHS staff who believe they know best because people come to them and ask them for medical advice.
Again I'm not telling anybody to get the flu vaccine, all I want is for those people who have objections to taking it to explain them to me and not to just say they've made an informed opinion which they can't provide any evidence to back up.
[i]Whilst I respect your Paramedic skills and knowledge, I'm pretty sure the rule of self preservation don't really apply here now does it?[/i]
Yes it does there's a risk involved, some may not be prepared to take that risk.
[i]But again, I'm willing to be proven wrong when you show me some evidence of high probability of morbidity or mortality caused by seasonal flu vaccinations[/i]
Side effects exist with pretty much every drug and vaccine it doesn't need to be high for people to choose not to have it.
[i]I'm sorry, but you've given me no evidence of an 'informed opinion', and that really riles me up, I've met too many NHS staff who believe they know best because people come to them and ask them for medical advice.[/i]
I'm sorry neither have you, like I say Googling for articles doesn't really count.
I'm sorry neither have you, like I say Googling for articles doesn't really count.
Drac, you still aren't getting it (unfortunately) I don't have to make an informed opinion as I've already had it and I don't have to put immunocompromised patients at risk as part of my job. The search engine I use to search for medical articles is irrelevant be it Google scholar, pubmed or any of the others out there, at least I've attempted to put forward some justification for my point of view - you haven't.
Maybe you'd prefer I went back down the medical library and scanned through microfiches, got the journals off the shelf photocopied them and posted the articles to you, would that be better than finding them via a search engine? I remember those days well, not sure I want to revisit them though!
I'll leave you with my last thought on the matter and let the experts highlight the debate better than I can (and yes I used a search engine to find this article shame on me!):
[url= http://www.bmj.com/cgi/content/full/339/aug25_2/b3398?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=%22Should+healthcare+workers+have+the+swine+flu+vaccine%3F%22&searchid=1&FIRSTINDEX=0&sortspec=date&resourcetype=HWCIT ]Should healthcare workers have the swine flu?[/url]
That's just it Hagi you don't work in the health care profession but seem to think we're not allowed the choice of taking a vaccine and we have a duty of care to take it. What if members of the public started dictating you should be made to do something as it's your job and that there should be no choice.
Read that article and again it's encouraging healthcare workers to vaccinate to keep the system alive and not so much to prevent spread of infection.
That's just it Hagi you don't work in the health care profession but seem to think we're not allowed the choice of taking a vaccine and we have a duty of care to take it.
Actually you are correct there I don't work in the health profession (any more). However, if you [b]actually[/b] care to read any of my posts you will see that I've said all along that I fully support the individuals choice, my opinion is that you have to have a genuine reason for not taking it given the potential impact to those whose lives you are supposed to be saving.
You did but others seemed to think we don't, I kind of see where your coming from but people still have the right to choose if they inject anything into their body. Some will do it because the risk of a reaction, others because they seen the small health risks there may be a few who choose not to because they've had it before and felt ill after, even most evidence suggests this is coincidence. Still I prefer people to have the choice, I've had people refuse all sort of treatment that can help getting worse, save their lives or just make them feel well. They have the right to refuse, yeah your going to say they aren't going to cause problems for others but we have the right to refuse healthcare workers or not.
How ironic. Just checked my work email and there's a clinic on my station in just over a week so now have to try to encourage as many as my staff as I can to have the jab. Wonder if I should print of Hagi's thoughts. 😀
Regarding the "it hasn't been tested enough" argument:
I'm interested if this is just a general feeling or based in fact?
Does anyone know how much testing it has actually had compared to other vaccines and drugs? And do people with this concern generally limit themselves to only taking 30-40 year old drugs where the long term effect is better known, or are they treating the swine flu vaccine with more suspicion than normal for some reason?
How ironic. Just checked my work email and there's a clinic on my station in just over a week so now have to try to encourage as many as my staff as I can to have the jab. Wonder if I should print of Hagi's thoughts.
Lol! I'd suggest that BMJ article as a slightly more useful starting point - theres also some interesting comments in response to it.
[i]Lol! I'd suggest that BMJ article as a slightly more useful starting point - theres also some interesting comments in response to it. [/i]
It's ok there is loads of stuff lying around at work and we all got a letter and leaflet the other day about it. Still I won't and can't force my staff to have it only encourage them.
GrahamS - It was tested on 8,000 people IIRC but as I've mentioned earlier it only varies slightly from the seasonal one anyway so essentially the base of it has been tested millions of times.
Drac, thanks. That fits with my understanding. The base medium is well known and thoroughly tested; there is a good understanding of attenuated flu viruses in vaccines in general; and there is base knowledge about the H1N1.
So, as I understand it, the "untested" bit is a very slight risk that attenuated H1N1 in that medium doesn't perform the same as all the previous attenuated strains that are used every year?
And the trial of 8,000 showed no indication of that?
