Monday, March 21, 2011

APhA 2011- New Business... Mandatory Vaccinations

Cruising around the APhA site a couple days ago, I found this proposed policy on the House of Delegates portion of the site. The subject: Requiring Influenza Vaccination for All Pharmacy Personnel.

After all of the proposal-y language, this is the policy that is being introduced:

APhA supports an annual influenza vaccination (unless a valid medical or religious contraindication precludes vaccination) as a condition of employment for all persons employed by, completing education and training within, or volunteering for, an organization which provides pharmacy services or operates a pharmacy or pharmacy department.

I have issue with five words in the proposal. As a condition of employment. Excuse me. I'm an adult. I believe that I can make my own decision about if, when, and against what I will be vaccinated. And to make my employment conditional on getting a vaccination... I don't think so.

I understand the rational behind the proposal. Health care providers should try to keep from getting sick. And health care providers should do what they can to prevent transmitting disease to our patients.

The policy is calling for mandatory influenza vaccinations, yet the background information on the policy lists several more potential things that we could pass to our patients. Why not include hepatitis B, meningococcal, varicella, pertussis, measles, mumps, and rubella shots to the list of vaccines and boosters that pharmacy staff should receive in order to stay employed?

I looked at the sources that were cited to back-up the policy. The most recent article was published in 2000. I would like more current information. Eleven years is an eternity in health care. Plus, two of the cited articles looked at health care workers in the long-term care setting. Usually patients in long-term care see the same caregivers multiple times, creating multiple chances for disease transmission. Down at the local CVS, the patient sees the drop-off tech for a couple minutes, might see the pharmacist for two minutes, and the cashier for a minute or two. Not the same as a nurse who may spend 20 or 30 minutes continuously with a patient in a long-term care setting.

In the real world pharmacy setting, there are more practical steps that can be done to prevent the transmission of infectious diseases. Things like using disinfectant on surfaces that the patient comes in contact with. Think of all the patients who walk up to the pharmacy counter, cough/sneeze into their hand, then rest their hands on the counter/grab the pen on the signature pad. Next patient comes up and touches those same surfaces. We can't Lysol after every patient, but regular disinfecting will do a lot to prevent disease transmission.

Sneeze shields are a must. I can tell you the number of times that a sneeze shield has stopped droplets from a cough or sneeze from making it to my face. It's sad to say, but at least half of the people who come to the pharmacy don't even attempt to cover their coughs or sneezes.

My pharmacy is usually too warm in the winter, so we have fans running to keep us cool. Orienting them to blow air out of the pharmacy creates a pseudo positive-pressure environment that keeps germs from getting to our staff. Then we are not the vectors for transmission.

We have also considered wearing gloves and masks to keep our staff from becoming infected. If there is an influenza outbreak in our area we may put that into play. I have a physician at a local urgent care center who wears a mask from November until April. I don't think that pharmacy needs to be that drastic.

But, if the APhA is going to enter the workplace with policy, how about something like this.

Community pharmacists are allowed to have sick days

And there will be pharmacists available to cover the sick pharmacist's shift. I've been offered positions at five different chains over the years, as well as several hospital positions. The hospital positions always included sick days. Not one retail position has had sick days included as part of the job offer.

How difficult is it to have an extra pharmacist or two available in a district to cover an ill pharmacist's shift? Apparently it's very difficult because whenever a pharmacist gets ill, it usually falls on their partner to cover the shift. Even if the partner just finished a five day stretch and only has one day off before starting another three or four day stretch. And the pharmacist who was ill is expected to make-up the missed shift.

This is just my opinion, but having the option to call-off with the knowledge that the shift would not need to be made up would keep sick pharmacists from working. As it stands now, pharmacists tough it out because they don't want to inconvenience their partner or make-up the missed day.

If the APhA is going to address the issue of transmitting disease from the pharmacy, workplace sick day policies are where the focus needs to be. Not injecting a vaccine into every pharmacy staff member in the hopes of keeping three or four strains of one particular illness from being passed to our patients.

Again this is just my opinion, but APhA resources are better spent addressing the issue of getting pharmacists provider status with Medicare and getting CPT codes so we can bill for our services. If we want to expand our practice, we need to get paid for it. Recognition from CMS is the first step.

APhA delegates, think about this before voting on the mandatory vaccination policy proposal.


Phathead said...

I typically do not get a flu shot because I am a young, healthy male and I do not wish to waste a shot that could otherwise go to someone who needs it.

Especially if there ends up being a shortage situation.

Anonymous said...

I typically do not get a flu shot because I am a young, healthy male and I do not wish to waste a shot that could otherwise go to someone who needs it.

Me too. The same goes for measles, mumps, rubella, pertussis, or any of those other vaccines given to reduce the transmission of disease. Who needs that crap when your a young healthy male, right?

The Nail Narc said...


No reason for this in a community pharmacy. Are they going to force all the cashiers, managers, etc.. too? How bout the cashier at the bank or the grocery store? STUPID!

Anonymous said...

Totally agree with this article. Unfortunately, this whole trend of making vacc inations mandatory is sounding more like a religion than based on science. Workers aren't cattle - sure, we want to protect patients, but who's protecting us. If a worker ends up with a neurological disorder from the flu shot or just some negative health consequence even 10 yrs down the line, who is going to take responsibility for that and take care of that worker? There are real effective ways to PREVENT flu, as eminently mentioned in this article - wiping down the workplace, keeping a good air supply, more sick days and let's not forget taking Vitamin D. There's real science backing that up, but no one seems to be wanting to mandate that, and even like that, I would want that to be a person's option. When flu vac cines become manda tory for pharmacy staff, I'm outta this biz.