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"Declination of Influenza Vaccination," for work in a hospital. *update post #20*.

post #1 of 21
Thread Starter 
so my employer is pushing flu vax. i have been informed (through staff meeting minutes) that i must sign a form to decline:
================================================== ======
Declination of Influenza Vaccination


My employer, xxx, has recommended that I receive influenza vaccination in order to protect myself and the patients i serve.
I had a chance to review the following information:
  • Influenza is a serious illness that kills an average of 36,000 persons and hospitalizes more than 200,000 people in the United States each year
  • Influenza vaccination is recommended for me and all other health care workers to prevent influenza disease and its complications.
  • If I contract influenza, i will shed virus for 24-48 hours before influenza symptoms appear. My shedding virus can spread influenza virus to patients in this facility.
  • If I become infected with influenza, even when my symptoms are mild, i can spread severe illness to others.
  • I understand that the strains of virus that cause influenza infection change almost every year, which is why a different influenza vaccine is recommended each year.
  • I cannot get influenza from the vaccine
  • Not getting immunization could endanger my health and the health of those with whom I have contact, including my family and community
After reviewing these facts I am choosing to decline influenza vaccination at this time.

I understand that I may change my mind at any time, and accept influenza vaccination, if vaccine is available.

I have read and fully understand the information on this declination form

Signature______________________ etc
================================================== =================

i am realllllllllllllllllly not liking this form!!!!!!

all those nice "I" statements.

and the "after reviewing these facts" crap.

there is also a form to fill out to CONSENT, where they kinda sorta tell you a few of the things that might lead one to want to decline!

================================================== ========

CONSENT FOR INFLUENZA (FLU) VACCINE 2007-2008
  • I have received the Inactivated Influenza Vaccination Information Sheet (Rev 7/16/07).
  • I do not have any allergies to eggs.
  • I do not have any allergies to mercury.
  • I do not have a fever now.
  • I do not have a history of Guillan-Barre Syndrome.
  • I have not had a previous life threatening allergic reaction to flu vaccine.
  • For women: I am not pregnant, or if I am pregnant, I have provided written consent from my treating physician to receive the flu vaccine.
I have been given the Vaccination Information Sheet about the Influenza vaccine. I have had a chance to ask questions which were answered to my satisfaction. I believe I understand the benefits and risks of the vaccine and request that the vaccine is given to me.

Signature______________________ etc

================================================== =================

so no matter what happens, it's my fault! had an adverse reaction? well i ASSURED them i wasn't allergic to mercury!!!

anybody got a good way to deal with this? i am sooooo missing LongIsland. my thoughts are to write up my own statement of declination, omitting the personal pronouns. eg:

Declination of Influenza Vaccination


My employer, xxx, has recommended influenza vaccination fro employees in order to protect employees and patients served.
I had a chance to review the following information:
  • Influenza is a serious illness that kills an average of 36,000 persons and hospitalizes more than 200,000 people in the United States each year
  • Influenza vaccination is recommended for all health care workers to prevent influenza disease and its complications.
  • If one contracts influenza, one sheds virus for 24-48 hours before influenza symptoms appear. Shedding virus can spread influenza virus to patients in this facility.
  • If one becomes infected with influenza, even when symptoms are mild, one can spread severe illness to others.
  • The strains of virus that cause influenza infection change almost every year, which is why a different influenza vaccine is recommended each year.
  • One cannot get influenza from the vaccine
  • Not getting immunization could endanger one's health and the health of those with whom one has contact, including family and the community
After reviewing these statements I am choosing to decline influenza vaccination at this time.

I understand that I may change my mind at any time, and accept influenza vaccination, if vaccine is available.

I have read and fully understand the information on this declination form

Signature______________________ etc

================================================== =================
or i could line out their form left and right. or try to sneak mine in, switcheroo style.

or state i am allergic to mercury. but they'd still want me to sign that declination.

thoughts? strategies? any lawyers in the house?\
post #2 of 21
No way. That line about spreading illness to others is a lawsuit waiting to happen.
post #3 of 21
Seems awfully unfair if you're not getting it because of one of the things on the consent, like allergies.
post #4 of 21
I wouldn't sign anything. Has your employer stated any consequences for not signing either form?
post #5 of 21
Or I would make up my own form entirely. Stating things like I'm not getting the flu vax because its ineffective, etc., etc.
post #6 of 21
Unless your hospital has a written policy that all employees must receive the flu vax, they cannot legally make you sign anything. I also work in a hospital and they're pushing the flu vax, though our "declination" form isn't quite as severe as yours, and I had to educate my boss that they can't make us sign anything since there's no policy in place. If they push you to sign something just write up a piece of paper saying you're religiously opposed or something.
post #7 of 21
================================================== ======
Declination of Influenza Vaccination

I am religiously opposed to the practice if vaccination.

Signature,formerluddite
================================================== ======
post #8 of 21
Thread Starter 
thanks for the answers, everyone.

i think i will try:
1) slipping through the cracks.
2) simply stating i will not sign it.
3) offer a simple exemption form like used in public school.
4) rewrite their form.

Lisa, i'm not sure about the policy status. i'm hesitant to investigate at present, because it may preclude seeing if i can slip through the cracks. advice i've received elsewhere included inserting:

"After reviewing these facts I conclude that information provided is incorrect, incomplete and misleading and therefore I am choosing to decline influenza vaccination at this time."

into the part at the bottom.

thanks again for the ideas!
post #9 of 21
:

Rumor has it, we're to sign something if we decline at my hospital too. I'm just ignoring it until confronted, and keeping y'alls ideas in mind!
post #10 of 21
I work night shift, normally it was easier to avoid the flu shot pushers at our hospital. But alas that has changed. In order to make the shot more available to everyone there are people that are available to give it around the clock and on weekends. So now we have no excuse to decline it...so says management.

Still we are not required to get it...just "highly encouraged". When I declined it, the nurse giving them seemed like she was personally offended. And then I work in a NICU, so I basically got the "you're a baby killer if you don't get the shot" speech/guilt trip. If we do opt to get it, we have to sign a consent form. After the third time of being bugged about it, I just lied and said I got the shot at my doctors office. Nothing more was said.

I don't like that consent at all. It would make me worry about them trying to fire me if I get sick or something worse. I wouldn't sign it. Is there a way you can make up your own? There is a big push right now to make the shots mandatory where I work...I may have to think of something as well.
post #11 of 21
ooops....meant to be a PM
post #12 of 21
*
post #13 of 21
Quote:
Originally Posted by formerluddite View Post
Lisa, i'm not sure about the policy status. i'm hesitant to investigate at present, because it may preclude seeing if i can slip through the cracks.
I slipped through the cracks last year : They were supposedly keeping track of how many people had gotten the shot or signed the form, yadda yadda, but I never heard a peep from anyone. Do you know if your hospital policies are online? Ours are available on our intranet site, that's how I found out they're not required. They're *supposed* to be somewhere where the employees can easily access them.
post #14 of 21
Thread Starter 
Quote:
Originally Posted by CallMeMommy View Post
I slipped through the cracks last year : They were supposedly keeping track of how many people had gotten the shot or signed the form, yadda yadda, but I never heard a peep from anyone. Do you know if your hospital policies are online? Ours are available on our intranet site, that's how I found out they're not required. They're *supposed* to be somewhere where the employees can easily access them.
ooooh, they might be! there's a website for the hospital, it's pretty big, and there's a lot on it. i should poke around.
post #15 of 21
I like the idea of stating you got it at your dr's office. What with HIPAA and all, they can't really make you prove it, right?

While my rock-the-boat, take a stand, change minds part of me wants to be all in their faces about why I don't want it, the pay-the-bills, feed-my-kids part of me wants to just decline it quietly, KWIM?

We do have one surgeon that pitches a fit any time ANY vaccine is even offered to his patients. I've heard that it's because of the mercury, but I would LOVE to pick his brain. It is so rare to find a mainstream medical person who is anti-vax, and willing to say so and act on that publicly!
post #16 of 21
Thread Starter 
i think they probably COULD demand proof, if it's re: a "required" thing, just like TB testing. and if i can't prove it, then they'd just want me to vax again, since that's the default answer in these cases.

lately they are giving everyone admitted flu and pneumococcal vaxes. an order goes into the chart at admission, or rather a "nursing assessment" that lays out a few contraindications (but not fever!), and a flag to catch the MD attn and sig. given how thoroughly most docs read the chart (i've seen a lot of docs just sign everything while carrying on a side conversation), i'm sure many get a second vax. stick 'em, stick 'em again. more is better.
post #17 of 21
Quote:
stick 'em, stick 'em again. more is better.
Well, sure. If one vaccine is good, a second (third?) one will just make them that much more immune, right? :
post #18 of 21
Sounds exactly like what I had to sign for my hospital, rife with scare tactics and all that fun stuff. Apparently this is opt-out system is courtesy of JCAHO, so I'm sure a lot of hospitals are enacting this procedure.

http://www.mothering.com/discussions...d.php?t=772702

I went with a religious exemption, personally

I heard a few days later that Employee Health was going from department to department with the vaccines to make sure everyone was getting their shot : It's hard enough to sign a paper and put yourself out there when it's obviously against recommendation. How many people are going to feel comfortable declining the vaccine with them standing there???

Idjits.
post #19 of 21
Thread Starter 
it's tough when the zombies want you to become one of them. i only work 2 or 3 days/month, and on the weekend at that, so going under the radar is a possibility, unless they are being really thorough in going after anyone not signed, sealed and delivered.

thanks for linking your thread, emily, it got me to vaclib which has given me more phrasing for making my own declination form.

i wonder how many sheeple will be signing that they aren't allergic to mercury and obligingly rolling up their sleeves?
post #20 of 21
Thread Starter 
so the cracks tightened up.

apparently the managers are getting daily emails about getting 100% compliance with either vaxing or signed form. anyone with neither will not be working as of Jan 1st.

if the nurse running the vax assembly line at my campus is to be believed, the declination and consent forms are coming from JCAHO, the "middleman" that makes the recommendation for accreditation to the gov't (HCVA=medicare). and that they probably get it verbatim from the CDC.

hospitals to JCAHO.

the nurse said that the hospital actually watered down the strong language from the JCAHO form. not sure if that's true, but i wasn't going to get into debate about it. (she had earlier told my manager, while i awaited a call back, that there wasn't any mercury in the vax. so i'm not looking to her for accuracy, since labeled "no mercury" is not the same as really, truly NO mercury, and she probably doesn't know the difference).

anyway, she was fine with me lining out "facts" (replacing it with "statements") and adding in the suggested line about "incorrect, incomplete," etc. supposedly as far as the hospital is concerned, they just want it on file that they have informed me as to the risks as they present them, but they don't care if i sign agreement to them. all this is just in case the next time JCAHO shows up, if a patient chart gets audited, and i am a care provider, they will check my file to see that i am either vaxed or was "educated."

so i signed (i condensed a bit due to handwriting/space restrictions):
Quote:
After reviewing these [s]facts[/s] statements, I conclude that information provided is inaccurate, incomplete and misleading. I am choosing to decline influenza vaccination at this time.

I understand that I may change my mind at any time, and accept influenza vaccination, if vaccine is available.

I have read and fully understand the information on this declination form

Signature______________________ etc
they also had an additional section on the bottom, surveying for non vaxers' reasons:

Quote:
The following information is voluntary, but would be appreciated

I am declining due to the following reasons: (check all that apply)

__ I have already been vaccinated this year (2007-2008 season).
__ I am allergic to components of the vaccine (eg: eggs) of the vaccine (specify) _______________
__ I don't believe in vaccines.
__ I don't think it's important to me because i never get the flu.
__ I won't take the vaccine because of the side effects.
__ I have specific medical problems that preclude me from receiving the vaccine.
__ Other (specify) _________________________________________________
which i left blank. too much big brother already. no need to get it written up somewhere that may one day preclude my ability to use a religious exemption.

thanks again all for your ideas and support. much less intimidating when there's a community to lean on. not that i wasn't shaking when i was on the phone with my manager (who sounded sympathetic but hamstrung) and slamming rescue remedy while i was driving in, thinking that if they took the hard line i would be quitting, after 15 years there (even if i only work ~3 days/mo the last few years).

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