Gov. Paterson caved in to New York State healthcare workers’ superstitious fears of the new H1N1 vaccine. With the compliance of the State Health Commissioner Richard Daines, Paterson rescinded the mandatory vaccination program. This weekend, during my afternoon spent volunteering as a physician supervisor at one of the seven free flu vaccine locations sponsored by the New York City Health Department, I watched a similar retreat from sound science.
I responded to a summons from the Medical Reserve Corp. and arrived at a Maspeth, Queens site, where I had expected to find hordes of kids and parents seeking free protection from the ongoing “swine flu” H1N1 epidemic. Instead, there were few patients but perhaps fifty or more healthcare workers--volunteers by and large, with a smattering of City Health Department representatives.
My fellow volunteer physician--who had given up his entire Saturday--informed me that it had been busier in the first hour after the 9am opening of the free-vaccine site but had slowed considerably thereafter.
Were the workers there vaccinated, I inquired? He didn’t know, so I asked several official-type workers. They seemed reluctant to address the question directly. One woman, a Department of Health employee, suggested that the vaccine was not intended for the workers, only for the students. Whatever the intent, I helpfully suggested, shouldn’t the workers tasked with giving the shots (or nasal droplets) be immunized as a matter of course? She headed for the cafeteria without satisfying my curiosity.
To my surprise, though, someone appeared who, I felt, might be able to address such policies: New York City Commissioner of Health, Dr. Thomas Farley. He was surveying the premises, greeting volunteers and patients alike. I introduced myself, and he thanked me for my volunteer efforts. Nevertheless, I had to ask him: Why are the folks giving out the vaccine not immunized against the highly communicable virus from which they are trying to protect the youngsters? (We both well knew that the Centers for Disease Control (CDC) triage list puts healthcare workers among the groups most warranting immunization).
The Commissioner first opined that this location was hosting what was meant as a “youth-focused event,” and therefore the vaccinators themselves were not targeted. I countered that there was plenty of vaccine at the school, few potential schoolchildren to receive it--and plenty of workers in need of vaccinations with nothing much else to do.
He then shared with me his concern that the workers, being either City employees or working under the aegis of the City Health Department, might be perceived to have “jumped the line”--gotten vaccine before the general public. Risking being impolite, I suggested that perhaps perceptions of unfairness should take a back seat to saving more lives and preventing illness. He told me--also heading for a snack--that in future weeks he hoped that the sites initially earmarked for schoolchildren’s vaccinations would be opened up to older age groups, including healthcare workers. But why not now?
Another City employee, overhearing our conversation, advised me that the Department had “taken a hit” when flu vaccine had been delivered to Goldman Sachs and Citigroup at their request--even though that was by order of the CDC (whose chief, Dr. Tom Frieden, was Farley's immediate predecessor as the City Health czar). So our Health Department, it appears, is avoiding any appearance of preferential treatment for its own workers--even at the cost of increasing the risk of those workers becoming vectors of illness.
I was gladdened to learn this morning that the City had decided to open up the free vaccine clinics over the next few weekends to all those in the higher-risk groups--not just schoolchildren and pregnant women. But I was disappointed to say the least that the policy on vaccinating City healthcare workers--or rather the lack of such a policy--remains in effect. Dr. Farley’s excuse--that making H1N1 vaccination mandatory for City healthcare workers would provoke a political tempest--is unacceptable. Nothing less than full vaccination of all healthcare workers should be the goal of our City’s Department of Health
Dr. Gilbert Ross is Medical Director of the American Council on Science and Health (ACSH.org).