Masks instead of flu shots? A bad idea then, and still.

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In the online posting of JAMA last month, well-respected bioethicist Dr. Art Caplan of NYU-Langone in New York City, and New York State Commissioner of Health Dr. Nirav Shah co-authored a Viewpoint article endorsing the new NYS requirement for healthcare workers in hospitals and long-term care facilities regarding influenza vaccination. (I would have linked to that Oct. 1st online publication, but all links to it now take me directly to the current, Nov. 6th publication. So I ll simply note it s previous existence:

Managing the Human Toll Caused by Seasonal Influenza: New York State s Mandate to Vaccinate or Mask Arthur Caplan, PhD, Nirav R. Shah, MD. JAMA. Published online October 01, 2013. doi:10.1001/jama.2013.280633).

We discussed the policy promoted in the article in a Dispatch piece written contemporaneously. We said 5 weeks ago: This is not protecting vulnerable patients with compromised immune systems, or neonates with barely functional immunity it is only a pretense.The masks required are well-known to be useless against flu transmission, so wearing one simply tells the patient that, My caregiver is possibly a flu vector. I guess they hope that those shunning the shot will feel shamed enough to throw away the mask and get vaccinated as they should have initially. The arguments against mandatory vaccination are flawed or circular or baseless or all of the above. I fear that the number of workers actually protected against the flu this season will be even lower than the unacceptable figure of last year: an abysmal 36 percent!

Nothing has changed: a cop-out to powerful and fearful unions, mainly the Nurse s organizations, who fail to grasp that their right to not be vaccinated takes away a patients rights to be safe from preventable contagion, the opposite of primum non nocere: First, do no harm. Those who refuse to be vaccinated should be ashamed, and we remain saddened that Dr. Caplan, who signed our petition last year to demand mandatory vaccination, has apparently decided to go along with this misguided policy. Let s see how many workers get vaccinated this season, and what the cost will be for New York s vulnerable patients.