Who Decides Our Health?

T he Boston winter is fast approaching, and the falling temperature is simply a delayed reminder of what is to come—the upcoming flu season. With sanitization stations dotting the campus, e-mails from deans reminding us to wash our hands with soap and water and sanitizer, and special rooms on campus quarantining sick students, we would be hard-pressed not to notice the particular attention paid to this year’s flu season, especially with the spread of the H1N1 flu.

Yet even with all these warnings, people still hesitate to use vaccines, given the results of a recent survey conducted by the Harvard School of Public Health in which 41 percent of adults say they will not get vaccinated for H1N1. This statistic may seem surprising, since vaccinations have long been considered a safe and effective means for preventing serious illnesses. There are reasons why, as a child, we get a host of vaccinations that prevent us from contracting diseases ranging from polio to rubella to, now, chicken pox. And while chicken pox may seem like just a rite of passage for children, the Centers for Disease Control and Prevention reports that, before the vaccine, more than 10,000 people were hospitalized and about 100 to 150 people died from chicken pox in the U.S. each year. While these vaccinations do not prevent all instances of their diseases, they do help prevent the occurrence of these diseases with minimal risks of side effects. With already more than a million people in the U.S. infected, you would think H1N1 vaccines would be an obvious choice.

Nevertheless, people will still refuse to get vaccinated, which will greatly increase their chances of contracting the virus. They can then become carriers who can contribute to the further spread of the disease. The resolve to avoid vaccination is bolstered by popular personalities like Glenn Beck, who said on his radio show that the vaccine could be “deadly,” and comedian Bill Maher, who on his Twitter feed called anyone who received the H1N1 vaccine an “idiot.” Regardless of the validity of these claims and the science that strongly indicates otherwise, do people have a right to make what may be an unhealthful decision?

In line with the government’s stance on recreational drugs, the State of New York attempted to say no—when it affected its health-care workers. Until a State Supreme Court judge issued a temporary restraining order, it was state policy to require all health-care workers to be vaccinated or risk losing their jobs. Still, the state’s health commissioner believes in the vaccination policy and will appeal the ruling. This mandate was intended not merely for the safety of health workers; it was primarily to ensure the safety of patients. The rationale is the following: Health workers interact with people who come to hospitals to treat illnesses. Unvaccinated workers greatly increase the chance of passing on an illness to a patient, undermining the entire health facility.

While this intention is laudable, such a practice undermines important rights that we hold dear. First, how would we feel if we were forced to take a vaccine for a disease we do not usually get, but then get sick from the vaccine after the vaccine was intended to prevent sickness in the first place? This policy can implode if we see even minor side effects. Alongside these immediate health concerns, there are larger ideological arguments. How can the government decide what we put in our bodies? And with these mandates, do we open the door for the government to take more control in other matters? The government walks a fine line when it issues such forceful mandates—on the one side, there are the rights of the workers; on the other, the safety of patients.

With the health workers, regardless of how statistically safe these vaccinations are, there are relevant concerns with getting vaccinations. For example, the H1N1 vaccine packaged in a multidose vial contains the mercury compound thimersol, which though present in trace amounts, could still bother consumers. And there is the infamous case from 1976 when the vaccine used to treat swine flu was associated with Guillain-Barré syndrome, causing paralysis in some patients. There are few data to provide conclusive evidence of causation, and scientists now assure us that the production of vaccines has greatly improved in the last 30 years, but consumers may still be worried. If the worker feels confident that the risks of contracting the diseases are not worth the supposed risks of the vaccines, they should not be mandated to take it.

With the patients, their safety needs to be taken into account. If some workers are not going to get vaccinated, patients should be informed about this and be given the choice to be treated by a vaccinated caregiver. Or maybe there are less invasive options for non-vaccinated caregivers, such as facemasks and gowns, which may prevent the spread of viruses. In a health-care facility, the care of patients is tantamount and must be the primary focus of the workers.

However ill-conceived people’s conceptions of vaccines may be, they should not be forced to take them for fear of losing their jobs. Though such a solution may require compromise, a mandatory H1N1 vaccine would be a step in the wrong direction. Unless such a vaccine is proven absolutely critical for the performance of their job, health workers’ right to choose must be protected.

Christopher J. Hollyday ’11, a Crimson editorial writer, is a chemistry concentrator in Lowell House.