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House Calls: Flu by you

Relax, this won't hurt a bit. Last month, Dr. Perry Kendall, provincial health officer (aka. B.C.'s top doc) issued a sweeping decree. All healthcare workers in B.C. must get a flu shot to protect patients from infection.

Relax, this won't hurt a bit.

Last month, Dr. Perry Kendall, provincial health officer (aka. B.C.'s top doc) issued a sweeping decree. All healthcare workers in B.C. must get a flu shot to protect patients from infection.

Shortly thereafter, Lynda Cranston, president of the Provincial Health Services Authority, emailed the healthcare masses, noting that any "health authority staff_ who choose not to be immunized will be required to wear a surgical mask during the flu season, which typically runs from the end of November to end of March."

Failure to comply with this decree, added Cranston, may result in "disciplinary measures" because the "flu vaccine is safe and effective."

The reaction was swift, led by Margaret Dhillon, executive councillor for the B.C. Nurses' Union. "Our main concern is the compulsory nature, the mandatory nature and the punitive nature of this proposed policy," said Dhillon, during a Courier interview last week. "We feel it's far better to have a voluntary program combined with excellent education and outreach."

To be clear. Dhillon is pro-flu shot. But she wants her union's 32,000 members to retain the right of refusal where vaccinations are concerned. According to Dhillon, the old policy, which prevented non-vaccinated staff from working with certain patients, works just fine.

So why the mandatory decree? And why now?

According to Dhillon, Perry and friends aren't happy with flu shot compliance rates among B.C. healthcare workers, which Dhillon estimates at roughly 50 per cent.

Union officials will continue talks with provincial representatives. In the meantime, Dhillon wants more information. "We're seeking the science behind it and what the latest research is showing," she said, noting nurse concerns. "They want to make sure it is in fact safe for all circumstances."

Fair question. Exactly what is a flu shot? And is it safe?

Dr. Monika Naus helps lead immunization and vaccination programs at the B.C. Centre for Disease Control. She's pro-flu shot. And pro-mandatory flu shot for healthcare workers.

During a phone interview with the Courier, Naus described how technicians manufacture flu shots from ordinary chicken eggs. "The eggs are inoculated with the virus strain_ then the virus multiplies in the eggs and it's harvested from the eggs."

This flu season, manufacturers will produce three separate vaccines catering to different demographics based mainly on age. The majority of participating British Columbians, including most healthcare workers, will receive either Agriflu or Vaxigrip shots.

So is it safe? Dr. Naus says yes.

However, according to Vaxigrip's product monograph (basically a list of ingredients and directions) obtained by the Courier, Vaxigrip may cause a range of side effects including "erythema and edema_ asthenia, headache and myalgia" with the possibility of "anaphylactic or acute hypersensitivity reaction." (That's shock, in layman's terms.)

The monograph includes a list of unknowns, which Dhillon and her nurses may find interesting. "Guillain-Barr syndrome has been reported after influenza vaccination" but it's "not known" if vaccination "might increase the risk" of this potentially fatal nervous system disorder.

Moreover, it's "not known" if Vaxigrip causes "fetal harm when administered to a pregnant woman or can affect reproductive capacity." Therefore, Vaxigrip "should be given to pregnant women only if clearly needed."

Finally, Vaxigrip shots contain "thimerosal," a preservative "associated with allergic reactions."

Allergic reactions, yes. And more controversially, with autism.

While no definitive thimerosal/autism link has been established, according to a report by the Centers for Disease Control and Prevention, a U.S. federal agency, "in July 1999, the Public Health Service agencies, the American Academy of Pediatrics, and vaccine manufacturers agreed that thimerosal should be reduced or eliminated in vaccines as a precautionary measure."

Despite these concerns, Dr. Naus stands by Vaxigrip. Mandatory, voluntary, whatever.

"There have been lots of good studies demonstrating its lack of association with neurodevelopmental disorders like autism," she said. "I think that's been aptly debunked_ there's really no evidence that supports that thimerosal causes these kind of things."

So that's that. The provincial powers have spoken while the nurses' union remains steadfast. As an election year approaches, you can't ignore the politics. The NDP is the union party. Where do they stand on the flu shot-or-else issue?

Shane Simpson, MLA for Vancouver-Hastings/official NDP labour critic, could not be reached for comment on this story.

But stay tuned. Things are bound to heat up when the leaves start falling, the coughing grows louder and the surgical masks appear in hospital hallways and emergency rooms all over B.C.

mhasiuk@vancourier.com

Twitter: @MarkHasiuk