US healthcare company fires 69 employees for refusing flu vaccinationBMJ 2017; 359 doi: http://www.libreriabv.com/10.1136/bmj.j5473 (Published 24 November 2017) Cite this as: BMJ 2017;359:j5473
All rapid responses
It seems to me that there is a Domino Theory haunting the minds of US vaccine authorities: they worry that if people refuse one vaccine, sooner or later they will refuse them all, and influenza vaccine is a special case. Left to their own devices, just 43% of US healthcare workers, including doctors and nurses, get the flu shot; this is a poor example for the general public, who may wonder why the other 57% don't get this "lifesaving vaccine." Thus, authorities ignore the evidence in setting what some of us consider a draconian policy mandating flu shots for healthcare workers. I remind you that we still do not know if seasonal flu shots actually do more good than harm in the long run, for healthcare workers or anyone else.
Competing interests: No competing interests
It is troubling to see a report in today's Daily Mirror, apparently inspired by British government sources, blaming the low uptake of flu vaccine on false web rumours put about Vladimir Putin  and the Russian government, when the public might even have found critical articles in the British Medical Journal. Clearly, this is not a sensible or intelligent way to obtain compliance or conduct a debate. The problem is the problem.
 Russell Myers, 'Russian cyber units 'spreading false information about flu and measles jabs in the UK'', Daily Mirror 27 November 2017 http://www.libreriabv.com/news/uk-news/russian-cyber-units-spreading-false...
Competing interests: No competing interests
This News article states that the Infectious Diseases Society of America (IDSA), Pediatric Infectious Diseases Society (PIDS), and Society for Healthcare Epidemiology of America (SHEA) all support influenza vaccination mandates in healthcare settings.1
But are these organisations any more independent than the industry and CDC funded vaccine advocacy non-profits I recently profiled?2 While the PIDS website does not list its donors, SHEA and IDSA state that they receive money from pharmaceutical companies.3,4 IDSA further lists industry support in excess of $5000, which includes the vaccine manufacturers Merck ($378,000 between 2010-15) and Pfizer ($1.3m between 2010-15).4 In addition, IDSA has a long-standing financial relationship with the CDC (which has funded its Emerging Infections Network with around $3m between 2007-2017).
It is also unclear how independent the three non-profits are from one another. IDSA, PIDS, and SHEA share a single mailing address and tax filings state that all employees of both PIDS and SHEA are IDSA employees. Furthermore, IDSA’s board of directors includes liaisons from both PIDS and SHEA.
Would these organizations be willing to explain why they support mandatory influenza vaccination of healthcare workers despite the multiple reviews showing a lack of evidence that such policies carry benefits for patients?5–7 (One of these reviews was co-authored by a current IDSA board member.5)
1. Dyer O. US healthcare company fires 69 employees for refusing flu vaccination. BMJ. 2017 Nov 24;359:j5473.
2. Doshi P. The unofficial vaccine educators: are CDC funded non-profits sufficiently independent? BMJ. 2017 Nov 7;359:j5104.
3. Society for Healthcare Epidemiology of America. Financial Disclosure Policy [Internet]. 2017 [cited 2017 Nov 25]. Available from: http://www.libreriabv.com/index.php/about/financial-disclosure-policy
4. Infectious Diseases Society of America. IDSA Industry Relations [Internet]. 2017 [cited 2017 Nov 25]. Available from: http://www.libreriabv.com/IDSA_Industry_Relations/
5. Pitts SI, Maruthur NM, Millar KR, Perl TM, Segal J. A systematic review of mandatory influenza vaccination in healthcare personnel. Am J Prev Med. 2014 Sep;47(3):330–40.
6. Thomas RE, Jefferson T, Lasserson TJ. Influenza vaccination for healthcare workers who care for people aged 60 or older living in long-term care institutions. Cochrane Database Syst Rev. 2016 Jun 2;(6):CD005187.
7. De Serres G, Skowronski DM, Ward BJ, Gardam M, Lemieux C, Yassi A, et al. Influenza Vaccination of Healthcare Workers: Critical Analysis of the Evidence for Patient Benefit Underpinning Policies of Enforcement. PLoS One. 2017 Jan 27;12(1):e0163586.
Competing interests: PD has received funding from the UK National Institute for Health Research to conduct a systematic review of influenza antivirals. PD received €1,500 from the European Respiratory Society in support of his travel to the society's September 2012 annual congress in Vienna, where he gave an invited talk on the influenza antiviral oseltamivir. PD is an unpaid member of the IMEDS steering committee at the Reagan-Udall Foundation for the FDA, which focuses on drug safety research, and leads a RIAT Support Center funded by the Laura and John Arnold Foundation. PD received $11,000 from the American Association of Colleges of Pharmacy to support Ph.D. student involvement in a study to analyze written medical information regarding the possible harms of statins. None of the above organizations had any involvement in this letter. See http://www.libreriabv.com/about-bmj/editorial-staff/peter-doshi for additional disclosures and details. The BMJ is published by the publishing company BMJ, which is a wholly owned subsidiary of the BMA. BMJ receives revenues from subscriptions, open access fees, advertising, and sponsorship (see www.libreriabv.com/about-bmj). This includes revenues from vaccine manufacturers.