[MCOH-EH] [EXTERNAL] Re: Flu Vaccine Status Indicators

Lanzi, Maria Maria.Lanzi at va.gov
Thu Oct 10 07:38:17 PDT 2019

Melanie   -  this is why we all look to you for guidance.

Well done!

Maria C. Lanzi, MS, MPH, ANP-BC, COHN-S, CTH
Nurse Practitioner/Program Coordinator
Employee Occupational Health
Corporal Michael J Crescenz Veterans Affairs Medical Center
3900Woodland Avenue
Philadelphia, PA 19104
Work:  215 823 5800 x 2592
Fax:  215 823 5968

From: MCOH-EH <mcoh-eh-bounces at mylist.net> On Behalf Of Swift, Melanie D., M.D., M.P.H. via MCOH-EH
Sent: Thursday, October 10, 2019 8:03 AM
To: MCOH-EH <mcoh-eh at mylist.net>
Cc: Swift, Melanie D., M.D., M.P.H. <Swift.Melanie at mayo.edu>
Subject: Re: [MCOH-EH] [EXTERNAL] Re: Flu Vaccine Status Indicators

My personal opinion, but informed by reading the paucity of literature on the use of masks for asymptomatic theoretical source control, is that this really isn’t about patient protection. Hand washing is, staying home when sick is, but masking well people because they aren’t vaccinated is not.
Consider this: every so often we get early surveillance data that warns us that the seasonal vaccine is a mismatch for the circulating strains - instead of the expected 60% effectiveness in healthy adults, it’s 0-10%. (Recall that one the Osterholm metanalysis establishing the 59% average effectiveness estimate, these mismatch seasons were excluded) In those seasons, if the patient protection rationale holds, shouldn’t all vaccinated people also wear masks for the rest of the season? Which we now realize often extends into May? And what if the HCW is 70 years old and their (even high dose) vaccine is only reducing their risk of infection by 20% - although it may prevent complications it’s not great at preventing infection in seniors - shouldn’t all HCW over 65 have to wear a mask even if vaccinated?
Contrary as ever,
Sent from my iPhone

On Oct 9, 2019, at 6:42 PM, Tara Dockery <tdockery at oceanbeachhospital.com<mailto:tdockery at oceanbeachhospital.com>> wrote:

Our facility had a nurse that wanted to start a class action lawsuit last year because she felt her personal beliefs were HIPAA protected, and that if we asked her to wear a mask when she administered Chemotherapy because she hadn’t had a flu vaccine that it would be a violation of her right to privacy if she would have to tell the patients she wears the mask because she didn’t get the flu vaccine.  We then had to take it to the lawyers to be sure, and they told us that our cute little “promotional badges that advertise flu vaccines to patient and visitors by saying “I got my flu shot” were the ones that were in violation” so we had to stop asking that to be a marker for who does and doesn’t need to mask, and that if we changed to some buttons that said “get your flu shot” and made them optional to wear (all the admitting staff demanded them, as they wanted it known as the first person who greets a patient or visitor)  that we would be ok, and if our masking policy were written with safety as its focus, and put the owness on managers to monitor their staff for compliance, then we would be ok legally.

We had to amend our policy, for fear of such lawsuit, to state they had to wear the masks in patient care areas or when working with or talking to patients. I guess the whole hubbub is they can take a mask off when walking in the hallways as long as not with or talking to a patient, but put them on in the rooms, care areas, or at the desk as visitors and patients often come up and ask questions at the desk?

Either way, its been eye opening…


From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Reichen, Catherine
Sent: Wednesday, October 9, 2019 1:02 PM
To: MCOH-EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] Flu Vaccine Status Indicators

CAUTION: This email originated from outside your organization. Exercise caution when opening attachments or clicking links, especially from unknown senders.

That is interesting.  Our HR employee rights lawyer told us that this is not a HIPPA violation.  We use different colored stickers with the year on them to indicate vaccination and declination (without  the wording of “I got my flu shot” on them).  Our policy states that they have to have a sticker by Dec 1 and they must be placed on the front of the badge for identification of compliance.


From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of da.sampson via MCOH-EH
Sent: Wednesday, October 09, 2019 3:53 PM
To: MCOH-EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Cc: da.sampson <da.sampson at yahoo.com<mailto:da.sampson at yahoo.com>>
Subject: Re: [MCOH-EH] Flu Vaccine Status Indicators

Hello Anne
Several years ago legal counsel at another medical center in NH indicated that placing a sticker on an ID badge for flu vaccination was not a great idea since this is a public acknowledgment of individual medical information and could be challenged as a HIPAA violation regardless of facility policies.
Just a thought.

Deb Sampson

Sent from my Verizon, Samsung Galaxy smartphone

-------- Original message --------
From: Anne Mills <amills at crhc.org<mailto:amills at crhc.org>>
Date: 10/9/19 4:23 PM (GMT-04:00)
To: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
Subject: [MCOH-EH] Flu Vaccine Status Indicators


We recently transitioned to a influenza vaccine policy that requires masking for non-vaccinated health care personnel.  We use badge stickers as status indicators.  I am curious how others have made this work.  We are a regional medical center with multiple, off-site primary care and specialty practices.  We have many non-employed credentialed providers who participate in this program.

Flu vaccine is provided in Employee Health Services and department-based, "Flu Vaccine Ambassadors".  However, there are so many others that vaccinate elsewhere, or are in departments without an Ambassador.

We have not been able to identify an efficient means to deploy stickers. Your experiences are welcomed.


Anne C. Mills, MSN, RN, COHN-S
Concord Hospital
Director Employee Health Services
| • (603) 230-1962| 7 (603) 227-7126
|  amills at crhc.org<mailto:amills at crhc.org>

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