Monday, January 30, 2017

New article showing lack of evidence for healthcare workers' flu shots/ PLOS

The issue of healthcare worker (HCW) flu vaccine mandates is of particular interest because no one has shown the shots help patients.  Healthcare workers have had to accept many vaccines, including that for Hepatitis B, for decades.  But flu vaccination mandates are particularly egregious.

The flu shot is given yearly.  It does not prevent flu infections or flu deaths in patients.  And the more often you get a flu shot, the less well it works.  It may reduce absenteeism, but only by a small amount-- because the effectiveness of the shots is low.  Effectiveness is estimated at 37%, averaging CDC data on effectiveness over the past 12 years.  Per the Cochrane Collaboration, you need to vaccinate 71 people to prevent one case of clinical flu.  (I have added all these citations to earlier posts.)

The experts at CDC, FDA, NIH and their parent DHHS know this.  We all read the same literature, and they hold and attend conferences where this is discussed. The federal govt paid for some of the research.

So why does the federal government insist on pushing these shots? Why must healthcare workers get them, or in many cases, be fired?  Some thoughts:

1.  Who controls healthcare? Healthcare workers (HCWs) must be trained to march in lockstep with what their anointed health agencies tell them, irrespective of the science. Loyalty must be to government and employer, rather than to professional standards. Doctors may no longer interpret the medical literature for themselves. Hospital administrators have happily issued draconian edicts and fired disloyal employees, increasing their power in the process.

2.  Once doctors and healthcare workers have been pacified, the rest of the adult population, like the pediatric population, can be made to take whatever vaccines the government designates.

3.  Autonomy is to be chipped away.  We are not to be in control of our own bodies; rather, the government is, for the good of the community.  Will mandated drugging be next?

4.  While the flu shot program is being sold using the powerful memes of patient protection and Science, everyone who has looked into the science knows neither is true. But (as in George Orwell's 1984) it is the memes we must bow down to, not the science.

Anyway, the new PLOS study concluded, as have others: 
The impression that unvaccinated HCWs place their patients at great influenza peril is exaggerated. Instead, the HCW-attributable risk and vaccine-preventable fraction both remain unknown and the NNV (number needed to vaccinate) to achieve patient benefit still requires better understanding. Although current scientific data are inadequate to support the ethical implementation of enforced HCW influenza vaccination, they do not refute approaches to support voluntary vaccination or other more broadly protective practices, such as staying home or masking when acutely ill.
I believe the last sentence is  directed at healthcare administrators, who a) demand unvaccinated staff wear face masks throughout flu season (totally stupid since you can't spread flu when you don't have it--but then, that is not why the mask edict was issued) and b) make it very difficult for HCWs to stay home when they are sick.  

Sunday, January 29, 2017

Draining the swamp: moving in the right direction/ Reuters

From Reuters came a short piece on a new Executive Order, without much commentary to put it into perspective re how things worked in former administrations.
President Donald Trump on Saturday put restrictions on the kind of lucrative lobbying gigs his White House aides and other administration officials can accept after they leave government. 
Trump, a Republican businessman whose campaign was based in part on getting rid of Washington insiders, had pledged during last year's election campaign to "drain the swamp" of political practices that he said made politicians beholden to business interests. 
On his executive order making good on that pledge, Trump said his appointees would agree to refrain from lobbying their own agency for five years after leaving, and would not lobby any government appointee for two years.Trump's order also requires his officials to agree to a lifetime ban on working on behalf of foreign governments or foreign political parties.

Friday, January 27, 2017

Robert F Kennedy Jr. on why we have a vaccine problem and a CDC problem


I am pro vaccine. I had all of my six children vaccinated. I believe that vaccines save millions of lives.  So let me explain why I edited the book Thimerosal: Let The Science Speak, which exposes the dangerous—and wholly unnecessary—use of the mercury-based preservative thimerosal in vaccines being given to millions of children
and pregnant women here and around the world.
Vaccines are big business. Pharma is a trillion-dollar industry with vaccines accounting for $25 billion in annual sales. CDC’s decision to add a vaccine to the schedule can guarantee its manufacturer millions of customers and billions in revenue with minimal advertis- ing or marketing costs and complete immunity from lawsuits. High stakes and the seamless marriage between Big Pharma and government agencies have spawned an opaque and crooked regulatory system. Merck, one of America’s leading vaccine outfits, is currently under investigation for deceiving FDA regulators about the effectiveness of its MMR vaccine. Two whistleblowers say Merck ginned up sham studies to maintain Merck’s MMR monopoly.
Big money has fueled the exponential expansion of CDC’s vaccine schedule since 1988, when Congress’ grant of immunity from lawsuits suddenly transformed vaccines into paydirt. CDC recommended five pediatric vaccines when I was a boy in 1954. Today’s children cannot ­­ school without at least 56 doses of 14 vaccines by the time they’re 18.
An insatiable pharmaceutical industry has 271 new vaccines under development in CDC’s bureaucratic pipeline in hopes of boosting vaccine revenues to $100 billion by 2025. The industry’s principle spokesperson, Dr. Paul Offit, says that he believes children can take as many as 10,000 vaccines.
Public health may not be the sole driver of CDC decisions to mandate new vaccines. Four scathing federal studies, including two by Congress, one by the US Senate, and one by the HHS Inspector General, paint CDC as a cesspool of corruption, mismanagement, and dysfunction with alarming conflicts of interest suborning its research, regulatory, and policymaking functions. CDC rules allow vaccine industry profiteers like Dr. Offit to serve on advisory boards that add new vaccines to the schedule. In a typical example, Offit in 1999 sat on the CDC’s vaccine advisory committee and voted to add the rotavirus vaccine to CDC’s schedule, paving the way for him to make a fortune on his own rotavirus vaccine. Offit and his business partners sold the royalties to his rotavirus vaccine patent to Merck in 2006 for $182 million. Offit told Newsweek, “It was like winning the lottery!” A 2009 HHS Inspector General’s report found that the CDC certified financial disclosure forms with at least one omission for 97% of committee members—and most forms had more than one type of omission. The same report stated that as many as 64% of committee members had potential conflicts of interest that CDC did not identify or resolve before certifying their forms. In addition to lucrative business partnerships with Merck, Offit holds a $1.5 million research chair, funded by Merck, at Children’s Hospital in Philadelphia. From this industry sinecure, he broadcasts vaccine industry propaganda and annually publishes books urging unlimited vaccinations and vilifying safe-vaccine advocates.
The corruption has also poisoned CDC’s immunization safety office, the research arm that tests vaccines for safety and efficacy. In August 2014, seventeen-year CDC veteran, Dr. William Thompson, who is author of the principal study cited by CDC to exculpate mercury- preserved vaccines from the autism link, invoked whistleblower protection, and turned extensive agency files over to Congress. Thompson, who is still employed at CDC, says that for the past decade his superiors have pressured him and his fellow scientists to lie and manipulate data about the safety of the mercury-based preservative thimerosal to conceal its causative link to a suite of brain injuries, including autism.
Thimerosal is 50% ethylmercury, which is far more toxic and persistent in the brain than the highly regulated methylmercury in fish. Hundreds of peer reviewed studies by leading government and university scientists show that thimerosal is a devastating brain poison linked to neurological disorders now epidemic in American children. My book, Thimerosal: Let the Science Speak, is a summary of these studies, which CDC and its credulous jour- nalists swear don’t exist. Although Thompson’s CDC and vaccine industry colleagues have created nine patently fraudulent and thoroughly discredited epidemiological studies to defend thimerosal, no published study shows thimerosal to be safe.

* Please click the headline link above or here for all source annotations

The common canard that US autism rates rose after drug makers removed most thimerosal from pediatric vaccines in 2003 is wrong. That same year, CDC added flu shots containing massive doses of thimerosal to the pediatric schedule. As a result, children today can get nearly as much mercury exposure as children did from all pediatric vaccines combined in the decade prior to 2003. Worse, thimerosal, for the first time, is being given to pregnant women in flu shots. Furthermore, CDC’s current autism numbers are for children born in 2002, when kids were still getting thimerosal in their pediatric vaccines. The best science suggests that thimerosal’s complete removal from vaccines is likely to prompt a significant decline in autism. For example, a 2013 CDC study in JAMA Pediatrics shows a 33% drop in autism spectrum disorder in Denmark following the 1992 removal of thimerosal from Danish vaccines. That paper is among 37 peer-reviewed studies linking thimerosal to the autism epidemic.
Thimerosal has precipitated a journalistic as well as a public health crisis. Big Pharma pumps over $3.5 billion annually into TV, newspapers, and other advertising, targeting news departments, which have become vehicles for pharmaceutical sales and propa- ganda platforms for the industry. Television and print outlets feature spokespeople like Dr. Offit—without identifying their industry ties— while censoring criticisms of vaccine safety andexcluding the voices of informed vaccine safety advocates. Busy journalists parrot the deceptive talking points dispensed by government and pharma officials rather than reading the science themselves. Unable to argue the science, they bully, pillory, and demonize vaccine safety advocates as “anti-vax,” “anti-science,” and far worse. The unwillingness of the press to scrutinize CDC has emboldened both industry and agency to follow the lowest paths of easy profit and bureaucratic preservation.
The measles scare was classic disaster capitalism, with media outlets dutifully stoking public hysteria on editorial pages and throughout the 24-hour broadcast cycle. With Dr. Offit leading the charge, CDC, drug makers, and industry-funded front groups parlayed a garden variety annual measles outbreak into a national tidal wave of state legislation to ban religious and philosophical vaccine exemptions. The national media frenzy over 159 measles cases left little room for attention to the the autism cataclysm which has debilitated 1 million American children since the pandemic began in 1989, with 27,000 new cases annually. CDC refuses to call autism an “epidemic.” In defiance of hard science, and common sense, CDC and Offit have launched a denial campaign to gull reporters into believing the autism plague is an illusion created by better diagnosis.
Big Pharma is among the nation’s largest political donors, giving $31 million last year to national political candidates.  It spends more on political lobbying than any other industry, $3.0 billion from 1998 to 2014—double the amount spent by oil and gas and four times as much as defense and aerospace lobbyists. By February, state legislators in 36 states were pushing through over one hundred new laws to end philosophical and religious vaccine exemptions. Many of those state lawmakers are also on the industry payroll. You can see how much money bill sponsors from your state took from Big Pharma on
Normally plaintiffs’ tort lawyers would provide a powerful check and balance to keep vaccines safe and effective and regulators and policymakers honest. But Pharma’s dirty money has bought the industry immunity from lawsuits for vaccine injury no matter how dangerous the product. An obliging Congress disposed of the Seventh Amendment right to jury trial, making it impossible for vaccine-injured plaintiffs to sue pharmaceutical companies for selling unsafe vaccines. That’s right! No Class Actions. No discovery. No depositions and little financial incentive for the industry to make vaccines safer.
Vaccine industry money has neutralized virtually all of the checks and balances that once stood between a rapacious pharmaceutical industry and our children. With the re- search, regulatory, and policymaking agencies captured, the courts closed to the public, the lawyers disarmed, the politicians on retainer and the media subverted, there is no one left to stand between a greedy industry and vulnerable children, except parents. Now Big Pharma’s game plan is to remove parental informed consent rights from that equation and force vaccine hesitant parents to inject their children with potentially risky vaccines that the Supreme Court has called “unavoidably unsafe.”
Ending exemptions is premature until we have a functioning regulatory agency and a transparent process. The best way to insure full vaccine coverage is for the vaccine program to win back public trust by ending its corrupt financial ties with a profit-making industry.
To educate yourselves about CDC corruption and the truth about vaccine science, I hope you will read Thimerosal: Let the Science Speak and download the important movie Trace Amounts43 and insist your legislators watch it before voting on any of these bills.
—Robert F. Kennedy, Jr.

Why The American Press Does Not Want You To Read this Article
My manifesto (printed below) ran in USA Today as a full-page ad in the weekend issue April 24-26.  The broadside is partially a jeremiad on press suppression of the thimerosal issue – the debate that CBS reporter Sharyl Atkinson calls “the most censored and misreported story”of the century. Ironically, my manifesto had already run afoul the Kafkaesque industry taboo that one national reporter has characterized as “a borglike impenetrable cocoon” Before we ran it as a full-page ad, opinion editors at virtually all of the nation’s leading papers rejected a shorter version of the same article.  
read more >
“Why is everyone lined up against you?”
RFK, JR on Bill Maher (04/24/15)
Vaccine Courts Trampling Justice and Public Health
“In Suits at common law, where the value in controversy shall exceed twenty dollars, the right of trial by jury shall be preserved.”
In 2005, Robert F. Kennedy, Jr. wrote an article that was co-published by Rolling Stone magazine and about the connection between the vaccine preservative thimerosal and the autism epidemic. After several revisions to the article and nearly 6 years after the original publication date, retracted the article from its website archives without consideration or opportunity for rebuttal. Below is the full corrected article, a link to Salon’s retraction and the real reason behind it, as well an email delivered to Robert F. Kennedy Jr. by David Talbot, the founder and former editor-in-chief of
Deadly Immunity article – Rolling Stone 2005
The full Rolling Stone version including all of the corrections

Friday, January 20, 2017

Most Physicians Overestimate Treatment Benefits, Underestimate Harms/ Medscape

An interesting study, published in JAMA Internal Medicine, was discussed yesterday on Medscape.  Unsurprisingly, it appears we doctors overestimate the benefit of what we do, and underestimate the risk--by a lot.

"Clinicians are likely to underestimate harms and overestimate benefits of tests and treatments, according to the results of a review of 48 studies published online January 9 in JAMA Internal Medicine. 
"[P]atients cannot be assisted to make informed decisions if clinicians themselves do not have accurate expectations of intervention benefits and harms," write study authors Tammy Hoffman, PhD, and Chris Del Mar, MD, from the Centre for Research in Evidence-Based Practice at Bond University in Queensland, Australia. 
The review showed that the majority of clinicians correctly estimated harms only 13% of the time, and benefits only 11% of the time. Previous studies on patient expectations show that they, too, overestimate benefits and underestimate harms of many aspects of their care. 
The clinicians' estimates varied widely across specialties and treatments. For example, more than 90% overestimated hormone replacement therapy's ability to reduce the risk for hip fracture, whereas more than 90% underestimated the risk for fatal cancer from bone scans..."

Thursday, January 19, 2017

Why is the Deep State Fighting So Hard Against Trump? His treatment of women, Mexicans, Muslims is the last thing they care about

From Mike Whitney at Counterpunch, what we all should consider, as we seek to understand the craziness of the last several months : 
"Trump wants to fundamentally change Washington’s  approach to policy, that is, he wants to abandon the destabilizing wars and regime change operations that have characterized US policy in the past and work collaboratively with countries like Russia that have a mutual interest in establishing regional security and fighting terrorism.
This has not been warmly received in Washington, in fact, Trump’s recommendations have triggered a firestorm among elites who now believe that he is a serious threat to their interests. Recent attacks in the media and preemptive provocations with Russia, suggest that an effort to remove the new president from office is already underway. We expect that these attacks will only intensify in the weeks ahead. Here’s an excerpt from the speech Trump delivered in Cincinnati on December 1 that is the source of the controversy: 
“We will pursue a new foreign policy that finally learns from the mistakes of the past…We will stop looking to topple regimes and overthrow governments…. Our goal is stability not chaos, because we want to rebuild our country [the United States]… We will partner with any nation that is willing to join us in the effort to defeat ISIS and radical Islamic terrorism …In our dealings with other countries, we will seek shared interests wherever possible and pursue a new era of peace, understanding, and good will.” 
None of the major media published Trump’s comments, and for 'good' reason. The statement is a straightforward repudiation of the last 70 years of US foreign policy during which time the United States has either overthrown or attempted to overthrow 57  foreign governments according to author William Blum. Removing governments that refuse to follow Washington’s diktats has been a mainstay of US foreign policy for the better part of the last century. Regime change is what we do. And while GOP administrations have relied more on direct military power (Re: Afghanistan, Iraq) as opposed to the more covert operations (proxy-wars –Syria, Ukraine, Libya) preferred by the Democrats,  both parties fully support the violent and illegal ousting of foreign leaders provided Washington’s geopolitical objectives are achieved. 
Trump has charted a different course altogether, which is why the media, the Intelligence Community, the political establishment and the deep state puppet-masters who operate behind the curtain,  have abandoned all restraint and are doing whatever they can to delegitimize him, back him into a corner and potentially remove him from office. .."

Wednesday, January 11, 2017

Trump is saying/doing some great, important things, and people aren't getting it

I don't understand why many people are still upset about Donald Trump's election victory. The movement to keep all things Trump stirred up is unprecedented. The only conclusion I can draw is that many Americans have gotten lost in the jungle of identity politics that was created by and for the Hillary campaign, and are unable to see the Trump woods for the trees. Don't forget that Hillary and her team may have to face serious judicial music under Trump, and creating a post-election storm of disinfo and vitriol seems their only post-election Plan B.

Instead, forget about what Trump may have said, and look at what he is doing.  Remember the last 8 years. When you examine what Obama said while he was campaigning, it sounded wonderful, but he failed to follow through on those campaign promises. Did the media hold his feet to the fire?  Did they try to take him down with fake news?  

Remember that the candidates are acting and only telling us what they think we need to hear to elect them. The mainstream media's focus on words, to the exclusion of deeds, is deliberate. Don't be fooled.

Look at some big positives for Mr. Trump, positives that would have been inconceivable in a Hillary presidency.

1. Trump actually has the establishment freaked out.  The establishment has been worsening things for the 99% for a long time -- and so i.m.h.o. freaking them out is a very good sign.  We don't know where this is going to go, but the establishment hysteria has proved itself real, which tells us that Trump does intend to change things.  I say give him a chance, and I say Bravo!

2.  He is appointing billionaires to some Cabinet posts.  Well, one thing you can say about billionaires is that they have no need to steal from the rest of us. While this doesn't mean they will be great Secretaries, it removes one strike against them that Hillary, and presumably her people, had: she used her position to steal, and had long-honed knowledge of how to do so.  (More on that below.)

3.  He says we should have lower drug prices and they should be negotiated.  Well, that's a no brainer. Did Obama, the healthcare Prez, do anything about that?  Bernie Sanders just backed Trump up on this.  Update:  thirteen Democrats in the Senate just voted down cheaper medications.

4.  Trump says we need to look into vaccine safety.  Of course we need the safest vaccines we can get. Why would this be controversial? Only because the drug/vaccine industry has bought the media, politicians and federal agencies, do we hear it's controversial, when it clearly is not.

How many television commercials advertise drugs?  Pharma owns TV.  How many Pharma lobbyists are there for each member of Congress?  Three: a lobbyist army to be reckoned with.

The federal government has paid out $3.5 billion dollars' compensation for vaccine injuries. The chorus of 'medical authorities' who are having a cow over Trump's questioning vaccine safety choose to ignore the facts. Where does their media-anointed 'authority" come from, we should ask.  Are their remarks thoughtful and well-informed, or designed to shut down discussion of something important to us all, the safety of what gets injected into ourselves and our families, often as a result of government mandates. Especially when the manufacturers have no legal liability for the end product.

Vaccines are a highly diverse group of substances, and their safety and effectiveness vary considerably between products and brands; due to the age, nutritional status, and genetics of the person being inoculated; and to the integrity of the manufacturing process.  These are well-established facts. Every vaccine is relatively safe and relatively effective.  If they were all 100% safe you wouldn't use doctors to prescribe them. Instead, you could buy them in bubble gum machines.

In fact, CDC emphasizes the importance of maintaining an "active and ongoing vaccine safety program" in its #1 vaccine reference book, the Pink Book:
"The Importance of Vaccine Safety Programs
Vaccination is among the most significant public health success stories of all time. However, like any pharmaceutical product, no vaccine is completely safe or completely effective. While almost all known vaccine adverse events are minor and self-limited, some vaccines have been associated with very rare but serious health effects. The following key considerations underscore the need for an active and ongoing vaccine safety program..." 
So much for the medical establishment being up in arms because vaccine safety needs to be watched. Everyone but the Pharma-paid media and its carefully selected shills knows it needs to be watched.  The meme that 'investigating vaccine safety is dangerous' is an oxymoron. Why is this called news?

5.  Trump is pissed off at the lying, war-making, fake news-spreading "intelligence" agencies and appears to want to rein them in.  For this we should be immensely grateful, as they have caused so much damage around the world and domestically -- inciting wars we have no business to be in, wars in which the public has no idea why the US is involved.  Not to mention fomenting plots to terrorize at home and abroad. Pretty please, do rein them in.

6.  He wants peace with Russia, while Hillary did her best to antagonize Russia.  Hang up the nukes for the next 4 years: I say that's a very good thing!

Obama said a lot of pretty things, but what did he do?  Got us into more wars, didn't get us out of any. He sold us a pig in a poke 'Affordable Care Act' that many people (mainly those who never had to use it) were conned into thinking was a big improvement over what came before. In fact, Obamacare changed the landscape of health insurance, ushering in an era of higher copays and reduced benefits not only for beneficiaries of the A.C.A., but also for those buying commercial insurance in other markets.

What about Hillary?  Come on, we know who her constituency really is:  they 'donated' billions to her campaign and to her Foundation, and paid her killer fees for speeches.  The Clinton Foundation, starting to unravel, is looking like a pay-to-play scheme that led to the resignation of the New Zealand PM (some of the NZ Herald reportage is no longer accessible) and announcements by Australia and Norway that they will cease funding the Foundation.

Don't people understand yet that her strategy to become President was to foster racial, religious, sexual orientation and gender divisiveness, and then ride in on a white horse to fix the mess she had fed and exploited?  In truth, she represented only the Business and War Party.  Her campaign relied on the politics of gender, religion, sexual orientation and race, because championing them does not cost business anything, and because it allowed her to skirt the much more threatening issue of economic injustice.

Hillary cheated Bernie out of the nomination.  Sixteen years ago, she stole White House gifts and furniture. Were those items loot from pay-to-play when Bill was in office? I suspect she collected on foreign policy decisions made when she was Secretary.  She certainly was the main cheerleader (why?) for the destruction of Libya and Syria, and bears significant responsibility for the current refugee crisis, which she says is bigger than any refugee crisis since the Second World War.

Hillary played us.  Stop being played, the election is over.  Let's see what Mr. Trump can do.

Thursday, January 5, 2017

Here is the EEOC decree on forced HCW flu vaccinations: Hospital must notify employees of their right to a religious exemption, and hospital has no right to judge a religious belief/ EEOC

Below is the EEOC decree on the Erie, PA hospital's flu vaccine mandate from December 23, 2016. Hopefully, this will be the beginning of the end for flu vaccine mandates for healthcare workers.  And also the beginning of the end for financially-motivated flu shots for all patients hospitalized from October to April each year, unless patients insist otherwise.

Remember, influenza vaccines are reformulated, with minimal testing, each year.  In the US, since a Supreme Court decision (Bruesewitz) in 2011, no vaccine manufacturer faces liability for problems with vaccines.  Put simply, when you get a flu shot, its effectiveness and safety are unknown.  There is insufficient incentive for vaccine manufacturers to maximize safety.
Saint Vincent Health Center To Pay $300,000 To Settle EEOC Religious Accommodation Lawsuit 
 January 1, 2017
Hospital Refused To Grant Employees Religious Belief-Based Exemptions From Flu Vaccination Requirement and Instead Fired Them, Federal Agency Charged 
Saint Vincent Health Center will pay $300,000 constituting back pay and compensatory damages to a class of six aggrieved former employees and provide substantial injunctive relief to settle a religious discrimination lawsuit brought by the U.S. Equal Employment Opportunity Commission (EEOC), the federal agency announced. Senior U.S. District Judge Barbara J. Rothstein entered a consent decree on December 23, 2016. EEOC filed the lawsuit, U.S. EEOC v. Saint Vincent Health Center, Civil Action No. 1:16-cv-234, on Sept. 22, 2016, in U.S. District Court for the Western District of Pennsylvania, Erie Division. 
In its lawsuit, EEOC alleged that in October 2013, Saint Vincent Health Center (the Health Center) implemented a mandatory seasonal flu vaccination requirement for its employees unless they were granted an exemption for medical or religious reasons. Under the policy, employees who received an exemption were required to wear a face mask while having patient contact during flu season in lieu of receiving the vaccination. Employees who refused the vaccine but were not granted an exemption by the Health Center were fired, according to EEOC's lawsuit. From October 2013 to January 2014, EEOC alleged, the six employees identified in its complaint requested religious exemptions from the Health Center's flu vaccination requirement based on sincerely held religious beliefs, and the Health Center denied their requests. When the employees continued to refuse the vaccine based on their religious beliefs, the Health Center fired them. According to EEOC's lawsuit, during this same period, the Health Center granted fourteen (14) vaccination exemption requests based on medical reasons while denying all religion-based exemption requests. 
In addition to requiring monetary relief and offers of reinstatement for the six employees, the consent decree contains multiple injunctive components. Under the decree, if the Health Center chooses to require employee influenza vaccination as a condition of employment, it must grant exemptions from that requirement to all employees with sincerely held religious beliefs who request exemption from the vaccination on religious grounds unless such exemption poses an undue hardship on the Health Center's operations, and it must also notify employees of their right to request religious exemption and establish appropriate procedures for considering any such accommodation requests. The decree also requires that when considering requests for religious accommodation, the Health Center must adhere to the definition of "religion" established by Title VII and controlling federal court decisions, a definition that forbids employers from rejecting accommodation requests based on their disagreement with an employee's belief; their opinion that the belief is unfounded, illogical, or inconsistent in some way; or their conclusion that an employee's belief is not an official tenet or endorsed teaching of any particular religion or denomination. The decree further requires that the Health Center provide training regarding Title VII reasonable accommodation to its key personnel and that it maintain reasonable accommodation policies and accommodation request procedures that reflect Title VII requirements. 
"While Title VII does not prohibit health care employers from adopting seasonal flu vaccination requirements for their workers, those requirements, like any other employment rules, are subject to the employer's Title VII duty to provide reasonable accommodation for religion," said Philadelphia District regional attorney, Debra M. Lawrence.  "In that context, reasonable accommodation means granting religious exemptions to employees with sincerely held religious beliefs against vaccination when such exemptions do not create an undue hardship on the employer's operations.  We are pleased that Saint Vincent Health Center worked cooperatively with EEOC to reach an early, reasonable resolution of this case." 
© Copyright U.S. Equal Employment Opportunity Commission

National Law Review discussion of mandatory flu shots for HCW: the NLR assumes the shots help patients (while the evidence says they do not) religious beliefs trump hospital policy on mandatory shots, per EEOC

Will Requiring Flu Vaccinations Leave Employers Feeling Under the Weather?
Wednesday, January 4, 2017
With flu season quickly approaching, health care employers may be considering mandatory influenza vaccinations for their workforce. Mandatory vaccination policies may dramatically increase patient safety, but they may also cause friction within the workforce when employees object on religious grounds to being vaccinated.
While no federal and few state statutes address the legality of enforcing mandatory vaccination policies, the EEOC and private litigants recently have moved this issue forward in the courts. Under Title VII of the Civil Rights Act of 1964 (“Title VII”), employees with sincerely held religious beliefs are entitled to a reasonable accommodation of those beliefs, provided that such accommodation does not create an undue hardship for their employer. This year, the EEOC has filed at least three separate lawsuits against hospitals in Pennsylvania, Massachusetts, and North Carolina alleging failure to accommodate religious beliefs in relation to such hospitals’ respective mandatory influenza vaccination policies.[1]These lawsuits follow shortly on the heels of a decision in the District Court of Massachusetts, granting summary judgment in favor of a hospital employer that terminated an employee who refused a mandatory flu vaccination because of her religious beliefs. In Robinson v. Children’s Hospital Boston, Civ. No. 14-10263 (D. Mass. Apr. 5, 2016), the defendant hospital implemented a policy requiring all persons who worked in or accessed patient care areas to be vaccinated against the flu to ensure the safest possible environment and highest possible care for its patients.
The plaintiff, one of the first hospital employees to interact with patients as they entered the emergency room, refused the flu vaccination for religious reasons and was permitted by the hospital to explore whether there was another internal position outside of patient care that would exempt her from the flu vaccine. The court concluded that the hospital’s efforts to locate another position for the plaintiff—including allowing her to use earned time off to search for employment elsewhere—and to label her termination a voluntary resignation to preserve her ability to re-apply for other hospital positions in the future, constituted a reasonable accommodation under Title VII.
The court also concluded that granting the plaintiff’s request not to be vaccinated would have caused the hospital an undue hardship because it would have increased the risk of transmitting influenza to the hospital’s already vulnerable patient population. The admissible evidence led the court to find that (i) health care employees are at a high risk for influenza exposure, which can be fatal to vulnerable patients; (ii) numerous medical organizations support mandatory influenza vaccination for health care workers; and (iii) the medical evidence in the record demonstrated that a vaccination is the single most effective way to prevent the transmission of the flu.
While the hospital’s policy in Robinson only covered patient-facing employees, health care employers with flu vaccination policies impacting all employees should be aware that they will be subject to heightened scrutiny by regulators such as the EEOC. For instance, in EEOC v. Baystate Medical Inc., Civ. No. 3:16-cv-30086 (D. Mass. June 2, 2016), Baystate’s policy required employees who refused the flu vaccination to wear a surgical mask at all times while working at the hospital’s facilities. The employee in question worked in human resources, had no patient contact, and argued that it was not reasonable for her to wear the mask because people complained that they could not understand what she was saying. Following several occasions in which the employee pulled the mask down away from her mouth so that people could understand her, the plaintiff was discharged for violating Baystate’s policy. While the facts have yet to be developed, these allegations were sufficient to prompt the EEOC to file suit.
Other courts addressing religious discrimination claims in this context also have indicated the importance of the employee’s interaction with patients in determining whether and to what extent a mandatory vaccination policy may be enforced. In Chenzira v. Cincinnati Children’s Hosp. Med. Ctr., Civ. No. 1:11-cv-00917 (S.D. Ohio Dec. 27, 2012), the plaintiff-employee alleged that her adherence to veganism prohibited her from receiving a flu shot. On a motion to dismiss, the court allowed a religious discrimination claim to proceed, finding that the plaintiff could subscribe to veganism with a sincerity equating to that of sincerely held religious views. Notably, the court made a point of stating that the decision did not address the safety of patients at the hospital, which was the hospital’s presumed justification for terminating the plaintiff. The court signaled that it would consider this justification in light of what, if any, contact the plaintiff had with patients, and/or what sort of risk her refusal to receive a vaccination could pose in the context of her employment. (The case later settled.)
Employers looking for additional guidance as to whether and to what extent they must accommodate an employee’s refusal be vaccinated against seasonal influenza also should look to any state or local laws that may impact their ability to mandate flu vaccinations. For instance, a New York statute requires people to be vaccinated if they are affiliated with or employed by a health care facility and who engage in activities that could potentially expose patients to influenza.[2] Those who decline the flu shot during flu season must wear a surgical mask while in areas where patients are normally present. The statute also requires health care facilities to supply such masks to personnel free of charge.
TakeawaysParticularly given the implications to patient safety, health care employers are well within their rights to implement a mandatory flu vaccination policy. Nonetheless, employers should be prepared to address requests for reasonable accommodation made by employees who decline a vaccination because of sincerely held religious beliefs. In those circumstances, employers should engage in the interactive process, with the following considerations in mind:
Consider the nature of the employee’s position, as you may have more difficulty in enforcing the policy against employees who do not routinely interact with patients. Courts are more likely to require an alternative accommodation for employees in non-patient-facing roles.
Determine whether the employee can be accommodated by wearing a surgical mask or by temporarily or permanently transferring that employee to another position that does not implicate patient safety.
Ensure that any refusal to be vaccinated originates from a sincerely held religious belief, but be aware that challenges to a sincerely held belief have been heavily scrutinized by the courts.