• Mon, Dec 23 - 4:00 pm ET

Pregnant Nurse Wrongfully Fired For Refusing Flu Shot Because Of Miscarriage Concerns

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Dreonna Breton, a pregnant nurse in Pennsylvania, recently lost her job because she refused to get a flu shot. Breton, who is pregnant with her second child, did her research on the pros and cons of flu shots (including the one mandated by her employer, Fluzone) and ultimately decided against one. But her employer, Horizon Health Services, found her decision to be grounds for termination. Breton said:

“It would be a false statement to say the flu vaccine is known to be safe during pregnancy. I have lost my job, one that I love and am good at, because I chose to do what I believe is best for my baby.”

Breton says she asked for an exemption to the healthcare system’s mandatory flu shot policy, but was denied. She also says that she offered to wear a mask while at work, something some other health care organizations allow for employees who decline flu shots, but was also denied.

This is Breton’s fourth pregnancy; She’s had two miscarriages in the past and she says that risk of miscarriage contributed to her decision to forego the shot. She supplied a note to her employer explaining her history of miscarriage as a reason for why she wanted to decline the shot. Breton’s midwife wrote, ”€œIn my view getting the flu shot would significantly and negatively impact her health because of the increased fear and anxiety it would create as well as the emotional impact it could cause if she does miscarry again.” But apparently the note was deemed inappropriate for grounds for exemption because it was from a midwife rather than a doctor. Local doctors in Breton’s area, including, apparently, the doctors who are responsible for making the decisions on who gets exemptions or not, say it’s much more dangerous for Breton and her baby to risk getting the flu while pregnant.

While the CDC recommends it for all pregnant people, concerns remain, mainly because pregnant women were not included in the original clinical studies involving flu vaccines. Even Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy has spoken out against the shot’s efficacy and popularity. The shot that Breton was required to receive, Fluzone, specifically states in its patient information that its “safety and effectiveness […] have not been established in pregnant women.”

I don’t know enough about pregnancy and flu shots to have a strong opinion one way or the other, but I must say I’m inclined to side with Breton on this one. It’s her body and her baby, after all. I understand why health care professionals are required to get flu shots, but why was the pregnant Breton denied an exemption in this case? After all, the warning about that particular flu shot and pregnant woman is right there in the literature provided by the manufacturer. Of course, that doesn’t mean a pregnant woman who does get a flu shot will suffer any adverse affects, but to me, Breton’s concerns sound reasonable enough for an exception to be made in her case.

Breton said she’s not against vaccines or even flu vaccines, but that she felt that her objections were enough to risk her job:

“I’m certainly not against it for everyone. The elderly and sick children, for people with weak immune systems, getting the flu can be a big deal. But for the healthy population, the flu is the flu and it’s been around a long time. If other pregnant women want to get it that is fine as well but I don’t want it for myself and I feel I have very valid questions. I would rather risk getting the flu than risk the unknowns of getting the flu vaccine.”

Photo: webphotographeer/Getty Images

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  • EX

    I guess I understand her concern about getting the flu shot (although, full disclosure, I got the flu shot during both my pregnancies) but she knew her employer’s policy and did not get the doctor’s note needed for an exemption so, it’s a little hard for me to get outraged over this one…

    • JLH1986

      Exactly. The Dr.’s note she got stated something about it would cause her anxiety. Not as her medical doctor I wouldn’t recommend her getting the shot. Which I think would have given her employer what they needed to be protected from liability. Which is ultimately what this was about. Working with immune compromised patients her employer said these are the rules. I can understand that. While I think it stinks she was asked to leave, she knew the score, she failed to get the appropriate doctor’s note. I hope she finds a new job soon, but I can’t fault the old job for this.

  • keelhaulrose

    I understand why she chose not to get one, and I feel it’s completely within her rights to refuse for her and her baby’s health.
    However, as we saw recently with the Phil Robertson scandal, employers have contracts that employees agree to and sign. Go against your contact, your job is in jeopardy and you can and will get fired. I worked in a group home. After I was hired there was a mandatory TB test. No exceptions. One girl who was hired with me didn’t want to get one, she was let go before ever stepping foot in the home. When you’re working with immuno compromised people your employer doesn’t play around.

  • Kay_Sue

    I don’t really understand why she didn’t go to a doctor to get another note if she feels this strongly about it. Maybe her employer didn’t give her the option, I guess, but if she had the option, that seemed like one thing that should have been tried too.

    Other than that, I do think her employer should have looked into precautions offered by other healthcare systems for folks that can’t get the vaccine. For instance, do they have precautions for folks that can’t get the vaccine due to allergies? I don’t understand why they didn’t take that into account, unless the only reason was because she did not have a doctor’s note.

    • elle

      So if you click over to the Daily Mail article that is linked it makes me think that quite possibly while writing the article Cary Murphy got confused on some of the details. What happened is that she got a note from her midwife and they didn’t accept it because it wasn’t from an MD and the note she got from the MD is the note written in the article that the company wouldn’t accept because it gave no specific medical reason. So she did get two, and I am really wondering if maybe she couldn’t find a doctor willing to cite a specific medical issue as to why she shouldn’t get it and that’s why she didn’t get a third? Again just me wondering, also no disrespect to Cary, that paragraph is kinda confusingly written.

  • Bethany Ramos

    I will say this, a midwife’s note got me out of jury duty. Yippee!

  • Sara610

    Are there other flu shots that have been shown to be safe for pregnant women? If so, could she have had one of those instead?

    Regardless, she knew the requirements and regulations when she decided on this line of work. Yes, it’s her right to refuse to get vaccinated, but her employer does not have to enable her in that decision at the risk of her patients’ health.

  • Coppie

    I gotta say, I side with the employer on this one. Flu shots have been proven to reduce flu rates in the hospital. As someone who works in hospital administration at a place where flu shots are required, I wouldn’t buy note either- but because we require a life-threatening allergy, not “potential stress.”

  • Mel

    I’m gonna have to side with the employer here. I’m sympathetic to her, but using what I consider to be more “junk science” (take that claim as you will, since I’m admittedly not a scientist) as a reason to put her patients at risk just so she can avoid stress is just not okay with me.

  • Momma425

    While the regular fluzone isn’t appropriate for a pregnant patient, we give the preservative free one to pregnant patients at the clinic all the time without a problem.

    I don’t understand why her work didn’t tell her that she needed to get a doctor’s note instead of the midwife note. I’m sure her midwife could have referred her to an OB/GYN who would have excused her.

    • SarahJesness

      Many vaccines that say “may be unsafe for pregnancies” only say that because the vaccine hasn’t been tested on pregnant woman. After all, it’s difficult to get pregnant women to sign up for clinical trials. Who would want to take that risk? So it’s put there as a liability thing.

  • Mama

    When did Mommyish become an anti flu vaccine blog? You’re spreading inaccurate information that is wholly out of context.

    • Carolina

      Ha, I should have read down one comment before commenting.

  • Carolina

    Why is this blog turning anti-vax? Isn’t there enough of that polluting the interwebs?

    • rrlo

      I am extremely pro-vax (having grown up in a third world country where I saw kids with polio and other vaccine preventable diseases). I had the flu shot with my first pregnancy and intend to get one with my current pregnancy too.

      However, I do believe that always questioning and demanding safer vaccines is not a bad thing. It shouldn’t be all or nothing.

      Nothing is risk free – not even vaccines (http://www.ctvnews.ca/w5/narcolepsy-w5-fact-file-1.1524679) – for example this article talks about possible narcolepsy links with the H1N1 vaccine.

      Also, pregnant women are constantly told that completely mundane things like cheese and eggs can cause a miscarriage. I can see how someone already terrified of a miscarriage would be hesitant to inject themselves with a vaccine that no one will *guarantee* will not be harmful to the baby.

      For instance, when I went for the flu shot, I informed the pharmacist of my pregnancy and she said “we will give you the preservative free one. It is safer during pregnancy.” “Safer” is not a good word to hear during pregnancy… because it still implies some danger. I still went ahead with the flu shot of course because I did not want the flu while I was pregnant.

    • NYCNanny

      Carolina- this blog is SUPER pro-vax and pretty much everything that goes along with that. Read any of the comments… everyone loves vaccines.

  • yeppers

    How is it “wrongful” termination as the title suggests? I have known two people in healthcare that were fired due to refusing immunizations. This individual works around people she could infect and possibly kill if she was to pick up the virus. Her employer was within their rights to terminate her.

  • SusannahJoy

    When I was pregnant I was just told that I had to get a specific flu shot, and couldn’t do the nose one. Mandatory shots are kinda tricky, because obviously we want people to have autonomy over what goes in their body, but when you work in the medical field you have to sacrifice some of that. They don’t require flu shots because they’re just so much fun to give out, they require them because then the immune system comprised patients are less likely to get very, very ill.

  • SarahJesness

    I disagree that the firing was wrong. She didn’t have a doctor’s note saying that the vaccine would be harmful to her. She’s a nurse, and I assume regularly works with the sick and the elderly. People for whom the flu would be much more serious for. This is not something that hospitals take lightly.

  • Richard Gray

    Wow. Talk about the pot calling the kettle black. For a group of enlightened people, most of you are spreading your own brand of misinformation, anecdotal evidence, and superstitions. Just because a clinic has been giving pregnant women the flu shot doesn’t make it safe. Thousands of retailers sell cigarettes, and every year people die from smoking them.

    Do flu vaccinations reduce the risk of contracting the flu in healthcare settings? This study by the University of Minnesota could find little evidence that it does: http://www.cidrap.umn.edu/news-perspective/2013/09/analysis-finds-limited-evidence-hcw-flu-vaccination

    So, do hospitals take the flu lightly? You tell me. This researcher says that physical barriers, such as masks, are much more effective: http://content.time.com/time/health/article/0,8599,1967306,00.html
    Why aren’t they mandatory? It is much less invasive to wear a mask than to undergo a medical procedure that has death as a possible side effect.

    rrlo, getting a flu shot does not mean you will not get the flu, whether you want to get the flu or not. 1.9% vaccinated with Flublok still got the flu while only 3.4% without
    any vaccination at all got the flu. So, in the best case scenario it reduces your chances from 2 out of 100 to 3 out of 100. I wouldn’t bet the farm based on
    those odds. See: http://www.flublok.com/PackInsert.pdf. Afluria is another – 2.24% vaccinated with Afluria still got the flu while only 3.87% of unvaccinated people got the flu. Here is the link to the manufacturer’s insert: http://www.merck.com/product/usa/pi_circulars/a/afluria/afluria_pi.pdf. Here is a link to all of the approved influenza vaccines on the market: http://www.cdc.gov/flu/protect/vaccine/vaccines.htm. You can do your own research. Please don’t think that I expect you to take my word for it.

    I have found no flu vaccine that has been clinically tested on pregnant women and found safe. SarahJesness, you are correct when you say it is a risk to sign up for a clinical trial of a vaccine. So, instead of doing an trial with informed participants, doctors are willing to talk their pregnant patients into taking the shot without informed consent – they aren’t usually told that the product hasn’t been tested on pregnant women. Then the doctors are told to report side effects to a pregnancy registration. See the inserts to all of the flu vaccines in use this flu season. Start with Flublok at http://www.flublok.com/PackInsert.pdf.
    Pay special attention to page 6 where it says “…this vaccine should be used during pregnancy only if clearly needed.” They don’t qualify “clearly needed.” However, you are incorrect about liability. Vaccine manufacturers are effectively immune (no pun intended) from liability. In the US they are protected by the National Vaccine Injury Compensation Program. This is effectively a “vaccine court.” All complaints pertaining to vaccines in the US go through this “court.” The court isn’t really a court as we think of such. However, it makes final decisions on any case involving vaccines. Who pays for the court? Each vaccine sold includes a $0.75 tax to fund the court and damages.

    I have provided sound evidence – not anecdotes, personal opinions, superstitions, or the belief that flu vaccines are safe because the government says so. I believe in the
    science behind vaccinations. I just don’t believe that anyone should be forced into any vaccination, especially the less than effective flu vaccination.

    Here’s one for the conspiracy theorists and those who make fun of them alike: Former CDC head lands vaccine job at Merck. Apparently, the director of the CDC, the main cheerleader for flu vaccinations, received a cushy job with vaccine maker Merck. I’m not a conspiracy theorist, but this reeks of conflict of interest. Find the article at: http://www.reuters.com/article/2009/12/21/us-merck-gerberding-idUSTRE5BK2K520091221

    One more thing – even vaccinated people can transmit the flu. In fact, since a vaccinated person’s symptoms may not even be noticeable, they may be more dangerous to an immunocompromised person than an unvaccinated person. At
    least an unvaccinated person with the flu might know that they are infected and
    stay home.