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Record deaths predicted for 2019 flu season puts the morality of vaccination in the spotlight

Called in sick: Forty thousand Australians will contract the flu this year.

EXPERTS predict 4000 Australians will die from influenza in 2019 after an unprecedented start to the flu season claimed 25 lives in Queensland.

The Immunisation Coalition Australia said almost 40,000 laboratory-confirmed cases of influenza had occurred this year, with about 10,000 of those reported in Queensland.

Queensland businesses and organisations, including the Archdiocese of Brisbane, have provided free vaccinations for staff in an attempt to curb the number of flu cases.

Brisbane archdiocese’s Work Health and Safety director Sue Lloyd said there were a number of benefits for companies to immunise staff.

“My view is that workplaces should be supporting programs like this,” Ms Lloyd said.

“I think it’s critically important for the organisation we are in, where we provide a lot of support across parishes and also within Centacare to those who are vulnerable within our community.

“If we talk specifically about the flu vaccinations, we know the flu is a significant health concern for elderly and young vulnerable people in our communities,” she said.  

“Vaccinations work on the fact that you try to get 90-95 per cent of the population vaccinated and that means there is a very small chance for transmission between those who are unvaccinated.

“The five per cent who are unvaccinated are generally unvaccinated because they have underlying health conditions – they can’t have the vaccine because they are already immune-compromised.

“As good corporate citizens we should be providing an opportunity for our staff to get vaccinated so that we can support the community.”

Although companies can’t force staff to get the flu shot, they can advocate for its usage in areas that are considered highrisk for infection.

Centacare work health safety manager Lucy Beikoff said she wanted work places to look at the risk they had. 

“It can be really hard to force someone to have something like that (vaccination), so within Centacare it’s something that is recommended when people are working with vulnerable client groups like small children and the elderly,” she said.

“We want to protect the employees as well, so it goes both ways.”

Queensland Bioethics Centre director Dr David Kirchhoffer said the obligation to immunise was strongest when there was a clear public health benefit. 

“(With) something like polio you would be saying that the vaccination has significant public health benefits, so the obligation to vaccinate is not simply about you not getting sick, it’s about other people not getting sick,” Dr Kirchhoffer said. “In epidemiology you reach a kind of critical mass where there are enough people who aren’t vaccinated that the disease actually starts to spread substantially.

“So, it’s about minimising the number of people that aren’t vaccinated.

“Because vaccinations are made from materials that a person might be highly allergic to, for example, they can’t get vaccinated.

“So the obligation on me to vaccinate myself is stronger – not because there are some people who don’t want to vaccinate, but because there are some people who can’t, and therefore they are at higher risk of contracting the disease.

“In order to ensure that those kinds of people then don’t contract a disease, you have a wider circulation of vaccinations.

“You want to make sure that as many people as possible are vaccinated so that the ones who can’t get vaccinated don’t contract the disease.”

A growing number of people known as “anti-vaxxers”, are choosing not to vaccinate themselves, and in some instances their children either. 

Dr Kirchhoffer said this behaviour could slow down the rate of successful immunisation amongst the general public.

“When you have anti-vaccination, then that number shifts and you have fewer and 

fewer people who are vaccinated.

“That means that not only the people who, by choice are not vaccinating (because they don’t think it’s a problem) but they put other 

people at risk who could contract the disease. 

“A lot of people will say ‘chicken pox didn’t kill me’, or ‘measles didn’t kill me; I had it when I was a child and I’m fine so why should I vaccinate for measles?’

“So, they might say, ‘Sure, I’ll vaccinate for polio because that’s pretty horrid, but measles and chicken pox aren’t very horrid so why are we vaccinating?’

“That’s where the more sophisticated public health arguments have to come into place and say, well it’s not necessarily about whether you might survive or not, the problem is that if an adult contracts one of those and they’re in a vulnerable state it could be deadly for them, so that’s why we vaccinate.

“That’s an argument that has to take people out of a very self-centred view.”

Dr Kirchhoffer said the more people who were vaccinated, the more effective the vaccine became.

It remains unclear as to whether there is an evident moral obligation to get the flu shot. 

In a 2017 document on vaccines, the Pontifical Academy for Life noted a “moral obligation to guarantee the vaccination coverage necessary for the safety of others … especially (for) the safety of more vulnerable subjects such as pregnant women and those affected by immunodeficiency who cannot be vaccinated against these diseases”.

Some people, however, maintain religious or ideological objections to vaccinations, including the flu shot. 

“To say that there is an obligation is probably a bit strong,” Dr Kirchhoffer said.

“To suggest that everybody must be vaccinated for the flu … that would be problematic. 

“The obligation potentially becomes stronger in certain industries. 

“If you were working in aged care, for example, there’s a risk of you passing on the flu to someone who’s immune system is compromised and they’re likely to die if they get the flu, then you should be vaccinated. 

“The level of obligation, if you like, increases in certain industries. 

“You might say that childcare workers and people working in aged care actually have a moral responsibility that is an obligation to get the vaccine so they don’t pass it on to people who are immuno-compromised.

“The public health model is: ‘we don’t want vulnerable people to get sick’. 

“And the vaccination basically protects vulnerable people from sickness and from (becoming) an excessive burden on the health-care system.”

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