Flu Vaccine Myths and Healthcare Providers

By Elizabeth Sepper

2013 is rife with reports of the terrible human costs of the flu.  Emergency rooms nationwide have been overwhelmed.  Art Caplan’s great blog post urges doctors to educate patients that the flu vaccine is not just for their benefit.  He tells healthcare providers to send a clear message by getting the flu shot themselves.  But what should we do when they refuse?

Flu vaccination of healthcare providers has come a long way.  Before 2009, rates never broke 49%.  Today, almost two-thirds of healthcare providers are vaccinated.

Still, one-third of healthcare providers do not protect themselves, their patients, and the public from influenza.  We remain far short of the national Health People 2020 target of 90%. Do these providers have religious beliefs that raise tricky constitutional and statutory questions?  Do they assert deeply held philosophical objections?  Media accounts suggest so.  We hear of the vegan customer service representative who refuses the flu vaccine because it is grown in chicken eggs, and the religious holistic nurse who objects both to vaccination and to wearing a mask.

But the main reason for going unvaccinated, according to the Centers for Disease Control, is that healthcare providers simply did not want to get vaccinated. Other common reasons: they think flu vaccines don’t work, fear experiencing side effects, or don’t think they will need the vaccine.  Some reasons do not reflect the evidence. Others suggest, as Art Caplan puts it that healthcare staff need to “stop thinking only about themselves.” Continue reading

Conference Announcement: Universal Health Coverage in Low-Income Countries: Ethical Issues

The Harvard University Program in Ethics and Health announces its annual conference, Universal Health Coverage in Low-Income Countries: Ethical Issues, to be held in Boston on April 18-19, 2013.


Until very recently, universal coverage (“UC”) has been achieved in the health systems primarily in the wealthiest countries. Though there have been notable exceptions, including Cuba, it has been assumed that most of the world’s peoples would have to wait until economic development in their countries lifted them into the world’s upper class. The successful UC initiatives of middle-income countries such as Mexico, Thailand, and Taiwan demonstrated that UC was achievable without very high national GDP.

Graphic: Three dimensions

Can Universal Coverage be achieved in even the world’s lowest-income countries? China’s recent health reform, which in three years has extended health coverage to 95% of Chinese citizens, including innovative financing initiatives in some of the poorest provinces, has focused the attention of governments of low-income countries on UC. The World Health Organization’s annual report of 2010, Health Systems Financing: The Path to Universal Coverage, identified the prospects for UC in even the least-developed countries and sparked an international effort to pursue this once-elusive goal.

While maintaining a constructive and optimistic frame of mind is essential for progress toward UC, it is necessary also to identify the key ethical dilemmas arising in trying to extend the health system to all with so few resources. The choices are unavoidable:

  • Between goals of UC (including financial protection against catastrophic medical expenses; health; and personal and national overall wellbeing);
  • Between dimensions of UC (who is covered; what is covered; what share of costs are covered); and
  • Trade-offs within and between each of these

Each country will resolve these dilemmas in its own way. Our hope is that this conference will enhance their capacity for ethical deliberation in UC, so that the ethical choices can be made responsibly and thoughtfully.

Dates and Times

Dates: Thursday and Friday, April 18-19, 2013
Times: 8:00 AM – 6:00 PM Each Day


The Inn at Longwood Medical (Best Western Boston)
Longwood Hall, 342 Longwood Avenue, Boston, Massachusetts




No fee. Space limited. Registration required. Please register on our registration website.