COEUR d'ALENE - A new mandatory vaccine policy at Kootenai Health may cost the hospital a few employees, but officials believe it's necessary to protect public health.

"If there is a flu epidemic and the staff gets the flu, then we wouldn't be able to take care of the community," said Kim Anderson, spokesperson for Kootenai Health.

Anderson said Kootenai Health established the policy last year, and modified it this year to say that unless someone is allergic to the flu vaccine, it is mandatory for all employees, vendors and doctors.

"As health care providers, we are morally obligated to take precautions needed to prevent the spread of viruses like influenza," she said.

The policy was established based on a recommendation from the Centers for Disease Control, and the number of employees vaccinated is reported to the Centers for Medicare and Medicaid Services.

"But there is no money tied to it," Anderson said, adding it is not a requirement of the Affordable Care Act, commonly referred to as "Obamacare."

Employees who decide against being vaccinated will be terminated, according to Thomas Madison, a critical care nurse at the hospital for more than 25 years.

"I assume Nov. 7 will be my last day of work there," Madison said, adding he has already found another job if he is fired by Kootenai Health.

In the past, Madison said, employees who didn't want to take the vaccine had an option to wear a face mask to prevent the spread of the virus.

"About five years ago we went through an H1N1 flu epidemic. I worked with many of the flu patients and never came down with the flu," he said. "I do know others who took the shot and became very, very ill."

Madison takes his health seriously and he doesn't feel it is fair to force someone to take what he believes to be an unnecessary health risk. He said he has enjoyed working for the hospital and considers Kootenai Health a good employer, but he just can't bring himself to take the shot.

He has penned a three-page paper explaining how he believes the flu vaccine is being pushed by major pharmaceutical companies, and offers very little benefit to otherwise healthy people.

Dr. David Souvenir, an infectious disease specialist at Kootenai Health, said in his opinion, any potential risks associated with the flu vaccine are far surpassed by the potential benefits. There are documented cases of health care workers spreading influenza in the workplace, he said.

Anderson said making the vaccines mandatory doesn't prevent that from happening with 100 percent certainty, but it is the best potential Kootenai Health has to prevent the spread of the virus and its complications.

"We do know that the flu is the No. 1 cause of vaccine-preventable death," she said. "And patient safety always needs to be our top priority."

Madison maintains that even if he did get the flu shot, it is only effective 9 percent of the time for people in his age group.

Souvenir said the latest study indicates flu shots are effective 10 percent of the time with the old vaccine, but there is a higher dose vaccination available this year, which may prove to be more effective in the 65-plus age group.

Souvenir said the vaccine works by creating an increase in antibodies in the body. It takes about two weeks to build up the acceptable levels needed to protect the patient from the flu virus.

"You can have some symptoms during that period," he said, adding that the symptoms such as sore muscles and low level fevers can lead people to believe they are contracting the flu, but it's not the flu unless the patient contracted the virus in some other way.

He said the usually mild side effects can last as long as 48 hours after inoculation.

"You cannot contract the flu from the vaccine. It's not possible because it is an inactivated virus," he said. "I hear this all of the time, but it's not even a possibility."

However, Souvenir said a person can still catch the flu for a number of different reasons but mainly because the strain of the virus is subject to change from year to year.

The vaccine is always made to protect against the strain of flu from the previous year, but may not prevent a new strain.

"It is the best we can offer for what we know," he said, explaining there is no way to anticipate how the virus is going to change in the future.

As for the vaccine being less effective on the senior population, Souvenir explained that the antibody response in older people is decreased significantly. That is why the high dose vaccine was introduced this flu season. The side effects are the same, Souvenir said.

However, there are some people who are allergic to the vaccine, and those who can show medical documentation of that allergy are exempt from the hospital's new policy.

There are also some very rare side effects which have been associated with the vaccine, but not necessarily caused by the vaccine.

Souvenir said one is called Guillain-Barre syndrome, a rare disorder in which your body's immune system attacks your nerves.

The other is Parsonage-Turner Syndrome, a rare syndrome which begins with sudden, abrupt shoulder pain which may begin rather insidiously but quickly amplifies in severity and intensity.

Souvenir said those syndromes can be contracted by other means, but they are reported as a possible side effect to the flu vaccine if a patient experiences them less than six weeks after inoculation.

"These are extremely rare cases," Souvenir emphasized.

He said the benefits of vaccination are obvious. Vaccines prevent catching influenza, reduce the risk of hospitalization and can prevent death from flu complications.

"Patients with other health problems can complicate things by contracting the flu," he said, adding there are a number of professional medical associations which support the use of the vaccine.

Anderson said there is still vaccine available at Panhandle Health District and other vendors in the area.