Federal and state health agencies agree workers at the Sunnyview Nursing and Rehabilitation Center should get flu shots. Tom Skinner, spokesman for the Centers for Disease Control & Prevention, said all health care workers should be vaccinated against influenza. “It’s the single most important thing they can do to protect themselves and others,” he said. “The bottom line is health care workers need to get vaccinated.” The union representing the Butler County-owned nursing home’s 200 workers on Sept. 27 filed a grievance over a new policy requiring employees who don’t get flu shots to wear surgical masks while working around residents. SEIU Healthcare, which is a division of the Service Employees International Union, based the grievance on a mandatory policy being a change in working conditions without bargaining. Under the original policy, masks would be required after the state Department of Health identifies the first case of flu in the county. During the grievance process, Sunnyview officials offered a compromise stating that masks would have to be worn only after a high level outbreak is reported by the state. Another compromise on the bargaining table is that masks would only be required while doing resident care as opposed to wearing them in all resident areas. County officials are waiting for the union’s response to the argument for the policy. If the union doesn’t change its stance, the grievance could move to arbitration. Holli Senior, deputy press secretary for the state Department of Health, concurs with Skinner. Senior stated in an e-mail that nursing home workers in particular should be vaccinated annually. “This is especially important for health care workers in long-term care facilities, since the elderly are at the highest risk of any segment of the population for flu-related complications and deaths,” Senior stated. She pointed out elderly people with chronic health conditions, such as those in nursing homes, don’t respond as well to vaccinations. “So they receive added protection when their caregivers are also vaccinated,” Senior stated. According to data referred to in the county’s grievance response, 90 percent of influenza-related deaths are with people ages 65 and older. Deborah Bonn, director of the Nurse Alliance of Pennsylvania, a SEIU Healthcare affiliate, said the union’s stance isn’t to discourage workers from getting flu shots. “We support the flu vaccine,” she said. “However, we feel it should be a voluntary program.” Bonn said workers should be sent home if they’re sick. She stressed Sunnyview should educate workers so they’ll volunteer to be vaccinated. Sue Murray, Sunnyview administrator, said 84 percent of the medical staff already has complied with the policy. Murray said the problem isn’t workers ignoring precautions once they know they’re sick. But she pointed out people don’t exhibit flu symptoms until days after catching the virus. “Our biggest concern is before they know they’re sick, they’re transmitting the flu,” Murray said. “They don’t feel sick at that point.” Pennsylvania isn’t the only state concerned with vaccinating health care workers. Last month, Rhode Island became the first state to mandate seasonal flu shots for medical staff, other workers and volunteers in health care facilities such as hospitals and nursing homes. Colorado and California also are in the process of mandating flu vaccinations for hospital and nursing home employees. Bonn said some workers won’t be able to get the shot for such reasons as allergies. “One hundred percent is unrealistic,” she said about compliance with the policy. Although Bonn expressed support of flu vaccinations, she pointed to a report by the University of Minnesota’s Center for Infectious Disease Research and Policy that found the effectiveness of vaccinations is limited. According to that study, LAIV, or live attenuated influenza virus vaccine, is not effective for people ages 8 to 59. However, Sunnyview doesn’t use LAIVs. Murray said the nursing home instead has mercury-free vaccines. She stressed new vaccinations are formulated each year to keep up with the ever-mutating viruses. According to Senior and Skinner, surgical masks are one measure to take in preventing the spread of illness, not an alternative to being vaccinated. “They are part of standard barrier precautions,” Senior wrote. “However, they are not considered to be a substitute for receiving flu vaccine.” Bonn agreed masks aren’t the answer. She said while the flu is an airborne virus, it can cling to fabric. “Viruses settle out of the air,” she said.