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Dreonna Breton of Elizabethtown, a registered nurse, lost her job because she refused to receive an employer-mandated flu shot.

(Submitted photo)

Dreonna Breton got fired because she refused a mandatory flu shot. A registered nurse, she's pregnant and has a history of miscarriage.

Breton says she became alarmed by notifications such as this, contained in the packaging of a popular flu vaccine: "Fluzone should be given to a pregnant woman only if clearly needed."

Similar statements accompany other brands. So do notifications that it's unknown whether flu vaccine can harm an unborn child. Breton says she's had two miscarriages in four pregnancies and refuses to take the chance.

"It would be a false statement to say the flu vaccine is known to be safe during pregnancy," says Breton, 29, of Elizabethtown. "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."

But she faces a rising tide of mandatory flu vaccination policies at health care organizations including hospitals and nursing homes. The intent is to prevent health care workers from spreading the flu to the elderly and others with weakened immune systems who are at high risk of dying from the flu.

Breton is further at odds with conventional wisdom of doctors and public health experts, who say flu vaccine is highly beneficial to most people, and especially beneficial to pregnant women.

"I would say she has a million times greater chance of of having a problem if she gets the disease rather than the vaccine," says Dr. Alan Peterson, the director of environmental and community medicine at Lancaster General Health.

Peterson says pregnancy changes the immune system, and a case of the flu can pose a severe threat to mother and unborn child. That's why organizations such as the U.S. Centers for Disease Control and Prevention and the American Academy of Obstetricians and Gynecologists recommend flu shots for most pregnant women.

Breton worked for Horizon Healthcare Services, which provides drug and nutrition infusion services to patients in their homes. Horizon is co-owned by Lancaster General and several other hospitals, including Harrisburg-based PinnacleHealth System.

Horizon is among the growing number of health care organizations requiring employees to get flu shots, as are Lancaster General and PinnacleHealth.

Breton says she explained her flu shot reservations to her employer, and also provided a doctor's note which described her history of miscarriage. The doctor wrote, "In 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."

Breton says she offered to wear a mask during work. Some health care organizations allow employees who don't receive a flu shot to wear a mask.

Carolyn Carlson, a registered nurse and the president of Horizon, said in an email that requests for exemptions are reviewed by a committee of doctors. She wrote that flu vaccination is a condition of employment because it "protects our patients, employees, and community from getting this potentially serious infection."

Flu causes about 24,000 deaths and 150,000 hospitalizations annually. It's highly contagious and is typically spread when droplets released when an infected person coughs or sneezes reach another person.

The CDC recommends flu shots for health care workers. This includes doctors and nurses as well as staff such as housekeepers, maintenance staff and volunteers.

The CDC estimated 72 percent of health care workers were vaccinated in the 2012-2013 flu season, up from 63.5 percent two years earlier.

The University of Loyola Heath System in Chicago first required employees to get flu shots in 2009, becoming one of the nation's first hospital systems to do so. It recently reported a vaccination rate of nearly 99 percent. It said fewer than 15 employees out of 8,000 chose termination rather than vaccination since 2009.

Such policies typically allow exceptions for religious or medical reasons such as a previous history of allergic reaction to the vaccine.

Breton says she received a flu shot during her first year as a nurse as a result of "peer pressure."

She says she doesn't totally oppose vaccinations. But she says she has "reservations" about some, including the chicken pox vaccine, which she contends haven't been sufficiently researched or aren't critically important.

Breton says she has thoroughly researched flu vaccine and "struggled to find the science behind mandated flu vaccinations."

But Peterson, the Lancaster General physician, says there's substantial research backing up the position that flu shots are beneficial for most people in terms of protecting them from a potentially serious illness, and in minimizing spread of the flu by reducing the number of people who can carry it.

In general, flu shots are recommended for most people older than six months.

Sanofi Pasteur is the maker of Fluzone, one of the brands with a packaging insert stating that the impact on a pregnant woman and her fetus are unknown.

Donna Cary, a spokeswoman, attributed that to the fact that results of clinical studies involving pregnant women weren't included in the research presented decades ago when flu vaccine received government approval.

Because of that, flu vaccine manufacturers can't state that it's safe for pregnant women, she said.

However, there is a registry of negative impacts of flu vaccine, and nothing in that registry has prompted the groups such as the CDC to conclude that flu vaccine poses a danger for pregnant women, she said.

A sampling of flu vaccine policies at Harrisburg area hospitals found that some but not all mandate flu vaccine. PinnacleHealth mandates vaccinations, but allows exceptions for documented medical reasons, such as coming down with Guillian-Barre syndrome following a previous vaccination, or for religious reasons. Those who are exempt must wear a mask when within six feet of patients during flu season. A spokeswoman said no one has been fired or resigned due to the policy.

Carlisle Regional Medical Center has a similar policy, and no one has been fired as a result, a spokeswoman said.

Penn State Milton S. Hershey Medical Center urges employees to get a shot and provides them for free, but doesn't require vaccination. But staffers who haven't been vaccinated must display a sticker on their ID badge and wear a mask when within six feet of patients.