The August 15 Federal Register announced the federal government’s proposed regulation to withhold Medicare payments from long-term care facilities that do not provide (offer and recommend) flu and pneumonia vaccines to nursing-home residents.

According to the U.S. Department of Health and Human Services (HHS), approximately 2 million people reside in nursing homes (long-term care facilities). An estimated 74 percent are vaccinated against flu. HHS’s goal is 90 percent.

The proposed rule, however, states, “The resident or the resident's legal representative must be provided the opportunity to refuse immunization. If the resident or the resident's legal representative refuses immunization, the facility must ensure the resident or the resident's legal representative receives appropriate education and consultation regarding the benefits of influenza immunization.” (Emphasis added.)

HHS continues, “[W]e believe it vital that facilities secure the consent of their residents or legal representative for vaccination and provide their residents with vaccinations.” However, a clear, concise right respecting written informed consent is not delineated in the proposed rule. HHS should clarify its support for written informed consent. No senior (or other citizen) should be coercively vaccinated or treated. Seniors should be informed of their right to refuse vaccination, and the written consent form should specify not only the purported benefits, but also the risks of any treatment.

Coercion conflicts with freedom, whether it’s direct or indirect (the latter including not being fully informed about one’s right to refuse vaccination). Consent is a precious ethic that must always be upheld in the United States and worldwide.

Concerned citizens should submit their public comments to HHS by 5 p.m. Tuesday, August 30, 2005. Submit comments:

Electronically: http://www.cms.hhs.gov/regulations/ecomments (attachments should be in Microsoft Word, WordPerfect, or Excel; Microsoft Word is preferred)

Regular mail: Send one original and two copies to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-3198-P, P.O. Box 8010, Baltimore, MD 21244-8010. HHS says to allow sufficient time for mailed comments to be received before the close of the comment period.

Express or overnight mail: Send one original and two copies to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-3198-P, Mail Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850.

For further information contact: Anita Panicker (410) 786-5646, Jeannie Miller (410) 786-3164 or Rachael Weinstein (410) 786-6775.

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