Epidemija koronavirusa (Covid-19 / SARS-Cov2) - dnevne aktuelnosti iz zemlje i sveta

[wwww]

https://apps.who.int/iris/bitstream/handle/10665/340841/WHO-2019-nCoV-Policy-brief-Mandatory-vaccination-2021.1-eng.pdf?sequence=1&isAllowed=y

COVID-19 and mandatory vaccination:
Ethical considerations and caveats
Policy brief
13 April 2021

WHO

 

Background

Spoiler

Vaccines are one of the most effective tools for protecting people against COVID-19. Consequently, with COVID-19 vaccination
under way or on the horizon in many countries, some may be considering whether to make COVID-19 vaccination mandatory in order to increase vaccination rates and achieve public health goals and, if so, under what conditions, for whom and in what contexts.
It is not uncommon for governments and institutions to mandate certain actions or types of behaviour in order to protect the well-
being of individuals or communities. Such policies can be ethically justified, as they may be crucial to protect the health and well-
being of the public. Nevertheless, because policies that mandate an action or behaviour interfere with individual liberty and autonomy, they should seek to balance communal well-being with individual liberties (1). While interfering with individual liberty
does not in itself make a policy intervention unjustified, such policies raise a number of ethical considerations and concerns and
should be justified by advancing another valuable social goal, like protecting public health.
This document does not provide a position that endorses or opposes mandatory COVID-19 vaccination. Rather, it identifies
important ethical considerations and caveats that should be explicitly evaluated and discussed through ethical analysis by
governments and/or institutional policy-makers who may be considering mandates for COVID-19 vaccination.

What does “mandatory vaccination” entail?

Spoiler

Contemporary forms of “mandatory vaccination” compel vaccination by direct or indirect threats of imposing restrictions in cases
of non-compliance (2). Typically, mandatory vaccination policies permit a limited number of exceptions recognized by legitimate
authorities (e.g., medical contraindications) (3). Despite its name, ‘mandatory vaccination” is not truly compulsory, i.e., force or
threat of criminal sanction are not used in cases of non-compliance. It is therefore the kind of mandatory vaccination described at
the beginning of this paragraph to which we refer in this document. Still, “mandatory vaccination” policies limit individual choice
in non-trivial ways by making vaccination a condition of, for example, attending school or working in particular industries or settings,
like health care. Such policies are not uncommon (2), although it should be noted that the World Health Organization (WHO) does
not presently support the direction of mandates for COVID-19 vaccination, having argued that it is better to work on information
campaigns and making vaccines accessible (4). In addition, WHO recently issued a position statement that national authorities and
conveyance operators should not require COVID-19 vaccination as a condition of international travel (5).
Laws and the legal justifications for mandatory vaccination differ by jurisdiction (6). A legal obligation to be vaccinated is distinct
from an ethical obligation insofar as the latter is not enforced by threats of restrictions in the case of non-compliance. The focus of
this document is ethical considerations and caveats for mandatory COVID-19 vaccination policies.

Ethical considerations and caveats regarding mandatory COVID-19 vaccination

Spoiler

The following considerations and caveats should all be explicitly evaluated and discussed through an ethical analysis by
governments and/or institutional policy-makers who may be considering mandates for COVID-19 vaccination. They should be
considered alongside other relevant scientific, medical, legal, and practical considerations not described in this document.

1. Necessity and proportionality

Spoiler

Mandatory vaccination should be considered only if it is necessary for, and proportionate to, the achievement of an important public
health goal (including socioeconomic goals) identified by a legitimate public health authority. If such a public health goal (e.g., herd
immunity, protecting the most vulnerable, protecting the capacity of the acute health care system) can be achieved with less coercive or intrusive policy interventions (e.g., public education), a mandate would not be ethically justified, as achieving public health goals
with less restriction of individual liberty and autonomy yields a more favourable risk-benefit ratio (1).
As mandates represent a policy option that interferes with individual liberty and autonomy, they should be considered only if they
would increase the prevention of significant risks of morbidity and mortality and/or promote significant and unequivocal public
health benefits. If important public health objectives cannot be achieved without a mandate – for instance, if a substantial portion
of individuals are able but unwilling to be vaccinated and this is likely to result in significant risks of harm – their concerns should
be addressed, proactively if possible. If addressing such concerns is ineffective and those concerns remain a barrier to achievement
of public health objectives and/or if low vaccination rates in the absence of a mandate put others at significant risk of serious harm,
a mandate may be considered “necessary” to achieve public health objectives. In this case, those proposing the mandate should
communicate the reasons for the mandate to the affected communities through effective channels and find ways to implement the mandate such that it accommodates the reasonable concerns of communities. Individual liberties should not be challenged for longer
than necessary. Policy-makers should therefore frequently re-evaluate the mandate to ensure it remains necessary and proportionate
to achieve public health goals. In addition, the necessity of a mandate to achieve public health goals should be evaluated in the
context of the possibility that repeated vaccinations may be required as the virus evolves, as this may challenge the possibility of a
mandate to realistically achieve intended public health objectives.

2. Sufficient evidence of vaccine safety

Spoiler

Data should be available that demonstrate the vaccine being mandated has been found to be safe in the populations for whom the
vaccine is to be made mandatory. When safety data are lacking or when they suggest the risks associated with vaccination outweigh
the risks of harm without the vaccine, the mandate would not be ethically justified, particularly without allowing for reasonable
exceptions (e.g., medical contraindications). Policy-makers should consider specifically whether vaccines authorized for emergency
or conditional use meet an evidentiary threshold for safety sufficient for a mandate (7). In the absence of sufficient evidence of
safety, there would be no guarantee that mandating vaccination would achieve the goal of protecting public health. Furthermore,
coercive exposure of populations to a potentially harmful product would violate the ethical obligation to protect the public from
unnecessary harm when the harm the product might cause outweighs the degree of harm that might exist without the product.
Even when the vaccine is considered sufficiently safe, mandatory vaccination should be implemented with no-fault compensation
schemes to address any vaccine-related harm that might occur. This is important, as it would be unfair to require people who
experience vaccine-related harm to seek legal remedy from harm resulting from a mandatory intervention (8). Such compensation
would depend on countries’ health systems, including the extent of universal health coverage and how they address harm from
vaccines that are not fully licensed (e.g., vaccines authorized for emergency or conditional use).

3. Sufficient evidence of vaccine efficacy and effectiveness

Spoiler

Data on efficacy and effectiveness should be available that show the vaccine is efficacious in the population for whom vaccination
is to be mandated and that the vaccine is an effective means of achieving an important public health goal. For instance, if mandatory
vaccination is considered necessary to interrupt transmission chains and prevent harm to others, there should be sufficient evidence
that the vaccine is efficacious in preventing serious infection and/or transmission. Alternatively, if a mandate is considered necessary
to prevent hospitalization and protect the capacity of the acute health care system, there should be sufficient evidence that the vaccine
is efficacious in reducing hospitalization. Policy-makers should carefully consider whether vaccines authorized for emergency or
conditional use meet evidentiary thresholds for efficacy and effectiveness sufficient for a mandate (7).

4. Sufficient supply

Spoiler

In order for a mandate to be considered, supply of the authorized vaccine should be sufficient and reliable, with reasonable, free
access for those for whom it is to be made mandatory (i.e., there should be few barriers that make it difficult for populations affected
by the mandate to access the vaccine). The absence of a sufficient supply and reasonable, free access would not only render a mandate ineffective in achieving vaccine uptake, but would create an unduly burdensome, unfair demand on those who are required
to be vaccinated but are unable to access the vaccine. Such a mandate would threaten to exacerbate social inequity in access to
health care.

5. Public trust

Spoiler

 

Policy-makers have a duty to carefully consider the effect that mandating vaccination could have on public confidence and public
trust, and particularly on confidence in the scientific community and public trust in vaccination generally (9). If such a policy
threatens to undermine confidence and public trust, it might affect both vaccine uptake and adherence to other important public
health measures, which can have an enduring effect (10). In particular, the coercive power that governments or institutions display
in a programme that undermines voluntariness could have unintended negative consequences for vulnerable or marginalized
populations (11). High priority should therefore be given to threats to public trust and confidence amongst historically disadvantaged
minority populations, ensuring that cultural considerations are taken into account. Vaccine hesitancy may be stronger in such
populations and may not be restricted to concerns of safety and efficacy (12), as mistrust in authorities may be rooted in histories of
unethical medical and public health policies and practices as well as structural inequity (9). Such populations may regard mandatory
vaccination as another form of inequity or oppression, making it more difficult for them to access jobs and essential services (13).

The extent to which mandatory vaccination policies accommodate conscientious objection may also affect public trust (14). There
should, however, be strict scientific and prudential limits to appeals for accommodation or “conscientious objection”, especially
when such accommodation might be used by individuals to ‘free ride’ the public health good of herd immunity or if they threaten
public health and others’ right not to be infected with a virulent infectious disease (15, 16).

 

6. Ethical processes of decision-making

Spoiler

Transparency and stepwise decision-making by legitimate public health authorities should be fundamental elements of ethical
analysis and decision-making about mandatory vaccination. Reasonable effort should be made to engage affected parties and
relevant stakeholders, and particularly those who are vulnerable or marginalized, to elicit and understand their perspectives. Steps
should be taken in good faith to respect human rights obligations not to discriminate or disproportionately disadvantage vulnerable
populations. Legitimate public health authorities that are contemplating mandatory vaccination policies should use transparent,
deliberative procedures to consider the ethical issues outlined in this document in an explicit ethical analysis, including the threshold
of evidence necessary for vaccine safety and efficacy to justify a mandate. As in other contexts, mechanisms should be in place to
monitor evidence constantly and to revise such decisions periodically.

Mandatory COVID-19 vaccination in context

Spoiler

Authorized COVID-19 vaccines have been shown to be safe and efficacious in preventing severe disease and death, and it is clear
that vaccine supply will continue to increase globally, albeit inequitably. That being said, the nature of the COVID-19 pandemic
and evidence on vaccine safety, efficacy, and effectiveness continue to evolve (including with respect to variants of concern).
Consequently, the six considerations identified above are described generally so that they can be applied at any point in time and in
any context. For illustrative purposes, we now turn our attention to the application of these ethical considerations in three settings
for which mandatory vaccination is commonly discussed: for the general public, in schools, and for health workers.

The general public

Spoiler

Vaccination mandates for general adult populations are rare (7). In the absence of a sufficient, reliable vaccine supply that would
permit every eligible member of the general public to be vaccinated, a mandate for the general public would fail to address ethical
consideration 4 regarding sufficient supply. Even if there is a sufficient, reliable vaccine supply, policy-makers should consider
whether mandatory vaccination of the general population is necessary and proportionate to achieve intended public health goals
(ethical consideration 1). More evidence may be required about vaccine uptake to determine whether a mandate is necessary, which
will depend on local contexts and on the goals of the health system (e.g., achievement of herd immunity, protecting the most
vulnerable). Similarly, the extent to which a mandate for the general public is proportional will depend to some extent on the local
context given the variation in COVID-19 epidemiology in different jurisdictions. Even if there is a sufficient supply and a mandate
for vaccination of the general public is considered necessary and proportionate, policy-makers should still consider whether a mandate for the general public would threaten public trust or exacerbate inequity for the most vulnerable or marginalized (ethical
consideration 5).

In schools

Spoiler

Given the lack of data on the safety and efficacy of COVID-19 vaccines for children (ethical considerations 2 and 3), COVID-19
vaccines have not yet been authorized for this population. Consequently, vaccination is not currently ethically justified as a condition
for attending school. Once such data are available and show favourable safety and efficacy in this population, policy-makers will
have to consider whether mandating vaccination as a condition of attending school is necessary and proportional to achieve the
public health objectives (ethical consideration 1) and whether this could undermine public trust (ethical consideration 5). In some
jurisdictions, vaccination against the viruses that cause a number of diseases (e.g., polio, measles, mumps, rubella) is a condition
for attending school or receiving state-sponsored entitlements (2); however, mandates for routine paediatric vaccines are distinct
from vaccines authorized for emergency use in many respects, including the relatively limited and evolving evidence for COVID-
19 vaccines in addition to uncertainty regarding herd immunity and new SARS-CoV-2 variants in the context of COVID-19.

Health workers

Spoiler

 

Mandatory vaccination is perhaps most often discussed in the context of health and social care, particularly where health workers
have direct contact with populations at high risk of SARS-CoV-2 infection or severe illness or death resulting from COVID-19 (e.g.,
congregate settings in which care is provided to older adults), because of the unique settings in which health workers work and their
ethical obligation not to harm their patients. Moreover, mandatory COVID-19 vaccination might appear to be particularly plausible
for health workers given that vaccination of this population might be seen as necessary to protect health system capacity (ethical
consideration 1) and because health workers are commonly identified as a priority group for vaccination, meaning there is more likely to be a sufficient supply to meet the needs of this population (ethical consideration 4). Whether a mandate for health workers
is necessary and proportionate (ethical consideration 1) and would not undermine trust (ethical consideration 5) might depend on
the local context and should be investigated empirically before a mandate is considered for this population.

Forms of mandatory vaccination are not uncommon in health care settings (17), including requirements that unvaccinated health
workers stay at home during outbreaks, policies in which vaccination is required as a condition of employment, requirements that
unvaccinated health workers be transferred to settings where the risk is lower, and so-called “vaccinate-or-mask” policies.
Given current rates (and concerns) of health worker “burn-out” as a result of the pandemic and the potential consequence of an
inadequately resourced health workforce (18), mandatory vaccination policies that require unvaccinated health workers to stay at
home or require vaccination as a condition of employment or hospital privileges might have significant negative consequences for
already overburdened health systems. Policies that require unvaccinated health workers to be transferred to settings where the risk
is lower might have similar consequences, as they might remove critical health workers from settings that badly need health human
resources, such as congregate living settings where care is provided to older adults. Additionally, it may be difficult to distinguish
high and low-risk settings where there is widespread community transmission of SARS-CoV-2.
Finally, some health institutions might wonder whether vaccinate-or-mask policies, which have not been proposed for COVID-19
but are sometimes used as a type of vaccine mandate for seasonal influenza (19, 20), should be similarly used to mandate COVID-
19 vaccinations among health workers. As masks are likely to be a requirement in health care settings for the foreseeable future, the
incentive for health workers to be vaccinated under vaccinate-or-mask policies – namely, that they will not have to wear a mask in
all patient care settings while the virus is circulating if they are vaccinated – will simply lack the same force. Vaccinate-or-mask
policies would retain this force if vaccination against COVID-19 meant that vaccinated health workers could refrain from wearing
masks, but this is not scientifically or ethically justified given the importance of personal protective equipment for institutional
infection prevention and control (21), particularly where there is uncertainty surrounding a vaccine’s capacity for sterilizing
immunity. In this case, vaccinate-or-mask policies risk placing too much emphasis on the protective effect of masks. Because no
vaccine is 100% effective, standard infection prevention and control precautions, which includes masks but also a number of other
standard precautions, should be used to minimize risk.

 

 

Quote

Conclusions
Vaccines are effective for protecting people from COVID-19. Governments and/or institutional policy-makers should use arguments
to encourage voluntary vaccination against COVID-19 before contemplating mandatory vaccination. Efforts should be made to
demonstrate the benefit and safety of vaccines for the greatest possible acceptance of vaccination. Stricter regulatory measures
should be considered only if these means are not successful. A number of ethical considerations and caveats should be explicitly
discussed and addressed through ethical analysis when considering whether mandatory COVID-19 vaccination is an ethically
justifiable policy option. Similar to other public health policies, decisions about mandatory vaccination should be supported by the
best available evidence and should be made by legitimate public health authorities in a manner that is transparent, fair, non-
discriminatory, and involves the input of affected parties

 

 

[Mthomy]

6 hours ago, Helena said:

Jeste

Edit-i Srbiji govorimo?

 

Hoću da kažem koliko je slabo interesovanje za vakcinu.

Pisao sam bas to, da sam primajuci trecu dozu fajzera cekao 2 sata da se skupi nas 6 da otvore pakovanje!!! Subotica, petak 12 sati!

[Akiro]

12 hours ago, Tomiprunet said:

Tebi su svi psihopate. I svi kaslju i bacaju klice bas na tebe kad ti prolazis ulicom, pa cak i te klice lete po 10ak i vise metara do tebe i ulecu ti u usta i nos.

Pokušaj za promenu da pročitaš napisano sa razumevanjem. Znam da nije lako, ali pokušaj. Lik koji potegne nož da ubije zdravstvenog radnika, zato što ga je ovaj zamolio da stavi u malom prostoru zatvorenog vozila masku kad već kašlje, je teško mentalno poremećen. Ne govorim o nekoj priglupoj budaletini, koja samo verbalno izražava svoje mišljenje, nego o ubici u pokušaju. Još jedan, koji bi poremećene ubice da mazi po glavici i titra im. Uzmi u obzir da ovorimo o ubici u pokušaju i o malom zatvorenom prostoru ambulantnog vozila. Nije tako teško.

 

13 hours ago, Tomiprunet said:

Da li su ti iz prve pomoci koji su dosli kod tog koji se iskasljao na njih nosili maske? 

Već gore komentarisano. Mali zatvoren prostor. Ali generalno ne mogu da poverujem da čak i ti postavljaš ovakvo pitanje. U početku pandemije, u prvom talasu, u Engleskoj se neki poremećeni psihopata, koji je znao da je zaražen, iskašljao i ispljuvao nedužnom građaninu u lice, na osnovu čega se ovaj zarazio i umro. Bilo je tu neke pozadine, koje se više ne sećam, neka svađa valjda, ali to nije ni bitno. Englezi su debilčinu optužili za ubistvo. Stara priča ali valja je se prisetiti.

 

Ovaj tvoj pokušaj relativizacije poprilično govori o tebi. Jel to sada nova politička korektnost da pazimo kako ćemo, na primer, Charlesa Mansona nazvati? Lik,  koji ima simptome, te time visoku verovatnoću da je zaražen,  i potrebu za hitnom pomoći, te koji smatra da ima puno pravo da u zatvorenom malom prostoru može da kašlje u druge ljude je već samo po tome teško mentalno poremećen, a potezanje noža sa namerom da ubije zbog toga što je zamoljen da stavi masku ga čini psihopatom koga treba smestiti na poduži rok u zatvoreno odeljenje. Ili u zatvor. Ni manje ni više. Evo nacrtano za prvi razred osnovne škole. One, koji smatraju da takav talog treba maziti po glavici i pokušavaju da njegov čin relativizuju, šta da se kaže za njih? Jednostavno tužno. 

 

Različita mišljenja su jedno, ali relativizacija pokušaja ubistva je već sasvim druga dimenzija. Ne bih dalje da komentarišem. Ova priča sa Coronom će još mnogo što-šta pokazati.

[urosg3]

Kovid 19 može da se otkrije u sistemu otpadnih voda aviona

Nešto se mislim kome je palo na pamet da testira otpadne vode iz aviona i zašto? Osim da potvrdi izreku da "ono što tražiš obično nađeš, ako si uporan"

[Tomiprunet]

Pitam druga iz Subotice, kako je on kako su supruga i deca. Kaze on dobro su, nema problema ali u Srbiji je haos. Kazem ja znam, citam vesti. Pitam ga da li je tako i u Subotici, ne odgovara. Pa ne interesuje me kako je u Srbiji, sta da radim kad su ljudi zaostali, i umiru zbog svoje gluposti. 

[wwww]

41 minutes ago, urosg3 said:

Kovid 19 može da se otkrije u sistemu otpadnih voda aviona

Nešto se mislim kome je palo na pamet da testira otpadne vode iz aviona i zašto? Osim da potvrdi izreku da "ono što tražiš obično nađeš, ako si uporan"

otpadne vode se testiraju vec vise od godinu i po dana (bar) : Holandezi su prvi poceli (a da sam ja cula) i time pratili koliko je virus rasiren u pojedinim naseljima/gradovima.

[Eddard]

Prekidamo sa glupostima. 

[Brian Setzer]

Kakav je stav cenjenih forumašica i forumaša po pitanju vakcinisanja dece 12- (uopšten, a i konkretan, vezan za sopstvenu decu)?

 

Nesumnjivo će vrlo brzo, s malim kašnjenjem u odnosu na Amere i ovde biti odobrene za upotrebu, takođe mislim da će se nekako i kineske vakcine paralelno odobriti.

 

I

[Milenko Puzigaca]

Pa što ne bi vakcinisali decu, sta moze da im bude? I tako većina njih svakodnevno gule viršle, paštete, podriguše itd, tj životinjske usne, šupkove, oči, creva, kožu, pileće glave i slično, i to od životinja koje su kljukane antibioticima, i ko zna kakvim đubretom. 

[Angelia]

Nemam pojma dal sam ovo prijavila vec, pa ako jesam pripisite odumiranju sivih celija sa godinama.

 

Prosle nedelje sam bila na ovecem eventu  u LA, oko 300 ljudi, pice, ice I sl. Grljenje prijatelja koji se nisu videli oko 1-2 godine, se vec podrazumeva. Uzi krug (oko 30-50 ljudi) znam da su, ili prelezali virus ili vakcinisani.

Pre 2-3 dana dolazi poruka, da je neko pozitivan, osoba koju ne poznajem I nismo imali kontakt, ali je prijatelj sa nekim ko je proveo blisko znacajnije vreme sa nasim uzim krugom. Uredno prijavljeno "moja prijateljica koja je bila tamo, radi u skoli, testirala pozitivno, njena porodica je negativna. Moj partner je testirao negativno, idem I ja da se testiram, pa javljam rezultat. Samo sam htela odgovorno da vas obavestim da smo mozda bili izlozeni virusu preko mene".

 

Kad vidim tako nesto, ima sanse za covecanstvo. Updejt je - I ona je negativna.

[Helena]

7 hours ago, Eddard said:

...jer se sa njim slažem i kao običan čovek i kao moderator. Dakle (ne, Helena, nije) nije prekršeno nijedno forumsko pravilo, što si lepo i sam objasnio. 
 

Ali, ja ne mogu sa njim da se složim kao zdravstveni radnik jer ona Hipokratova zakletva ipak ima neko značenje. Pretpostavljam da je i Helenu, koja je takođe zdravstveni radnik, to iziritiralo, pa je post, kao ipak malo preoštar, da ne bi izazivao dalje sukobe, obrisan. 
 

Btw, realna je mogućnost da lekari dođu u etičku situaciju i dilemu da biraju da li mesto na intenzivi ili u krajnjem slučaju krevet u bolnici daju mladom vakcinisanom ili mladom nevakcinisanom. Kako tad odlučiti? 

Mislim kao običan čovek i kao moderator me baš...pa dojmilo...

 

Možda nije forumsko, ali jeste ljudsko...mi moramo da naučimo da živimo sa ljudima koji se neće vakcinisati, ne žele i to je tako, ništa lakše biti neće  ako se budemo klali međusobno...propaganda, edukacija, lično iskustvo i na kraju nekakva zakonski uobličena obaveza moraju dati rezultat...Ovakav ton i rečnik sigurno neće.

 

Čitala sam šta ste pisali i moje iskustvo govori da većina ljudi koji ne žele da se vakcinišu ne tupe o nekakvim čipovima i sličnim budalaštinama, svoju decu uredno vakcinišu (dakle, nisu antivakseri) i imaju sasvim logično objašnjenje za nekog ko nije medicinar-nije dovoljno ispitana vakcina i slično...

 

A moram reči da sam ovako nešto i očekivala-ne znam zašto.

 

25. smo počeli i imunizaciju protiv gripapa  i to kilavo ide...

 

6 hours ago, DJ_Vasa said:

 

Nemoj tako, imaju oni odlične izvore informacija: dr sc. med baba Savka, doc. dr komšinica Živka, prim. dr majstor Đole, prof. dr Žika Taxi, dr spec. frizerka Mica, mr sc. med Jeca kozmetičarka... ima tu dosta stručnjaka.

A sad dozvoli i tebi da kažem-dr baba Savka & co koju si pomenuo je u istoj ravni sa tobom i tebi sličnima, Vox lekarima, koji tumače krivulje, mere, MOLEKULE I ATOME vakcina, savetuju koju vakcinu ko treba da uzme jer su im izvori kojekakve tabele i izjave sa TW i TV-a!!!

 

Nisam mogla da verujem da dozvoljavate sebi da ubeđujete čoveka (par) koji treba da dobije bebu da pobija odluku njenog lekara da ne uzme vakcinu dok je trudna!

Taj čovek je doktor koji je vodio začeće (a POJMA NEMATE kroz kakav pakao takvi parovi prolaze-i emocionalni i finansijski, fizički i svaki drugi), vodi je i dalje i zna o njima sve, ali ne...tu ste vi da kažete zadnju...

 

Imu tu još mnogo stvari da se kaže, ali ja ću stati uz savet za malo više empatije-svima nam je potrebna...

[Sunshine State]

7 minutes ago, Helena said:

Nisam mogla da verujem da dozvoljavate sebi da ubeđujete čoveka (par) koji treba da dobije bebu da pobija odluku njenog lekara da ne uzme vakcinu dok je trudna!

Taj čovek je doktor koji je vodio začeće (a POJMA NEMATE kroz kakav pakao takvi parovi prolaze-i emocionalni i finansijski, fizički i svaki drugi), vodi je i dalje i zna o njima sve, ali ne...tu ste vi da kažete zadnju...

 

Hoces da kazes da trudnice, ako (ne daj Boze) tokom trudnoce slome ruku, razviju potencijalno opasan mladez, dobiju "napad" zuci ili pneumoniju, treba da idu kod ginekologa, jer on "zna o njima sve"?

 

Coveku smo preporucivali da u odluku ukljuci i neke druge relevantne lekare, jer ginekolog nije sveznajuc

[Helena]

3 minutes ago, Sunshine State said:

 

Hoces da kazes da trudnice, ako (ne daj Boze) tokom trudnoce slome ruku, razviju potencijalno opasan mladez, dobiju "napad" zuci ili pneumoniju, treba da idu kod ginekologa, jer on "zna o njima sve"?

 

Coveku smo preporucivali da u odluku ukljuci i neke druge relevantne lekare, jer ginekolog nije sveznajuc

 

Dakle, sad ćete početi sa spinovanjem-ok...

 

Ali ja ću ti odgovoriti konkretno-zna više MNOGO više od tebe koji nisi lekar, plus sam napisala da vodi trudnoću, svakako je bilo uključeno više lekara...

 

Još konkretnije, da imate makar zvanične smernice kad budete ubuduće savetovali i preporučivali: zvaničan mejl koji je stigao u Dom Zdravlja:

 

Spoiler

Pošiljalac: UGOSCGRS <[email protected]>
Datum: okt. 20, 2021 8:58:17 pp.
Naslov: TRUDNOĆA I COVID 19 VAKCINACIJA
Za: undisclosed-recipients:, ;
 

Poštovane kolege,

 

Udruženje ginekologa i opstetričara Srbije, Crne Gore i Republike Srpske ( UGOSCGRS ), kao stručno i profesionalno udruženje redovno prati sva svetska naučna i stručna dešavanja u vezi sa pandemijom Covid 19 i njen uticaj na ginekologiju i  akušerstvo.

 

U skladu sa tim Udruženje je na svom sajtu https://www.ugoscgrs.rs/, odnosno linku TRUDNOĆA I COVID 19 VAKCINACIJA postavilo najnovije zaključke i preporuke svih najrelevantnijih institucija u vezi sa vakcinacijom Covid 19, trudnoćom i laktacijom.

 

Nadamo se da će Vam ove preporuke, koje su u primeni i kod nas, biti dobar potsetnik i olakšati Vaš svakodnevni rad, a naravno, na dobrobit nasih pacijenata.

 

Srdacan pozdrav,

 

Prof. dr Aleksandar Stefanovic, 

Predsednik UGOSCGRS

 

[Sunshine State]

19 minutes ago, Helena said:

 

Dakle, sad ćete početi sa spinovanjem-ok...

 

Ali ja ću ti odgovoriti konkretno-zna više MNOGO više od tebe koji nisi lekar, plus sam napisala da vodi trudnoću, svakako je bilo uključeno više lekara...

 

Još konkretnije, da imate makar zvanične smernice kad budete ubuduće savetovali i preporučivali: zvaničan mejl koji je stigao u Dom Zdravlja:

 

  Hide contents

Pošiljalac: UGOSCGRS <[email protected]>
Datum: okt. 20, 2021 8:58:17 pp.
Naslov: TRUDNOĆA I COVID 19 VAKCINACIJA
Za: undisclosed-recipients:, ;
 

Poštovane kolege,

 

Udruženje ginekologa i opstetričara Srbije, Crne Gore i Republike Srpske ( UGOSCGRS ), kao stručno i profesionalno udruženje redovno prati sva svetska naučna i stručna dešavanja u vezi sa pandemijom Covid 19 i njen uticaj na ginekologiju i  akušerstvo.

 

U skladu sa tim Udruženje je na svom sajtu https://www.ugoscgrs.rs/, odnosno linku TRUDNOĆA I COVID 19 VAKCINACIJA postavilo najnovije zaključke i preporuke svih najrelevantnijih institucija u vezi sa vakcinacijom Covid 19, trudnoćom i laktacijom.

 

Nadamo se da će Vam ove preporuke, koje su u primeni i kod nas, biti dobar potsetnik i olakšati Vaš svakodnevni rad, a naravno, na dobrobit nasih pacijenata.

 

Srdacan pozdrav,

 

Prof. dr Aleksandar Stefanovic, 

Predsednik UGOSCGRS

 

 

Neka tebe....ja vise verujem:

 

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html

 

https://www.gov.uk/government/publications/covid-19-vaccination-women-of-childbearing-age-currently-pregnant-planning-a-pregnancy-or-breastfeeding/covid-19-vaccination-a-guide-for-women-of-childbearing-age-pregnant-planning-a-pregnancy-or-breastfeeding

 

https://www.ema.europa.eu/en/documents/covid-19-vaccine-safety-update/covid-19-vaccine-safety-update-comirnaty-14-april-2021_en.pdf

 

To k'o da odvezes najnovijeg Maseratija kod majstor Mileta (tipa Zoran Radmilovic u "Price iz Majstorske radionice) u Mali Mokri Lug..... E, tako nekako bih slusala udruzenje srpskih i crnogorskih ginekologa

 

Edit: btw, na tom linku koji si dala, kad klines na Vise informacija OVDE, ne odvede me nigde, tako da ne vidim koje informacije pisu, pa ako neko moze da otvori i napize koje  to informacije i smernice daju

Edited October 29, 2021 by Sunshine State

[erwin]

1 hour ago, Helena said:

Nisam mogla da verujem da dozvoljavate sebi da ubeđujete čoveka (par) koji treba da dobije bebu da pobija odluku njenog lekara da [trudnica] ne uzme vakcinu dok je trudna!

 

Mnogi lekari u Srbiji se uživljavaju u uloge bogova koji odlučuju o tuđim sudbinama pa onda i zdravstveni radnici u njihovom okruženju papagajski ponavljaju takve budalaštine. Nažalost, ovome doprinosi i nizak stepen obrazovanja prosečnog pacijenta kome je onda lakše da se ni o čemu ne pita i ni u šta ne udubuljuje već da bespogovorno sluša.

 

Dobar lekar bi svakako dao preporuku i objasnio zašto bi trebalo postupiti na određeni način (tim pre što je on ovde suprotan onome koji preporučuju sva relevantna strukovna udruženja), a ne drugačije. Žalosno je što neko ko u ovom konkretnom slučaju ima toliko znanje pada na ovom jednostavnom testu jer nije dao relevantne informacije trudnici i njenom suprugu.

 

Ovo je plakat koji se nalazi na linku na sajtu domaćeg udruženja ginekologa i akušera.

 

http://www.ugoscgrs.rs/upload/2019/202111_UGOSCGRS_vakcine.pdf

Edited October 29, 2021 by erwin

[erwin]

7 hours ago, shonke said:

Pa mi smo gori nego na evrovizji... Jedva peti!

 

Jbg, sad se baš dosta crni po Evropi, mi smo pre mesec dana bili avangarda.

 

 

 

 

https://datawrapper.dwcdn.net/5JTxB/74/

[erwin]

Quote

Despite the deadly wave of delta variant coronavirus that overwhelmed hospitals and sent death rates soaring, high numbers of Americans are still refusing Covid-19 vaccines, according to a new poll by the Kaiser Family Foundation, underscoring the challenges officials face as they try to move beyond the pandemic.

One in five Americans said they would never get a Covid-19 shot (16%) or would only do so if required (4%), according to the Kaiser poll, conducted October 14-24 among 1,519 U.S. adults.
Around a third of Republicans (31%) and rural residents (33%)—the groups most opposed to vaccination—said they would definitely not get the shot, the poll found, with a further 3% and 2%, respectively, saying they would only do so if required.
The poll also found strong vaccine opposition among uninsured people under 65 (28% said they would definitely not get the jab or only do so if required), white evangelical Christians (26%), those aged 30-49 (25%), men (24%) and adults without a college degree (23%).   
Partisan divides persisted among vaccinated adults, Kaiser found, with nearly four in 10 (38%) fully vaccinated Republicans saying they probably or definitely would not get a booster shot if one was made available to them, nearly four times the number of like-minded Democrats (9%).  
A quarter (25%) of workers said their employer has required them to get vaccinated, Kaiser found. Just over half (51%) of workers not subject to a vaccine mandate at work said they did not want their employer to do so (vs 21% who do). Unsurprisingly, these figures change when split by vaccination status, with nearly three times as many (90%) unvaccinated adults saying they do not want their employer to require vaccination as vaccinated adults (35%). 
More than a third (37%) of unvaccinated workers said they would leave their jobs if their employer required vaccination even if they offered a testing alternative, Kaiser found. If no testing option was available, this rose to 72%. A third (32%) of Republicans polled said they already know someone who has left a job over a vaccine mandate. 

https://www.forbes.com/sites/roberthart/2021/10/28/1-in-5-adults-still-reject-covid-vaccines-poll-finds---here-are-the-biggest-groups-still-holding-out/?sh=6bb9d5d28d28

Edited October 29, 2021 by erwin

[Olosh]

10 hours ago, Eddard said:

 

Btw, realna je mogućnost da lekari dođu u etičku situaciju i dilemu da biraju da li mesto na intenzivi ili u krajnjem slučaju krevet u bolnici daju mladom vakcinisanom ili mladom nevakcinisanom. Kako tad odlučiti? 

I sta kaze triazni protokol za ovaj slucaj?

 

’Who lives, who dies? ‘ (Varys GoT)

[Helena]

1 hour ago, Sunshine State said:

 

Neka tebe....ja vise verujem:

 

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html

 

https://www.gov.uk/government/publications/covid-19-vaccination-women-of-childbearing-age-currently-pregnant-planning-a-pregnancy-or-breastfeeding/covid-19-vaccination-a-guide-for-women-of-childbearing-age-pregnant-planning-a-pregnancy-or-breastfeeding

 

https://www.ema.europa.eu/en/documents/covid-19-vaccine-safety-update/covid-19-vaccine-safety-update-comirnaty-14-april-2021_en.pdf

 

To k'o da odvezes najnovijeg Maseratija kod majstor Mileta (tipa Zoran Radmilovic u "Price iz Majstorske radionice) u Mali Mokri Lug..... E, tako nekako bih slusala udruzenje srpskih i crnogorskih ginekologa

 

Edit: btw, na tom linku koji si dala, kad klines na Vise informacija OVDE, ne odvede me nigde, tako da ne vidim koje informacije pisu, pa ako neko moze da otvori i napize koje  to informacije i smernice daju

Sa linka se snimi PDF format, koji se, gle?,poziva na američka istraživanja i koji je forumoumilni ervin postavio...

 

i sad ulazim u mali off:

 

Shvatila sam ja da si ti, kao i mnogi drugi, otišla odavde i to je lepo, ako si to htela...

 

Ono što ne shvatam je da dobar deo vas želi da unižava ljude koji su ostali pežorativnom upotebrom imena Mile, Savka, Živorad i slično, kao i njihovih zanimanja-majstor, mehaničar vodoinstalater( to u Americi ne postoji?)...

 

Jel se osećate bolje, još dalje, još uspešnije kad to radite ili šta?

 

1 hour ago, erwin said:

 

Mnogi lekari u Srbiji se uživljavaju u uloge bogova koji odlučuju o tuđim sudbinama pa onda i zdravstveni radnici u njihovom okruženju papagajski ponavljaju takve budalaštine. Nažalost, ovome doprinosi i nizak stepen obrazovanja prosečnog pacijenta kome je onda lakše da se ni o čemu ne pita i ni u šta ne udubuljuje već da bespogovorno sluša.

 

Dobar lekar bi svakako dao preporuku i objasnio zašto bi trebalo postupiti na određeni način (tim pre što je on ovde suprotan onome koji preporučuju sva relevantna strukovna udruženja), a ne drugačije. Žalosno je što neko ko u ovom konkretnom slučaju ima toliko znanje pada na ovom jednostavnom testu jer nije dao relevantne informacije trudnici i njenom suprugu.

 

 

 

 

Mnogi lekari u Srbiji se ubijaju bukvalno od posla, bivaju odvojeni od porodice i života od kako je korona i sad dođeš ti, Živorad sa Vox foruma i napišeš kako je taj lekar pao na testu...seriously? A znaš tri rečenice što je devil napisao...

 

I jako bih volela da znam tvoju struku, úrom,  kad već znaš kakav je profil prosečnog pacijenta...

 

 

 

 

[Sunshine State]

Napadnes nas sto smo coveku preporucivali sta da radi (sigurno ga ne mozemo naterati da vakcinise zenu!!), pa stavis link na  srpsko/crnogorske ginekoloske savete, pa kad ja dam link na ozbiljnije izvore, ti kazes da se i informacije na tvom linku pozivaju na isti izvor koji sam ja stavila?!?

 

Ovo ti je izuzetno bezobrazno i bespotrebno:

"Jel se osećate bolje, još dalje, još uspešnije kad to radite ili šta?"

 

S tobom, stvarno, nema smisla pricati...

[erwin]

I mnoge trudnice su umrle u Srbiji zato što im njihovi lekari nisu savetovali da se vakcinišu pa za to niko od tih lekara neće odgovarati, iako bi morao.

 

U trenutku kad je Srbija među 5 najgorih na svetu po raširenosti virusa i kad se u bolnicama van crvenih zona ljudi masovno zaražavaju virusom dobrim delom i zato što im nevakcinisani, a zaraženi zdravstveni radnici prenose virus ti imaš petlju da kritikuješ ljude koji imaju stav da nije baš najpametnije ne vakcinisati se ako ćeš provesti više dana tamo. Teško da može mnogo niže od toga.

 

A lekari se ubijaju od posla između ostalog i zato što se nisu odrekli kojekakvih Nestorovića, Jovana i Valentina u svojim redovima i izbacili ih iz lekarske komore.

 

21 minutes ago, Helena said:

Živorad sa Vox foruma

 

WTMIL.

 

Edited October 29, 2021 by erwin

[Helena]

2 hours ago, Sunshine State said:

Napadnes nas sto smo coveku preporucivali sta da radi (sigurno ga ne mozemo naterati da vakcinise zenu!!), pa stavis link na  srpsko/crnogorske ginekoloske savete, pa kad ja dam link na ozbiljnije izvore, ti kazes da se i informacije na tvom linku pozivaju na isti izvor koji sam ja stavila?!?

 

Ovo ti je izuzetno bezobrazno i bespotrebno:

"Jel se osećate bolje, još dalje, još uspešnije kad to radite ili šta?"

 

S tobom, stvarno, nema smisla pricati...

Али ти радиш то-ето српски извори не ваљају, амерички су озбиљнији!!!

+си поменула  мајстора Милета...или можда ниси?

[Helena]

2 hours ago, erwin said:

I mnoge trudnice su umrle u Srbiji zato što im njihovi lekari nisu savetovali da se vakcinišu pa za to niko od tih lekara neće odgovarati, iako bi morao.

 

U trenutku kad je Srbija među 5 najgorih na svetu po raširenosti virusa i kad se u bolnicama van crvenih zona ljudi masovno zaražavaju virusom dobrim delom i zato što im nevakcinisani, a zaraženi zdravstveni radnici prenose virus ti imaš petlju da kritikuješ ljude koji imaju stav da nije baš najpametnije ne vakcinisati se ako ćeš provesti više dana tamo. Teško da može mnogo niže od toga.

 

A lekari se ubijaju od posla između ostalog i zato što se nisu odrekli kojekakvih Nestorovića, Jovana i Valentina u svojim redovima i izbacili ih iz lekarske komore.

 

 

WTMIL.

 

 

Ја те опет молим да ми кажеш шта си по струци или чиме се бавиш-паушално и (полу)истинито информисање и објављивање новинских чланака, који свашта пишу нема никаквог смисла...

 

Да ли ти СИГУРНО знаш да су те жене биле саветоване да се не вакцинишу?Да ли сигурно знаш да здравствено особље шири заразу и колико?Што би ја веровала теби а не себи?

Ако знаш, дај неки хинт како знаш?

 

Гледе лекара, знам шта причам, то су провинцијски лекари који везе немају са никаквом Јованом и инима...

 

И молим превод за WTMIL

 

[Tomiprunet]

Napisao sam juce da sam pitao prijatelja iz Subotice kako je stanje u Subotici, da li isto tako kriticno kao i u Srbiji dole. Prvo nije odgovorio, da bi odgovorio kasnije i napisao : kako da ne , kod tate od njegove supruge , komsije zarazeni (muz i zena), i prijatelji iz Zvornika (muz i zena). Znaci to su 4. Prosle zime smo znali na 10ine (prijatelja, rodjaka )u Tavankutu i Subotici. 

[erwin]

 

 

 

 

 

 

 

Edited October 29, 2021 by erwin