The IAFF strongly recommends that all IAFF members receive a SARS-CoV-2 (COVID-19) vaccine to prevent the spread of disease and assist in administering vaccinations in jurisdictions where appropriate measures are taken to protect our members health and safety and their rights on the job when vaccinations are being administered, according to the specifications listed below.
âÂÂ€ÂÂ‹The IAFF strongly recommends all members be vaccinated against the coronavirus (SARS-CoV-2) for their own protection and the protection of their brothers and sisters, family members, friends and communities. It is critical that members are protected through vaccinations to maintain their readiness to respond to COVID-19 and other emergencies, as the number of positive tests, hospitalizations and deaths from COVID-19 continue to rise amidst flu season.
As fire fighters and medical emergency personnel who work in confined and uncontrolled environments while treating or transporting patients or interacting with the public, members are at a greater risk of contracting COVID-19. As of December 15, 2020, 21 members have died in the line of duty from COVID-19.
The IAFF has urged federal, state and local governments to include fire fighters in Tier 1a for vaccine distribution. In Canada the IAFF has requested the federal government include fire fighters in the same priority group as other healthcare workers.
The Fire Service Joint Labor/Management Wellness-Fitness Initiative (WFI) states, “Uniformed personnel must receive or provide documentation of having received vaccinations.” The IAFF and the International Association of Fire Chiefs (IAFC) have collectively embraced and promoted this initiative, and we continue to advocate, educate and recommend the COVID-19 vaccine for our members.
Under the advisement and guidance of our Johns Hopkins University medical team and WFI doctors, along with NFPA 1581 Standard on Fire Department Infection Control Program and NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments, the IAFF urges members to be vaccinated for COVID-19.
The IAFF recognizes that under some circumstances, including sincere religious objections or a bona fide medical reason, fire fighters may object to being vaccinated. These members may be able to obtain an exemption or reasonable accommodation from their fire departments. The IAFF recommends the following guidelines from the NFPA 1581 Standard:
- 22.214.171.124* Members who choose to decline immunizations offered by the department shall be required to sign a written declination.
- 126.96.36.199(a) Members who decline immunizations should be counseled by the fire department physician. If the member persists in refusing vaccination, a signed written declination is required.
- 188.8.131.52.1 The declination shall become part of the member’s confidential health database.
- 184.108.40.206.2 Members shall be allowed to recant a declination at any time and receive the offered immunizations.
In the event the state, provincial or local government or the fire department mandates the vaccine, members may be subject to penalization of workers’ compensation, disability or Public Safety Officers’ Benefit (PSOB). An exemption or preferred accommodation may be difficult to obtain through a lawsuit as employers are only required to offer a reasonable (not preferred) accommodation and will have little difficulty demonstrating that providing an exemption to a COVID-19 vaccination would cause an undue hardship given that public health and safety are at risk.
While vaccines present minimal side effects, no serious safety or health concerns have been reported at the time this position statement was written. The Pfizer and Moderna vaccines are molecular RNA based (not a live virus) and both vaccines have a 95% efficacy rate compared to a 40-60% efficacy rate of the influenza (flu) vaccine and provide antibodies and T-cell immunity against COVID-19.
Additionally, due to the public health crisis and state of emergency, the IAFF supports enlisting fire fighter and emergency medical personnel for vaccine distribution under the following conditions:
- Authorized by state, local or medical directors to provide immunizations
- Compensated at overtime rates as this would be in addition to regular shift work
- Assigning members to provide immunizations does not impact the department’s staffing levels for responding to emergencies and performing other duties
- Remain covered through workers’ compensation and disability
- Have been vaccinated
- Provided the proper training and education in vaccine handling, tracking and administration
- Provided the proper personal protective equipment (PPE) for vaccine distribution
- A safe environment to distribute the vaccine
The IAFF continues to remain engaged with the incoming Biden-Harris administration to ensure fire fighters are given priority access for PPE, testing and vaccinations at the federal level and seeks help from affiliate leaders in engaging governors and state, provincial and local health departments to ensure members remain a priority at the local level.
The IAFF will provide additional COVID-19 vaccination information developed internally and through the Centers for Disease Control and Prevention (CDC) to affiliate leaders to promote, educate and advocate for the COVID-19 vaccine for members and their families.
COVID-19 Testing Information
Until an effective vaccine is available, testing for COVID-19 can help slow the spread of the disease. The two main methods are testing for the molecular presence of the disease or testing for antibodies to the disease. Molecular tests are more capable of informing whether you have active virus, while serological tests inform whether you have been exposed to or have some level of immunity to the virus.
More research is necessary to determine the accuracy of serologic test results for COVID-19 and how to best use this technology to slow or stop the spread of this disease. The IAFF supports the recommendation from the Food and Drug Administration (FDA) that results from antibody testing alone should not be used to diagnose or exclude COVID-19 infection or to inform infection status.
Currently, the IAFF advises against the use of serologic testing alone as the basis of return-to-work decisions. Rather, such determinations should be through an evaluation by a healthcare provider.
Download a printable version of the IAFF guidance on testing.
For more information on guidelines for COVID-19 antibody testing, see the CDC’s antibody testing interim guidance document.
Call your healthcare professional if:
- You feel sick with fever or chills, cough, shortness of breath or difficulty breathing, or new loss of taste or smell. According to the CDC, other COVID-19 symptoms include muscle or body aches, headache, sore throat, congestion or runny nose, nausea or vomiting, or diarrhea. You should call your healthcare professional if you have these beyond what is normal for you (e.g., a runny nose is common with seasonal allergies).
- Have been in close contact with a person known to have COVID-19.
Your healthcare professional will work with your state’s public health department and CDC to determine if you need to be tested for COVID-19.
Testing may be limited to individuals showing symptoms, but this varies based on test availability. Personnel should expect COVID-19 test results 24-48 hours post testing, but this too will vary based on testing capabilities.
Testing in Skilled Nursing Homes
Some states are starting to require fire fighters to assist with performing testing on residents in skilled nursing homes. These are hot zones and often the tasks are out of the scope of individuals’ training or practice. This testing guidance on best practices includes how to safely perform testing for both the nursing home residents and fire fighters.
The San Antonio Fire Department has developed training videos to assist in creating guidelines for designing and safely performing testing at skilled nursing homes and large-scale testing:
SARS-COV-2 and COVID-19
Coronavirus is a family of viruses, including the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), as well as some common colds. SARS-CoV-2 is the virus that causes Coronavirus disease 2019 (COVID-19). The serologic tests and polymerase chain reaction (PCR) tests are used to identify SARS-CoV-2 nucleic acid to determine if individuals have COVID-19.
Infectious disease testing related to the COVID-19 disease:
|Detects for the presence of…
||the genetic material (RNA) of the virus. Any viral nucleic acid present in the patient’s sample is amplified by polymerase chain reaction (PCR)
||host antibodies against viral antigens (an immune response)
||nasopharyngeal swabs, oropharyngeal swabs, expectorated sputum, saliva
||blood via finger prick
The FDA has authorized that serologic testing is limited to laboratories and licensed healthcare providers at the point of care.
Detection of Viral RNA
Tests that detect viral RNA levels can identify current infections and suggest infectivity and transmission risk for others. Currently, the most widely used RNA test on the market is the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR), a real-time test (turnaround time from 15 minutes to several days) for the detection of nucleic acid from SARS-CoV-2 in upper and lower respiratory specimens (such as nasal, nasopharyngeal or oropharyngeal swabs) collected from individuals suspected of COVID-19. Negative results do not mean there is no COVID-19 infection and should not be used as the sole basis for patient management decisions.
Multiple studies have identified false negative results on initial PCR tests, but it’s not clear why this happens. Reasons may include stage of illness, lower amounts of virus in certain anatomic sites and in certain patients, and suboptimal sample collection methods. Overall, the FDA has asserted that FDA-authorized nucleic acid amplification tests for COVID-19 meeting emergency use authorization criteria are highly reliable. Thus, these tests are currently the gold standard. However, these tests are not at a level of production that is close to meeting national needs.
Detection of Host Immune Response
Tests that identify host immune response are referred to as serological tests and are intended to be administered as simple blood tests. These tests can indicate whether an individual has been previously exposed to COVID-19. Antibody test results are important in detecting infections in individuals with few or no symptoms and have been used in conjunction with RT-PCR results in establishing a diagnosis or exclusion of COVID-19 infection. IgM and IgG are the two major antibodies assessed by serologic testing.
- IgM antibodies typically appear earlier within the course of infection – within days to about one week after the onset of symptoms. The antibodies can persist for a week to a few months.
- IgG antibodies develop later in the course of infection, typically appearing in the bloodstream around two weeks after infection and may last for months to several years.
Those with IgM antibodies are likely in an early stage of infection, even if they don’t have any symptoms. Ideally, fire fighters with these markers should highly consider undergoing quarantine plus a reflex PCR test to confirm infectivity.
Emergency Use Authorization
During public health emergencies declared under section 564 of the Federal Food, Drug and Cosmetic (FD&C) Act, the FDA is able to issue Emergency Use Authorizations (EUAs) when certain criteria are met that allows for the use and distribution of potentially life-saving medical products to diagnose, treat, or prevent the disease, which can include diagnostic tests. EUAs are a shortcut in the FDA approval process that allows products to be used that have not gone through the full FDA approval process which sometimes can take years.
According to the FDA, there are currently no FDA-approved or cleared test to diagnose or detect COVID-19. Therefore, the FDA has issued several Emergency Use Authorizations (EUAs) for the use of new diagnostic tests to detect the SARS-CoV-2 virus, which causes COVID-19.
Review the list of EUA approved tests.
The FDA has also evaluated the performances of the EUA Serologic Test. The performance of these tests is described by their “sensitivity,” or their ability to identify those with antibodies to SARS-CoV-2 (true positive rate), and their “specificity,” or their ability to identify those without antibodies to SARS-CoV-2 (true negative rate). View the results.