Large study confirms flu vaccine safe in pregnancy

NEW YORK (AP) — A large study offers reassuring news for pregnant women: It's safe to get a flu shot.

The research found no evidence that the vaccine increases the risk of losing a fetus, and may prevent some deaths. Getting the flu while pregnant makes fetal death more likely, the Norwegian research showed.

The flu vaccine has long been considered safe for pregnant women and their fetus. U.S. health officials began recommending flu shots for them more than five decades ago, following a higher death rate in pregnant women during a flu pandemic in the late 1950s.

But the study is perhaps the largest look at the safety and value of flu vaccination during pregnancy, experts say.

"This is the kind of information we need to provide our patients when discussing that flu vaccine is important for everyone, particularly for pregnant women," said Dr. Geeta Swamy, a researcher who studies vaccines and pregnant women at Duke University Medical Center.

The study was released by the New England Journal of Medicine on Wednesday as the United States and Europe suffer through an early and intense flu season. A U.S. obstetricians group this week reminded members that it's not too late for their pregnant patients to get vaccinated.

The new study was led by the Norwegian Institute of Public Health. It tracked pregnancies in Norway in 2009 and 2010 during an international epidemic of a new swine flu strain.

Before 2009, pregnant women in Norway were not routinely advised to get flu shots. But during the pandemic, vaccinations against the new strain were recommended for those in their second or third trimester.

The study focused on more than 113,000 pregnancies. Of those, 492 ended in the death of the fetus. The researchers calculated that the risk of fetal death was nearly twice as high for women who weren't vaccinated as it was in vaccinated mothers.

U.S. flu vaccination rates for pregnant women grew in the wake of the 2009 swine flu pandemic, from less than 15 percent to about 50 percent. But health officials say those rates need to be higher to protect newborns as well. Infants can't be vaccinated until 6 months, but studies have shown they pick up some protection if their mothers got the annual shot, experts say.

Because some drugs and vaccines can be harmful to a fetus, there is a long-standing concern about giving any medicine to a pregnant woman, experts acknowledged. But this study should ease any worries about the flu shot, said Dr. Denise Jamieson of the Centers for Disease Control and Prevention.

"The vaccine is safe," she said.

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Online:

Medical journal: http://www.nejm.org

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Notre Dame: Football Star Was 'Catfished' in Hoax

Notre Dame's athletic director and the star of its near-championship football team said the widely-reported death of the star's girlfriend from leukemia during the 2012 football season was apparently a hoax, and the player said he was duped by it as well.

Manti Te'o, who led the Fighting Irish to the BCS championship game this year and finished second for the Heisman Trophy, said in a statement today that he fell in love with a girl online last year who turned out not to be real.

The university's athletic director, Jack Swarbrick, said it has been investigating the "cruel hoax" since Te'o approached officials in late December to say he believed he had been tricked.

Private investigators hired by the university subsequently monitored online chatter by the alleged perpetrators, Swarbrick said, adding that he was shocked by the "casual cruelty" it revealed.

"They enjoyed the joke," Swarbrick said, comparing the ruse to the popular film "Catfish," in which filmmakers revealed a person at the other end of an online relationship was not who they said they were.

"While we still don't know all of the dimensions of this ... there are certain things that I feel confident we do know," Swarbrick said. "The first is that this was a very elaborate, very sophisticated hoax, perpetrated for reasons we don't understand."

Mike Ehrmann/Getty Images

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Te'o said during the season that his girlfriend, Lennay Kekua, died of leukemia in September on the same day Te'o's grandmother died, triggering an outpouring of support for Te'o at Notre Dame and in the media.

"While my grandma passed away and you take, you know, the love of my life [Kekua]. The last thing she said to me was, 'I love you,'" Te'o said at the time, noting that he had talked to Kekua on the phone and by text message until her death.

Now, responding to a story first reported by the sports website Deadspin, Te'o has acknowledged that Kekua never existed. The website reported today that there were no records of a woman named Lennay Kekua anywhere.

Te'o denied that he was in on the hoax.

"This is incredibly embarrassing to talk about, but over an extended period of time, I developed an emotional relationship with a woman I met online," Te'o said in a statement released this afternoon. "We maintained what I thought to be an authentic relationship by communicating frequently online and on the phone, and I grew to care deeply about her."

Swarbrick said he expected Te'o to give his version of events at a public event soon, perhaps Thursday, and that he believed Te'o's representatives were planning to disclose the truth next week until today's story broke.

Deadspin reported that the image attached to Kekua's social media profiles, through which the pair interacted, was of another woman who has said she did not even know Te'o or know that her picture was being used. The website reported that it traced the profiles to a California man who is an acquaintance of Te'o and of the woman whose photo was stolen.

"To realize that I was the victim of what was apparently someone's sick joke and constant lies was, and is, painful and humiliating," Te'o said.

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France to stay in Mali until stability restored

BAMAKO/DUBAI (Reuters) - France pledged on Tuesday to keep troops in Mali until stability returned to the West African country, raising the specter of a long campaign against al Qaeda-linked rebels who held their ground despite a fifth day of air strikes.

Paris has poured hundreds of soldiers into Mali and carried out 50 bombing raids since Friday in the Islamist-controlled northern half of the country, which Western and regional states fear could become a base for terrorist attacks in Africa and Europe.

Defense Minister Jean-Yves Le Drian said that, despite French air support, Malian forces had not been able to dislodge Islamist fighters from the central Malian towns of Konna or Diabaly, just 350 km (220 miles) northeast of Bamako.

A column of French armored vehicles rolled northward from the dusty riverside capital of Bamako towards rebel lines on Tuesday, the first major northward deployment of ground troops. A military official declined to comment on their objective.

Thousands of African soldiers are due to take over the offensive. Regional armies are scrambling to accelerate an operation which was initially not expected until September and has been brought forward by France's surprise bombing campaign aimed at stopping a rebel advance on a strategic town last week.

President Francois Hollande, on a visit to the United Arab Emirates during which he sought Gulf states' financial backing for the African-led mission, suggested France would retain a major role in its former colony for months to come.

"We have one goal. To ensure that when we leave, when we end our intervention, Mali is safe, has legitimate authorities, an electoral process and there are no more terrorists threatening its territory," Hollande told a news conference.

Paris has said it plans to deploy 2,500 soldiers to bolster the Malian army and work with the intervention force provided by West African states.

AFRICAN TROOPS

West African Defense chiefs met in Bamako on Tuesday to approve plans for the swift deployment of 3,300 regional troops, foreseen in a United Nations-backed intervention plan. After failing to reach a final agreement, they adjourned their talks until Wednesday.

Nigeria pledged to deploy soldiers within 24 hours, and Belgium said it was sending transport planes and helicopters to help, but West Africa's armies need time to become operational.

Mali's north, a vast and inhospitable area of desert and rugged mountains the size of Texas, was seized last year by an Islamist alliance combining al Qaeda's north African wing AQIM with splinter group MUJWA and the home-grown Ansar Dine rebels.

Any delay in following up on the French air bombardments of Islamist bases and fuel depots with a ground offensive could allow the insurgents to slip away into the desert and mountains, regroup and counter-attack.

The rebels, who French officials say are mobile and well armed, have shown they can hit back, dislodging government forces from Diabaly on Monday.

Residents said the town was still under Islamist control on Tuesday despite a number of air strikes that shook houses.

An eye witness near Segou, to the south, told Reuters he had seen 20 French Special Forces soldiers driving toward Diabaly.

In Konna, whose seizure on Thursday sparked French involvement, residents said Islamist fighters were camped just outside town. Army troops had also withdrawn after entering the town on Saturday.

Malians have largely welcomed the French intervention, having seen their army suffer a series of defeats by the rebels.

"With the arrival of the French, we have started to see the situation on the front evolve in our favor," said Aba Sanare, a resident of Bamako.

QUESTIONS OVER READINESS

Aboudou Toure Cheaka, a senior regional official in Bamako, said the West African troops would be on the ground in a week.

The original timetable for the 3,300-strong U.N.-sanctioned African force - to be backed by western logistics, money and intelligence services - did not initially foresee full deployment before September due to logistical constraints.

Senegal, Burkina Faso, Niger, Nigeria and Guinea have all offered troops. Col. Mohammed Yerima, spokesman for Nigeria's Defense ministry, said the first 190 soldiers would be dispatched within 24 hours.

But Nigeria, which is due to lead the mission, has already cautioned that even if some troops arrive in Mali soon, their training and equipping will take more time.

Sub-Saharan Africa's top oil producer, which already has peacekeepers in Sudan's Darfur and is fighting a bloody and difficult insurgency at home against Islamist sect Boko Haram, could struggle to deliver on its troop commitment of 900 men.

One senior government adviser in Nigeria said the Mali deployment was stretching the country's military.

"The whole thing's a mess. We don't have any troops with experience of those extreme conditions, even of how to keep all that sand from ruining your equipment. And we're facing battle-hardened guys who live in those dunes," said the adviser, who asked not to be named.

FRENCH LINING UP SUPPORT

France, which has repeatedly said it has abandoned its role as policeman of its former African colonies, said on Monday that the U.S., Canada, Denmark and Germany had also offered logistical support.

Fabius has said Gulf Arab states would help the Mali campaign, while Belgium said on Tuesday it would send two C130 transport planes and two medical helicopters following a request from Paris.

A meeting of donors for the operation was expected to be held in Addis Ababa at the end of January.

Security experts have warned that the multinational intervention in Mali, couched in terms of a campaign by governments against "terrorism", could provoke a jihadist backlash against France and the West, and African allies.

U.S. officials have warned of links between AQIM, Boko Haram in Nigeria and al Shabaab Islamic militants fighting in Somalia.

Al Shabaab, which foiled a French effort at the weekend to rescue a French secret agent it was holding hostage, urged Muslims around the world to rise up against what it called "Christian" attacks against Islam.

"Our brothers in Mali, show patience and tolerance and you will win. War planes never liberate a land," Sheikh Ali Mohamud Rage, al Shabaab's spokesman, said on a rebel-run website.

U.S. officials said Washington was sharing information with French forces in Mali and considering providing logistics, surveillance and airlift capability.

"We have made a commitment that al Qaeda is not going to find any place to hide," U.S. Defense Secretary Leon Panetta told reporters as he began a visit to Europe. Panetta later said the U.S. had no plans to send troops to Mali.

One U.S. military source said the haphazard nature of French involvement reminded him of the U.S. entry into Afghanistan.

"I don't know what the French endgame is for this," the source said. "Air strikes are fine, but pretty soon you run out of easy targets. Then what do you do? What do you do when they head up into the mountains?"

(Additional reporting by Elizabeth Pineau and Raissa Kasolowsky in Abu Dhabi, Felix Onuah in Abuja and Tim Cocks in Lagos, Abdi Sheikh in Mogadishu, Michelle Nichols and Louis Charbonneau at the United Nations,; Richard Valdmanis in Dakar, Joe Bavier in Abidjan, Jan Vermeylen in Brussels; Writing by Pascal Fletcher, Daniel Flynn and David Lewis; editing by Richard Valdmanis, Giles Elgood and Will Waterman)

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Punggol East ward saw 3-way fight in 2011 GE

SINGAPORE: In the 2011 General Election, the Punggol East Single Member Constituency (SMC) saw a three-way fight among political parties that contested.

The People's Action Party's (PAP) Michael Palmer won over half of the votes.

The Punggol East SMC had over 30,000 voters in the 2011 General Election and it was the only constituency that saw a three-cornered fight.

Then, the PAP's Michael Palmer, The Workers' Party's Lee Li Lian and the Singapore Democratic Alliance's Desmond Lim campaigned for residents' hearts and minds.

The three focused largely on ground concerns during the hustings.

Mr Lim promised new facilities of over a million dollars for residents if he won.

It was something Mr Palmer cast doubt on. He was the ward's incumbent, elected in 2006 when the area was still under Pasir Ris-Punggol Group Representation Constituency, before it was carved out as a single seat.

Mr Palmer had said his time in the ward was used to build cohesion among residents, and hoped for continuing support.

Ms Lee, on the other hand, chose to look at estate cleanliness and cost of living issues.

When the dust settled, Mr Palmer won, taking around 55 per cent of votes.

Ms Lee took about 41 per cent.

And Mr Lim got around four per cent.

- CNA/ck

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Army Chief to meet martyred soldier's family in Mathura

MATHURA: Army Chief General Bikram Singh, will meet the family members of Lance Naik Hemraj here on Wednesday amid demands that the severed head of the martyred soldier be brought back.

General Singh had earlier on Monday said he would visit Hemraj's home.

"I will go. They are my people. Tomorrow is Army Day, I will send my senior officer there. I will definitely go. Let this event, the Army Day, be over, I will definitely go and meet the family. If that is the demand, I shall be there," General Singh told the media in New Delhi.

General Singh, who conveyed his condolences to the families of the two jawans killed brutally, had also said that the Pakistan army should be pressurised to return Hemraj's head.

General Singh had also warned Pakistan that India reserves the right to retaliate at the time and place of its choosing.

Hemraj's wife and mother had gone on a six-day fast demanding that the Army Chief must visit their house and assure them that the martyred soldier's severed head will be brought back.

The Prime Minister yesterday termed as 'barbaric' the brutal killing of Indian jawans along the Line of Control (LoC), and said there cannot be business as usual with Islamabad.

Manmohan Singh, who broke his silence on the prevailing tension with Pakistan on the LoC, said the attack on the Indian jawans is unacceptable.

"After this barbaric act, there cannot be business as usual with Pakistan. Pakistan must be held accountable for what happened on the LoC. Hope Pakistan will bring the perpetrators of beheading to justice. The future peace process depends on Pakistan," he said.

Tension between the two Asian neighbours has escalated ever since Indian jawan Lance Naik Hemraj was beheaded in an attack by Pakistani troops along the Line of Control on January 8.

India has lodged a strong protest against the ceasefire violations by Pakistan along the LoC and made it clear to it that the Army reserves the right to retaliate if provoked.

The Army's position was conveyed at a brigadier-level flag meeting between the two sides at Chakan-Da-Bagh crossing-point in Poonch sector of the Jammu region on Monday.

Pakistan has denied India's claim that its troops crossed the Line of Control to ambush a patrol party in the Mendhar sector in Poonch district.

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NRA Ad Calls Obama 'Elitist Hypocrite'

Jan 16, 2013 12:04am

Pablo Martinez Monsivais/AP Photo

As the White House prepares to unveil a sweeping plan aimed at curbing gun violence, the National Rifle Association has launched a preemptive, personal attack on President Obama, calling him an “elitist hypocrite” who, the group claims, is putting American children at risk.

In 35-second video posted online Tuesday night, the NRA criticizes Obama for accepting armed Secret Service protection for his daughters, Sasha and Malia, at their private Washington, D.C., school while questioning the placement of similar security at other schools.

“Are the president’s kids more important than yours? Then why is he skeptical about putting armed security in our schools, when his kids are protected by armed guards at their school?” the narrator says.

“Mr. Obama demands the wealthy pay their fair share of taxes, but he’s just another elitist hypocrite when it comes to a fair share of security,” it continues. “Protection for their kids and gun-free zones for ours.”

The immediate family members of U.S. presidents – generally considered potential targets – have long received Secret Service protection.

The ad appeared on a new website for a NRA advocacy campaign – “NRA Stand and Fight” — that the gun-rights group appears poised to launch in response to Obama’s package of gun control proposals that will be announced today.

It’s unclear whether the video will air on TV or only on the web. The NRA did not respond to ABC News’ request for comment.  The domain for the website is registered to Ackerman McQueen, the NRA’s long-standing public relations firm.

The White House had no comment on the NRA ad.

In the wake of last month’s mass shooting at Sandy Hook Elementary School, the Obama administration has met with a cross-section of advocacy groups on all sides of the gun debate to formulate new policy proposals.

The NRA, which met with Vice President Joe Biden last week, has opposed any new legislative gun restrictions, including expanded background checks and limits on the sale of assault-style weapons, instead calling for armed guards at all American schools.

Obama publicly questioned that approach in an interview with “Meet the Press” earlier this month, saying, “I am skeptical that the only answer is putting more guns in schools. And I think the vast majority of the American people are skeptical that that somehow is going to solve our problem.”

Still, the White House has been considering a call for increased funding for police officers at public schools and the proposal could be part of a broader Obama gun policy package.

Fifty-five percent of Americans in the latest ABC News/Washington Post poll say they support adding armed guards at schools across the country.

“The issue is, are there some sensible steps that we can take to make sure that somebody like the individual in Newtown can’t walk into a school and gun down a bunch of children in a shockingly rapid fashion.  And surely, we can do something about that,” Obama said at a news conference on Monday.

“Responsible gun owners, people who have a gun for protection, for hunting, for sportsmanship, they don’t have anything to worry about,” he said.

ABC News’ Mary Bruce and Jay Shaylor contributed reporting. 

SHOWS: Good Morning America World News

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West African army chiefs to approve Mali troops plan

BAMAKO (Reuters) - West African defense chiefs will on Tuesday approve plans to speed up the deployment of African troops against Islamist rebels in northern Mali, with some regional soldiers seen arriving next week.

France has already poured hundreds of troops into Mali and carried out days of air strikes in a vast desert area seized last year by an Islamist alliance that combines al Qaeda's north African wing AQIM with Mali's home-grown MUJWA and Ansar Dine rebel groups.

Western and regional powers are concerned the insurgents will use Mali's north as a launchpad for international attacks.

"On January 15, the committee of Chiefs of Defense Staff will meet in Bamako to approve the contingency plan," the mission head of the ECOWAS grouping of West African states, Aboudou Toure Cheaka, told Reuters.

"I can tell you that in one week, the troops will effectively be on the ground," he said, adding their immediate mission would be to help stop the rebel advance while preparations for a full intervention plan continued.

He did not say how many soldiers would arrive.

The original timetable for the 3,300-strong U.N.-sanctioned African force - backed by western logistics, money and intelligence services - did not initially foresee full deployment before September due to logistical constraints.

Senegal, Burkina Faso, Niger, Nigeria and Guinea have all offered troops. But regional powerhouse Nigeria, which is due to lead the mission, has cautioned that even if some troops arrive in Mali soon, training will take more time.

The plan is being fast-tracked after France rushed to respond to a plea for help by Mali's government after mobile columns of Islamist fighters last week threatened the central garrison towns of Mopti and Sevare, with its key airport.

The French defense ministry said on Monday it aimed to deploy some 2,500 soldiers to Mali to bolster the Malian army and the eventual West African force.

"SAFEGUARD MALI"

French Prime Minister Jean-Marc Ayrault said France's goals were to stop the Islamist rebels, to "safeguard the existence of Mali" and pave the way for the African-led military operation.

U.S. officials said Washington was sharing information with French forces in Mali and considering providing logistics, surveillance and airlift capability.

"We have made a commitment that al Qaeda is not going to find anyplace to hide," U.S. Defense Secretary Leon Panetta told reporters as he began a visit to Europe.

As French aircraft bombarded mobile columns of Islamist fighters, other insurgents launched a counter-attack further to the south, dislodging government forces from the town of Diabaly, 350 km (220 miles) from Bamako.

French intervention has raised the threat for eight French hostages held by al Qaeda allies in the Sahara and for 30,000 French expatriates living in neighboring, mostly Muslim states. Concerned about reprisals at home, France has tightened security at public buildings and on public transport.

The U.N. said an estimated 30,000 people had fled the latest fighting in Mali, joining more than 200,000 already displaced.

U.N. Secretary-General Ban Ki-moon on Monday welcomed the French-led military intervention in Mali and voiced the hope that it would halt the Islamist assault.

Amnesty International said at least six civilians were killed in recent fighting in the town of Konna, where French aircraft had earlier bombarded rebel positions, and called on both sides to spare non-combatants.

France, which has repeatedly said it has abandoned its role as the policeman of its former African colonies, is among the toughest proponents of a speedier deployment of the African troops, and convened a U.N. Security Council meeting Monday to discuss the crisis.

French U.N. Ambassador Gerard Araud told reporters after the meeting that the U.S., Canada, Belgium, Denmark and Germany had also offered logistical support for France's Mali operation.

"I felt that all the members of the Security Council were expressing their support (for) and understanding of the French decision," Araud told reporters.

No Europeans or other African Union members will be allowed in the defense chiefs meeting in Bamako on Tuesday, a western diplomat told Reuters, requesting not to be named.

"They don't want any French pressure at the meeting," the diplomat said.

(Reporting by Bate Felix; Additional reporting by Michelle Nichols and Louis Charbonneau at the United Nations Richard Valdmanis in Dakar, Brian Love in Paris and David Alexander in Lisbon; Editing by Richard Valdmanis and Giles Elgood)

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New Holocaust museum opens at gruesome WW2 site

BRUSSELS: Belgium's newly-opened Holocaust and human rights museum stands symbolically on the site of barracks commandeered by the Nazis as a wartime transit centre for Jews and Gypsies being sent to the death camps.

The new "Kazerne Dossin" in the Flemish town of Mechelen, comprising a museum, memorial and documentation centre, is located at the site of an 18th century barracks that officials dub "a silent witness to the greatest war crime, in the form of genocide, in Belgium".

The new World War II remembrance complex some 30 kilometres from Brussels was inaugurated by Belgian King Albert II and opened to the public last month.

Like the Drancy camp outside Paris where Jews were rounded up and sent to death camps, the Dossin barracks -- directly linked to the Belgian rail network -- was turned into a last-stop transit centre for the notorious Auschwitz-Birkenau camp run by the Nazis during the war.

More than 25,500 Jews and 350 Gypsies from both Belgium and northern France were sent there after their arrest, often with the help of local police.

There were more than 70,000 Jews in Belgium before the Second World War broke out, notably 18,000 in the nearby port city of Antwerp.

After two or three months at Dossin, deportees were herded into trains for the Third Reich's death camps. Only five percent of the Jews and Gypsies who left Mechelen in 28 convoys ever returned.

Last September, Belgian Prime Minister Elio Di Rupo presented the country's apologies for crimes committed by people who had worked hand-in-hand with Nazis to deport Jews.

"This new museum takes a more profound look at the history of the persecution of the Jews in Flanders and Belgium, based on new historic sources of information and insights," said Kris Peeters, who heads the Dutch-speaking government of Flanders.

"It also provides a link between the concepts of holocaust and human rights."

In 1995, members of the Jewish community opened a small museum in a part of the barracks but much of the building had already been turned into flats and sold.

The new complex, built with the help of a 25-million-euro investment by the government of Flanders, adds a state-of-the-art cube-like museum designed by celebrated Flemish architect Bob Van Reeth.

The top fourth floor, destined to house temporary exhibitions, is open to the light of day but the other three storeys smack of a mausoleum.

Rectangular shapes in the white facade symbolise bricked-up windows while the heavy sliding steel door recalls those on the freight trains used to carry the victims to their death.

Van Reeth said the total volume was equivalent to that of the freight cars used in the 28 convoys to the death camp; the number of bricks used being the same as the number of people deported.

The three floors touch on three themes -- intolerance, fear and death.

The museum expects to see 100,000 visitors a year.

- AFP/al

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Hospitals crack down on workers refusing flu shots

CHICAGO (AP) — Patients can refuse a flu shot. Should doctors and nurses have that right, too? That is the thorny question surfacing as U.S. hospitals increasingly crack down on employees who won't get flu shots, with some workers losing their jobs over their refusal.

"Where does it say that I am no longer a patient if I'm a nurse," wondered Carrie Calhoun, a longtime critical care nurse in suburban Chicago who was fired last month after she refused a flu shot.

Hospitals' get-tougher measures coincide with an earlier-than-usual flu season hitting harder than in recent mild seasons. Flu is widespread in most states, and at least 20 children have died.

Most doctors and nurses do get flu shots. But in the past two months, at least 15 nurses and other hospital staffers in four states have been fired for refusing, and several others have resigned, according to affected workers, hospital authorities and published reports.

In Rhode Island, one of three states with tough penalties behind a mandatory vaccine policy for health care workers, more than 1,000 workers recently signed a petition opposing the policy, according to a labor union that has filed suit to end the regulation.

Why would people whose job is to protect sick patients refuse a flu shot? The reasons vary: allergies to flu vaccine, which are rare; religious objections; and skepticism about whether vaccinating health workers will prevent flu in patients.

Dr. Carolyn Bridges, associate director for adult immunization at the federal Centers for Disease Control and Prevention, says the strongest evidence is from studies in nursing homes, linking flu vaccination among health care workers with fewer patient deaths from all causes.

"We would all like to see stronger data," she said. But other evidence shows flu vaccination "significantly decreases" flu cases, she said. "It should work the same in a health care worker versus somebody out in the community."

Cancer nurse Joyce Gingerich is among the skeptics and says her decision to avoid the shot is mostly "a personal thing." She's among seven employees at IU Health Goshen Hospital in northern Indiana who were recently fired for refusing flu shots. Gingerich said she gets other vaccinations but thinks it should be a choice. She opposes "the injustice of being forced to put something in my body."

Medical ethicist Art Caplan says health care workers' ethical obligation to protect patients trumps their individual rights.

"If you don't want to do it, you shouldn't work in that environment," said Caplan, medical ethics chief at New York University's Langone Medical Center. "Patients should demand that their health care provider gets flu shots — and they should ask them."

For some people, flu causes only mild symptoms. But it can also lead to pneumonia, and there are thousands of hospitalizations and deaths each year. The number of deaths has varied in recent decades from about 3,000 to 49,000.

A survey by CDC researchers found that in 2011, more than 400 U.S. hospitals required flu vaccinations for their employees and 29 hospitals fired unvaccinated employees.

At Calhoun's hospital, Alexian Brothers Medical Center in Elk Grove Village, Ill., unvaccinated workers granted exemptions must wear masks and tell patients, "I'm wearing the mask for your safety," Calhoun says. She says that's discriminatory and may make patients want to avoid "the dirty nurse" with the mask.

The hospital justified its vaccination policy in an email, citing the CDC's warning that this year's flu outbreak was "expected to be among the worst in a decade" and noted that Illinois has already been hit especially hard. The mandatory vaccine policy "is consistent with our health system's mission to provide the safest environment possible."

The government recommends flu shots for nearly everyone, starting at age 6 months. Vaccination rates among the general public are generally lower than among health care workers.

According to the most recent federal data, about 63 percent of U.S. health care workers had flu shots as of November. That's up from previous years, but the government wants 90 percent coverage of health care workers by 2020.

The highest rate, about 88 percent, was among pharmacists, followed by doctors at 84 percent, and nurses, 82 percent. Fewer than half of nursing assistants and aides are vaccinated, Bridges said.

Some hospitals have achieved 90 percent but many fall short. A government health advisory panel has urged those below 90 percent to consider a mandatory program.

Also, the accreditation body over hospitals requires them to offer flu vaccines to workers, and those failing to do that and improve vaccination rates could lose accreditation.

Starting this year, the government's Centers for Medicare & Medicaid Services is requiring hospitals to report employees' flu vaccination rates as a means to boost the rates, the CDC's Bridges said. Eventually the data will be posted on the agency's "Hospital Compare" website.

Several leading doctor groups support mandatory flu shots for workers. And the American Medical Association in November endorsed mandatory shots for those with direct patient contact in nursing homes; elderly patients are particularly vulnerable to flu-related complications. The American Nurses Association supports mandates if they're adopted at the state level and affect all hospitals, but also says exceptions should be allowed for medical or religious reasons.

Mandates for vaccinating health care workers against other diseases, including measles, mumps and hepatitis, are widely accepted. But some workers have less faith that flu shots work — partly because there are several types of flu virus that often differ each season and manufacturers must reformulate vaccines to try and match the circulating strains.

While not 100 percent effective, this year's vaccine is a good match, the CDC's Bridges said.

Several states have laws or regulations requiring flu vaccination for health care workers but only three — Arkansas, Maine and Rhode Island — spell out penalties for those who refuse, according to Alexandra Stewart, a George Washington University expert in immunization policy and co-author of a study appearing this month in the journal Vaccine.

Rhode Island's regulation, enacted in December, may be the toughest and is being challenged in court by a health workers union. The rule allows exemptions for religious or medical reasons, but requires unvaccinated workers in contact with patients to wear face masks during flu season. Employees who refuse the masks can be fined $100 and may face a complaint or reprimand for unprofessional conduct that could result in losing their professional license.

Some Rhode Island hospitals post signs announcing that workers wearing masks have not received flu shots. Opponents say the masks violate their health privacy.

"We really strongly support the goal of increasing vaccination rates among health care workers and among the population as a whole," but it should be voluntary, said SEIU Healthcare Employees Union spokesman Chas Walker.

Supporters of health care worker mandates note that to protect public health, courts have endorsed forced vaccination laws affecting the general population during disease outbreaks, and have upheld vaccination requirements for schoolchildren.

Cases involving flu vaccine mandates for health workers have had less success. A 2009 New York state regulation mandating health care worker vaccinations for swine flu and seasonal flu was challenged in court but was later rescinded because of a vaccine shortage. And labor unions have challenged individual hospital mandates enacted without collective bargaining; an appeals court upheld that argument in 2007 in a widely cited case involving Virginia Mason Hospital in Seattle.

Calhoun, the Illinois nurse, says she is unsure of her options.

"Most of the hospitals in my area are all implementing these policies," she said. "This conflict could end the career I have dedicated myself to."

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Online:

R.I. union lawsuit against mandatory vaccines: http://www.seiu1199ne.org/files/2013/01/FluLawsuitRI.pdf

CDC: http://www.cdc.gov

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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Armstrong Admits Doping in Tour, Sources Say

Lance Armstrong today admitted to Oprah Winfrey that he used performance enhancing drugs to win the Tour de France, sources told ABC News.

A goverment source tells ABC News that Armstrong is now talking with authorities about paying back some of the US Postal Service money from sponsoring his team. He is also talking to authorities about confessing and naming names, giving up others involved in illegal doping. This could result in a reduction of his lifetime ban, according to the source, if Armstrong provides substantial and meaningful information.

Armstrong made the admission in what sources describe as an emotional interview with Winfrey to air on "Oprah's Next Chapter" on Jan. 17.

The 90-minute interview at his home in Austin, Texas, was Armstrong's first since officials stripped him of his world cycling titles in response to doping allegations.

Word of Armstrong's admission comes after a Livestrong official said that Armstrong apologized today to the foundation's staff ahead of his interview.

The disgraced cyclist gathered with about 100 Livestrong Foundation staffers at their Austin headquarters for a meeting that included social workers who deal directly with patients as part of the group's mission to support cancer victims.

Armstrong's "sincere and heartfelt apology" generated lots of tears, spokeswoman Katherine McLane said, adding that he "took responsibility" for the trouble he has caused the foundation.

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McLane declined to say whether Armstrong's comments included an admission of doping, just that the cyclist wanted the staff to hear from him in person rather than rely on second-hand accounts.

Armstrong then took questions from the staff.

Armstrong's story has never changed. In front of cameras, microphones, fans, sponsors, cancer survivors -- even under oath -- Lance Armstrong hasn't just denied ever using performance enhancing drugs, he has done so in an indignant, even threatening way.

Armstrong, 41, was stripped of his seven Tour de France titles and banned from the sport for life by the U.S. Anti-Doping Agency in October 2012, after allegations that he benefited from years of systematic doping, using banned substances and receiving illicit blood transfusions.

"Lance Armstrong has no place in cycling and he deserves to be forgotten in cycling," Pat McQuaid, the president of the International Cycling Union, said at a news conference in Switzerland announcing the decision. "This is a landmark day for cycling."

The U.S. Anti-Doping Agency issued a 200-page report Oct. 10 after a wide-scale investigation into Armstrong's alleged use of performance-enhancing substances.

Armstrong won the Tour de France from 1999 to 2005.

According to a source, speaking to ABC News, a representative of Armstrong's once offered to make a donation estimated around $250,000 to the agency, as "60 Minutes Sports" on Showtime first reported.

Lance Armstrong's attorney Tim Herman denied it. "No truth to that story," Herman said. "First Lance heard of it was today. He never made any such contribution or suggestion."

Armstrong, who himself recovered from testicular cancer, created the Lance Armstrong Foundation (now known as the LIVESTRONG Foundation) to help people with cancer cope, as well as foster a community for cancer awareness. Armstrong resigned late last year as chairman of the LIVESTRONG Foundation, which raised millions of dollars in the fight against cancer.

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