Just a word like 'pandemic' is enough to scare anyone in the health care field. For registered nurse Deborah Gerhardt, there are words even scarier.
"Whenever you hear 'mandatory required,' you start to get a little bit anxious," said Gerhardt.
She's been a nurse for 15 years and has never had a flu shot.
"I feel that everyone should have a choice," says Gerhardt.
She recently learned she doesn’t have a choice.
"It was just one day we were told, 'you will receive the flu injection,'" said Gerhardt.
The New York State Department of Health is ordering tens of thousands of health workers to be immunized against seasonal and swine flu.
"As a parent, as a doctor, as a public health professional, please get your vaccine," New York State Commissioner of Health Dr. Richard Daines asked during a news conference last week.
The commissioner says refusal to be immunized against H1N1 could increase the spread of the virus and stress an already overwhelmed medical system. He says when a vaccine is approved, there's no reason to believe it won't be safe.
"It goes through that same system and the testing, so I'll have every confidence the Food and Drug Administration and the Centers for Disease Control put in it," said Daines.
After her own research, Gerhardt isn't as confident in a potential vaccine.
"It's left a lot of questions for me," Gerhardt said.
Questions that have left her with one final decision.
"I so strongly don't want a vaccine that I'm not comfortable having injected into my body," said Gerhardt. "If I refuse, I can't work in nursing."
It's a choice she wishes she didn't have to make.
"This is just so surreal right now," said Gerhardt. "I don't know what I will do."
Gerhardt says she's never had the flu, and practices simple preventative measures like hand washing and simple sanitation techniques. She believes that's even more effective.
She realizes she could lose her job for speaking out, but says it's important since she knows others in the health care field have the same concerns.