Improving Healthcare Worker Flu Vaccination Rates

Poland² says that healthcare providers are missing important opportunities to vaccinate people during office visits. Based on insurance claims filed by 240,000 physicians from 2004 to 2007, the researchers found that 25 million people at high risk for complications from influenza visited doctors an average of 2.2 times each year between November and February, the usual peak of influenza season, but did not get vaccinated. The researchers urge stepped-up efforts by healthcare providers to take advantage of ongoing access to patients and vaccinate them starting when they make visits during the early fall when vaccine becomes available, and continuing throughout the influenza season.

“Occasionally you have an early season, but most flu occurs in January and February,” Schaffner says. “You can have a flu vaccination campaign in October, but why not keep vaccinating in November, December and January? Some occupational health services want to get in, get done and get out, and we can’t convince them to extend their services through hundreds of other routine interactions with HCWs. In a routine examination they can look at a banged-up elbow and say, ‘By the way, did you get your flu vaccine?’ But they don’t do that. That’s how you can pick up more people along the way, and they will likely be at the front of the vaccination line next year.”

Breaking the barriers to HCW immunization and making influenza vaccination easy and convenient is one of the biggest challenges infection preventionists may face. Schaffner points to the continued misinformation about influenza vaccination that circulates among HCWs.

“There is the enduring belief that the influenza vaccine causes the flu, and this is particularly embedded among nurses,” he says. “That’s unfortunate, because if nurses carry this notion, they are not going to be advocates to get their patients vaccinated. We do realize the influenza vaccine is good but it is not perfect; we know it does not work optimally in certain older or immunocompromised individuals, and there’s not always a perfect match between the influenza vaccine and the circulating strains. Even if it’s not a perfect match, there is partial protection, which is better than no protection at all. Confidence in the vaccine is lacking in physicians as well; there are sophisticated physicians who are very skeptical about the effectiveness of the influenza vaccine and are not behind our institutional flu campaign. They are not barriers to the process, but they won’t be advocates. They’re not infectious disease specialists and they have not studied all of the data, but they know it’s not the greatest vaccine.”