Influenza Vaccination of Healthcare Workers

Healthcare workers (HCWs) being vaccinated against influenza is an important general infection control practice. It is recommended by the Centers for Disease Control and Prevention (CDC) that all HCWs be vaccinated against influenza annually.^1-3 According to the CDC, in the 2005-2006 flu season, only 42 percent of surveyed HCWs received a flu vaccination.⁴ It is important for hospitals to develop a comprehensive employee influenza campaign in order to decrease the transmission of the flu virus. In hospitals where less than 42 percent of HCWs consent to influenza vaccination, there is a greater challenge. This was the case at my facility, North General Hospital, and its employee influenza vaccination techniques were updated. A review of North General influenza campaigns in 2007 and 2008 showed a marked increase in screening and vaccination rates when employee education and roving clinics were implemented.

In previous influenza campaigns, the employees of North General would either receive flu vaccination at Employee Health Services or through their private clinicians. Without a focused influenza campaign, the screening and vaccination rates lagged at 15 percent and 9 percent, respectively, in 2006. There was no confidence in the influenza vaccine among HCWs. There was also the problem of the many myths and misconceptions regarding the flu vaccine. Following a guideline by the National Foundation for Infectious Diseases,⁵ the influenza campaign at North General was revamped. Employee Health Services focused on making the influenza vaccine mobile through the use of roving clinics and focused on education to dispel vaccination myths.

Up to 25 percent of unimmunized HCWs develop influenza during the winter.⁶ HCWs are exposed to the viruses of the general community via household contacts and public transportation and in the workplace via patients, co-workers, and visitors. This increase in exposure more than the general public, increases the risk of the HCW developing and transmitting influenza. It is also common practice for HCWs to continue working while they are ill. The nursing shortage and lack of coverage for sick employees can be attributed to this practice. The influenza virus can be transmitted from the day before symptoms appear up until a week later. A non-immunized HCW feeling “under the weather” but not sick enough to stay home can transmit the virus to their patients, their co-workers and any others they come into contact with. This can bring about serious influenza-related illnesses and complications in young children, adults older than 65 years, and our immunocompromised patients.