Flu Vaccination Coverage Among Healthcare Personnel Was 67.6 Percent for Early Season 2017-18

The Centers for Disease Control and Prevention (CDC) reports that early-season 2017–18 influenza vaccination coverage among healthcare personnel (HCP) was 67.6%, similar to early-season coverage during the 2016–17 season (68.5%). During the previous two seasons, flu vaccination coverage increased by 10 to 12 percentage points from early season to the end of the season.

By occupation, early-season flu vaccination coverage was highest among pharmacists (86.4%), physicians (82.7%), nurses (80.9%), nurse practitioners/physician assistants (79.7%), and other clinical personnel (75.1%).

Flu vaccination coverage was lowest among administrative and nonclinical support staff (61.0%) and assistants and aides (56.2%).

By work setting, early season flu vaccination coverage was highest among HCP working in hospitals (82.6%).

Flu vaccination coverage continues to be lower among HCP working in long-term care (LTC) settings (58.5%) compared with those working in hospitals and ambulatory care settings (68.7%).

Early-season flu vaccination coverage was higher among HCP whose employers required (88.4%) or recommended (65.1%) that they be vaccinated compared with HCP whose employer did not have a requirement or a recommendation regarding flu vaccination (29.8%).

Among unvaccinated HCP who did not intend to get the flu vaccination during this flu season, the most common reason reported for not getting vaccinated was fear of experiencing side effects or getting sick from the vaccine (22.1%).

Vaccination continues to be low among assistants, aides, nonclinical support staff, and HCP working in LTC settings. Providing free, on-site, and actively promoted influenza vaccination in the workplace can lead to improved coverage. Efforts to improve HCP coverage are most needed in LTC settings, where residents are at high risk of severe complications from flu.

The highest vaccination coverage was reported among HCP with an employer requirement for vaccination.

Flu among HCP can result in lost workdays for HCP and can spread to other HCP and to patients who are at higher risk of serious flu complications. Flu vaccination of HCP has been shown to reduce the risk of flu and absenteeism in vaccinated HCP and reduce the risk of respiratory illness and deaths in nursing home residents.

The Advisory Committee on Immunization Practices (ACIP) recommends that all HCP receive an annual flu vaccination.

Flu vaccination coverage among HCP has improved over the past six flu seasons, but remains below the national Healthy People 2020 target of 90%. Flu vaccination coverage among HCP measured using Internet panel surveys* was 79.0% at the end of the 2015–16 season and 78.6% at the end of the 2016–17 season.

The CDC analyzed data from an Internet panel survey conducted among HCP from October 26 through November 10, 2017. The November Internet panel survey of HCP is designed to provide early estimates of national flu vaccination coverage among HCP. The results of this survey provide information for use in vaccination campaigns during National Influenza Vaccination Week 2017 (Dec. 3–9, 2017). Final 2017–18 flu season HCP vaccination coverage estimates will be published in September 2018.

Early flu vaccination coverage was higher among pharmacists (86.4%), physicians (82.7%), nurses (80.9%), nurse practitioners and physician assistants (79.7%), and other clinical personnel (75.1%) compared with administrative and nonclinical support staff (61.0%) and assistants or aides (56.2%).

Flu vaccination coverage increased in pharmacists by 5 percentage points compared with early-season 2016–17. Coverage in all other occupational groups was similar to early-season 2016–17.

Early flu vaccination coverage varied by work setting and was highest among HCP working in hospitals (82.6%) and lowest among HCP working in long-term care settings (58.5%) and settings other than hospital, ambulatory, or long-term care (examples include pharmacies, dental offices, and emergency medical transport) (56.2%).

Coverage among HCP working in “other” settings decreased by 9.9 percentage points from early-season 2016–17 to early-season 2017–18. Coverage in all other work settings was similar in early-season 2016–17 and early-season 2017–18.

Early flu vaccination coverage among HCP varied by age, ranging from 65.0% among HCP 18–49 years to 78.0% among HCP ≥65 years. Vaccination coverage among HCP ≥65 years increased by 10.7 percentage points compared with early-season 2016–17; coverage in other age groups was similar compared with early season 2016–17.

Early flu vaccination coverage was highest among HCP with an employer requirement for vaccination (88.4%). Vaccination coverage was higher among HCP with an employer recommendation for vaccination but no requirement (65.1%) compared with those whose employers had neither a requirement nor a recommendation for vaccination (29.8%).

HCP working in hospitals were more likely to report an employer requirement for vaccination than HCP working in ambulatory care, long-term care, and other settings.

Overall, the early estimate of flu vaccination coverage among HCP in 2017–18 (67.6%) was similar to early coverage estimates from 2016–17 (68.5%). Flu vaccination coverage among HCP working in hospital settings was substantially higher than coverage among HCP working in ambulatory, long-term care, and other work settings. On-site vaccination and other successful promotional efforts to increase coverage in hospital settings could be implemented in work settings with lower coverage.

Main reasons for not getting vaccinated among those who do not plan to get vaccinated were concern about side effects or ingredients in the vaccine, thinking that vaccination is not needed, and thinking that vaccine is not effective. HCP should be provided with information about the impact of flu vaccination, including acknowledgement of the variability of flu vaccine effectiveness and resulting impact. HCP also should be reminded that flu vaccines have a long and good safety record and that substantial benefits of influenza vaccination have been documented, including the prevention of millions of illnesses, tens of thousands of hospitalizations, and thousands or tens of thousands of deaths each year.

Main reasons for not getting vaccinated among those who plan to get vaccinated included not getting around to it or having enough time and employer vaccination not available yet, not available at a time when employee is working, or not allowed time to get vaccinated. Onsite, free, and actively promoted flu vaccination is a recommended strategy to decrease cases of flu among HCP and their patients.

Interventions to promote flu vaccination among HCP each season include the following:

Employers should offer flu vaccination to HCP:
At the worksite over multiple days and shifts,
Free of charge, and with
Active promotion.
Educational materials should be provided to address questions and misperceptions about flu vaccination benefits and risks.

Employers and healthcare administrators should make use of the Guide to Community Preventive Services, which provides guidance on effective interventions to increase the uptake of flu vaccination among HCP. Long-term care (LTC) employers also can use the LTC web-based toolkit developed by CDC and the National Vaccine Program Office, which provides access to resources, strategies, and educational materials for increasing flu vaccination among HCP in LTC settings.
Measurement and feedback of vaccination coverage are recommended by the Community Preventive Services Task Force to increase uptake of recommended vaccinations. Measures such as the requirements by the Centers for Medicare and Medicaid Services (CMS) for acute care hospitals, ambulatory surgery centers, and outpatient dialysis facilities to report HCP influenza vaccination coverage rates for their facilities may be useful for this purpose.

Source: CDC; Health Care Personnel and Flu Vaccination, Internet Panel Survey, United States, November 2017