Infection Control Today - 06/2004: Perspectives


Improving Influenza Immunization Rates Among HealthcareWorkers
A Public Health Imperative

By Jeanne Pfeiffer, RN, MPH, CIC, and Barbara Soule, RN, MPA,CIC Jeanne Pfeiffer Barbara Soule

Influenza immunization rates amonghealthcare workers remain unacceptably low. On average, only 36 percent areimmunized each year, despite long-standing recommendations by the Centers forDisease Control and Prevention (CDC) for all healthcare workers to receive an annual vaccination.1

The Association for Professionals in Infection Control andEpidemiology (APIC) is taking a strong stand on this public health issue. APIChas issued new recommendations that call on healthcare facilities to develop andimplement comprehensive influenza vaccination programs for employees. APICsrecommendations (published in the May issue of the American Journal ofInfection Control) also provide specific guidance on strategies that canhelp institutions improve their programs and immunization rates.

Research shows healthcare workers, in particular, are at anincreased risk for contracting influenza due to contact with ill patients.Further, infected healthcare workers can spread the influenza virus to patientsin their care, many of whom may be at high risk for influenza-related complications.1

Vaccination is the primary means of reducing influenzatransmission and preventing infection by the influenza virus. Influenza causesan average of 36,000 deaths and 114,000 hospitalizations annually.1

Healthcare workers encounter patients throughout the influenzaseason in a variety of settings, including medical practices, general hospitals,specialty hospitals, pediatric hospitals, long-term care facilities, emergencydepartments, ambulatory care settings, rehabilitation facilities and home-caresites. Institutional influenza outbreaks can have serious consequences for bothpatients and healthcare workers.

Not only do outbreaks put patients at risk of contractinginfluenza, they can exacerbate existing staff shortages, limit admissions andincrease healthcare costs. Healthcare workers also tend to work through orreturn to work sooner during illness, thus increasing the likelihood oftransmitting the virus to patients and co-workers.

Infection control professionals can play a critical role inhelping institutions improve healthcare workers influenza immunization rates,by educating staff regarding the CDC recommendations. At this time, manyinstitutions do not have formal mandatory influenza control policies in place toensure workers are immunized and to protect patients. This has been a voluntaryprogram in hospitals for a number of years. APIC hopes this position paper willserve as a tool for implementing immunization plans in these facilities.

In January 2004, APIC initiated a multi-faceted initiativeaimed at increasing influenza immunization rates among healthcare workers. As akey step in this initiative, APIC is completing a membership survey to assessthe state of employee influenza immunization programs at members institutionsacross the country.

In addition, APIC is developing new resources for infectioncontrol professionals and other healthcare workers that will help facilitate theimplementation of formal influenza control policies. APICs initiative,including the survey results and new professional resources, will be highlightedat its 31st Annual Educational Conference to be held in Phoenix on June 9, 2004.

APICs position statement on healthcare worker influenzaimmunization, as well as additional information on the program are availableonline at

Jeanne Pfeiffer, RN, MPH,CIC, is president of APIC. Barbara Soule, RN, MPA, CIC, is immediatepast-president.

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