It’s officially flu season and whether or not we realize it, a nurse’s decision to vaccinate is contagious! According to Consumer Reports, 73 percent of people surveyed stated that health-care providers have the largest influence on their decision to vaccinate. Yet, only 52 percent of health-care workers were immunized during the 2010 seasonal flu. The Pennsylvania Department of Health states “influenza vaccination rates among Pennsylvania Health Care Workers (HCWs) remain at a suboptimal level of below 60 percent, which is far lower than the Healthy People 2020 target of 90 percent.”
Health-care workers are considered high-risk of being exposed to the flu, due to daily direct patient care. Since 1984, the U.S. Advisory Committee on Immunization Practices (ACIP) has recommended that employees in healthcare receive the influenza immunization. However, the Center for Disease Control and Prevention (CDC), estimates the current rate of immunization among health care providers is less than 50 percent.
I was surprised by this number. Nurses are aware of the deadly complication of the flu, and regardless of your occupation, the flu has financial implications by forcing you or your children to stay home for a week. What reasons are healthcare providers giving for not being immunized? Do we simply not realize that we are among a high risk group?
In 2007, the American Journal of Infection Control reported that ‘unvaccinated nurses tended to be less aware of the ACIP recommendations for health-care workers vaccination, and overall, nurses were not aware of the rationale for health-care workers vaccination. Attitudes were mixed regarding mandatory influenza vaccination programs.”
Influenza vaccination campaigns directed at healthcare workers are well supported by local departments of health and national vaccination agencies. An article from Oxford Journals, released this month, surveyed the influenza vaccination requirements for employees of acute care hospitals in the U.S. Surveyors concluded that the H1N1 epidemic of the 2009-2010 flu season was a common motivator for hospitals to implement strict immunization policies to promote employee health, decrease absenteeism and ultimately protect patients. Of the 808 responding hospitals, 56% required health care workers to receive or formally decline the flu-shot, a number which has nearly doubled every flu season since 2007. Only 4% required the flu-shot as a condition of employment.
Philly area hospitals have creative, and sometimes strict, methods for vaccinating their employees. I conducted a random survey of area hospitals and found that hospital policies for influenza immunization include all “health-care workers (HCW)” and “health care providers,” not just nurses. This group was defined as any staff who work on patient floors, not necessarily giving direct patient care. Therefore, Philly hospitals stressed the importance of vaccinating nurses as well as auxiliary staff, housekeepers, electricians, cafeteria personnel, patient aids, clerks, technician, etc.
At my hospital, it is not mandatory to receive the flu vaccine. However, our occupational health department circulates the hospital with a cart stock to distribute the flu vaccine while staff was working. This strategy combines peer pressure and convenience to gain compliance and seems to work. I have not been “caught by the cart” yet, but do plan on getting my vaccine this season especially with a one-year-old at home. I learned that Cooper University Health System has a similar vaccination strategy.
The Hospital of the University of Pennsylvania (HUP), produced a video to encourage employees to get vaccinated. Facilities such as St. Mary’s Medical Center, Temple University Hospital, and Atlantic Regional Medical Center do not have mandatory policies implemented and do not penalize for flu-related callouts. Atlantic Regional Medical Center conducts ‘flu fairs’ to target their large staff and is in its second year of an online registration program to help 100% of employees comply with the recommendations. This online program can record if employees received their vaccination outside of their hospital and identifies areas of education that are needed to address employ fears towards vaccinations.
Abington Memorial Hospital is in its second year of a mandatory vaccination program. Employees are given multiple weeks to be vaccinated by a deadline and can apply for exemptions based on allergies or religion. If employees are not vaccinated by a deadline, they are suspended for two weeks and terminated if they have not received the flu vaccine in those two weeks. In the 2010 flu season, Abington proudly achieved a vaccination rate of 98.9 percent.
Children’s Hospital of Philadelphia, as with most pediatric facilities, also mandates vaccinations and has a discipline policy similar to Abington’s. I was surprised to learn that St. Christopher’s Hospital for Children is in its first year of mandatory vaccinations although it reports that 95% “willingly complied” in the 2010 flu season. Hahnemann University Hospital makes employees wear a mask through the end of the flu season if you refuse to get vaccinated.
As always, I want your feedback. What does a nurse’s decision imply to the general public about vaccinations? Should nurses be mandated to receive the vaccine? What other methods are your employers using to get health care workers immunized? Is termination fair for nurses who opted out of receiving the flu shot? Does a nurse develop a natural immunity every time a patient coughs on them? Are we putting our patients and family at risk by not vaccinating?