CDC recommends that all health care workers receive an annual influenza vaccination to prevent transmission to patients. Influenza immunization rates among health care workers remain low, with only 36%-40% of health care workers reporting influenza vaccination each year. Influenza vaccination is an important patient safety issue because unvaccinated staff can spread influenza to patients, coworkers, and family members, leading to influenza-related illness and death. When health care workers become ill with influenza, absenteeism and disruption of care may result. When health care workers transmit influenza to patients, some of them may experience serious, even life-threatening complications or secondary pneumonias. When promoting vaccination among health care workers, emphasize the reasons to get the influenza vaccine:

Obstacles – Individual Beliefs

Some health care workers have misperceptions and misunderstandings about influenza vaccine. The scientific literature suggests several reasons for low immunization rates among health care workers including: concern about side effects or vaccine safety, perception of low personal risk of illness, inconvenience, ignorance of CDC recommendations, and dislike of needles. Therefore, there should be continuous and ongoing vaccine education updates emphasizing the seriousness of influenza and addressing employee misconceptions about influenza and the vaccine. Common misconceptions must be addressed (the flu shot does NOT give you influenza). Examples of notices that might be posted include:

You know that the influenza shot works, so why don’t more people get vaccinated?

Some people are concerned about side effects. They think that the influenza shot will make them sick. However, mild soreness of the arm at the injection site is the most common side effect. The shot itself will NOT give you influenza. Influenza vaccination is the best protection against the influenza. Protect VA patients, yourself, your co-workers and your family. Get vaccinated. Check with your supervisor for information on how to get your influenza shot.

Did you get your influenza shot last year?

If you didn’t, you may have harmed the health of some of our patients, your coworkers and family members. You can spread influenza to patients, putting them at risk for influenza and its complications. Studies show that vaccination of health care workers is associated with decreased mortality among nursing home patients. Protect yourself and your patients--get a shot. Ask your supervisor about information on how to get a flu shot.

“I don’t need to get a flu shot.” Is this you?

Influenza can cause serious illness and death even in young, healthy people. It’s not just a disease that affects the elderly. If you get influenza, you can spread it to your patients, putting them at risk for severe illness and complications from the flu. Protect yourself, your coworkers, and your patients—get a flu shot. Ask your supervisor for information on how to get vaccinated.

Successful Campaigns for Vaccinating Health Care Workers

Sending a letter, postcard or email to employees prior to the start of the vaccine season reminding them of the importance of vaccination, where and when they will be able to get the flu vaccine.
Writing something in the employee newsletter or posting information on staff bulletin boards and providing fact sheets with pay stubs to dispel misconceptions and increase acceptance.
Increasing the number of sites where the vaccine is given. Use mobile carts to transport to different clinic areas, service meetings, grand rounds or near cafeteria entrances. This approach can minimize inconvenience as well as means to advertise the vaccine availability. Carts should be stocked with vaccine, safety syringes, vaccine information statements, sharps disposal containers, alcohol hand rub, alcohol wipes, adhesive bandages, documentation forms, and injectable epinephrine with orders for administration in the event of an acute hypersensitivity reaction.
Making appointments with services to attend service meetings. A schedule should be posted or email sent to those in the service announcing that the vaccine is available at the staff meeting.
If your occupational health unit has a website, adding information to the website regarding flu shot locations and times.
In late November identifying employees not yet vaccinated and reminding them by email or a phone call that the flu vaccine is available.
Working closely with Pharmacy to get your supply of vaccine for employees.
Modifying education materials from CDC and elsewhere to address risks to employees if they are not vaccinated.
Encouraging the facility director, service chiefs, and other managers to lead the way by getting their vaccine and encouraging their staff to get vaccinated.
Giving out buttons or stickers to all staff who are vaccinated showing that they have been vaccinated. It is an additional advertising strategy for both employees and patients to be vaccinated against influenza.
Sponsoring a kick off event.
Adding an influenza reminder to occupational health’s telephone recording. When employees call they can automatically be reminded about the availability of the vaccine. If the recording capacity exists, add specific information regarding dates, times and locations for flu shots as well as any other pertinent information. These reminders should begin September 15 and conclude after the flu season has peaked, which usually occurs in February or March.
Extending hours that the vaccine is available to staff to include all shifts and days of the week. Plans must be made to have additional staff available during the extended hours of the clinic or available during off tours.
If there is a vaccine shortage, using additional strategies if necessary to ensure those who are identified as needing the vaccine are targeted. If the shortage resolves, there also should be a mechanism in place to remind those not vaccinated that it is not too late to get the vaccine.

Key elements of a successful staff flu vaccination campaign include:

Additional Measures to Take to Prevent the Spread of Influenza

Remind employees that although the influenza vaccination may be the best way to protect against the influenza, there are other measure that they should also take to protect themselves, their families, and patients.

Remember health care workers may also have health problems and conditions which put them at increased risk of complications from influenza. These include:

Immunization is the primary method to prevent influenza, limit transmission, and prevent complications from the flu.

Trivalent inactivated influenza virus vaccine may be administered to all categories of health care workers unless there is a contraindication for the vaccine. Live attenuated influenza vaccine (FluMistTM) may also be administered to health care workers. It is a good option for those health care workers who are in good health, are not pregnant, those who have a dislike of needles, and meet the criteria for LAIV.

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Improving Health Care Worker Vaccination Rates