It’s that time of year again – flu season. Though the Centers for Disease Control and Prevention (CDC) does not outline a specific period, the agency notes that influenza activity picks up in October of each year and can last through May.
During the annual eight-month flu season, between 5% and 15% of the population of the United States are affected by the influenza virus, resulting in an average of 150,000 hospital admissions and 24,000 deaths, according to a position paper by the Association for Professionals in Infection Control and Epidemiology (APIC). The 2017-18 flu season was the worst in a decade, with the CDC reporting the highest number of hospitalizations since it began using the Influenza Hospitalization Surveillance Network.
As the 2018-19 flu season progresses, many healthcare professionals will spend the next few months treating the thousands of patients who will contract the flu. Yet as doctors, nurses and other healthcare professionals administer treatment to their patients, some may forget a vital part of preventive care – receiving their own seasonal flu vaccination.
The CDC recommends an annual flu vaccine for everyone aged six months or older as the best way to protect against the virus. The CDC, along with the Advisory Committee on Immunization Practices (ACIP), and the Healthcare Infection Control Practices Advisory Committee (HICPAC), also has specific recommendations that all healthcare professionals receive their annual vaccination.
According to a 2018 CDC report, more than three-quarters of healthcare professionals reported getting a flu vaccination during the 2017-18 flu season. This number is an increase compared with previous years, yet still below the 100% target. Upon further segmentation of the data, researchers found that 95% of healthcare workers whose employers required them to be vaccinated were covered. Meanwhile, only 48% of those “working in settings where vaccination was not required, promoted, or offered on-site” received vaccinations.
The same article also found that personnel who worked in long-term facilities were less likely to be vaccinated, which corresponds to a study performed during the 2014-15 flu season, in which the CDC reported that coverage among those in long-term facilities was just 55%, compared with workers in hospital settings, where coverage averaged 79%. By role, vaccination coverage was high (70-80%) among physicians, nurse practitioners/physician assistants, other clinical professionals when compared with non-clinical support staff and aids (50-60%) whom also have contact with patients.
With rising infection and mortality rates, plus the CDC reporting new and resistant strains of the virus each year, some healthcare employers have implemented mandatory vaccination programs. Nearly 70% of hospitals require annual flu vaccination for healthcare personnel, according to a 2018 study published in JAMA.
For those who were not required and did not opt for an influenza vaccine, the CDC reports healthcare workers cited a lack of need for the vaccine or, more commonly, a lack of confidence in its efficacy as their reasoning.
The vaccination coverage gap among healthcare workers yields both personal and public impacts. The CDC states on its page regarding influenza vaccinations for healthcare workers that those who are not vaccinated carry a greater risk of infection than the average person because they spend most of their day exposed, either directly or indirectly, to potentially infected patients. Additionally, since the virus can be carried in the body for up to a day before symptoms develop, an infected healthcare worker can spread the disease long before they realize they should isolate themselves from patients.
The risk becomes even more serious in long-term care facilities that serve elderly or immunocompromised patients, as the CDC lists these groups at high risk of developing serious complications from the influenza virus.
While a mandatory policy may not always be necessary, there are other strategies healthcare organizations can utilize to both educate staff and increase flu vaccination rates among them. When it comes to flu season, it is important for healthcare workers to know that the care starts with them.