Infection Prevention: Influenza Vaccination for Health Care Workers
All health care workers should receive annual influenza vaccination
Influenza vaccination of health care workers benefits both the health care worker and the patients they provide care to.
- Benefits to Self
- Fewer respiratory infections - In healthy adults under the age of 65, the vaccine is 70-90% effective in preventing influenza illness when there is a good match with circulating influenza strains.
- Decreased absenteeism - A study of employee vaccination found that vaccination decreased time missed from work by 32% when there was a good match with circulating influenza strains (1).
- Fewer doctor visits - The same study found a 42% decrease in physician visits when there was a good match with circulating influenza strains (1).
- Decreased use of antibiotics - persons with viral respiratory illnesses such as influenza often receive antibiotics, especially if illness is severe or diagnosis is uncertain. Antibacterial drugs have no benefit against influenza, and can lead to increased risk of complications, antibiotic resistance, drug interactions, and increased cost.
- Benefits to Patients
- Decreased transmission of influenza -Vaccine effectiveness in older and more frail individuals (such as many long-term care residents) is significantly lower, so vaccination of residents alone is not sufficient to prevent influenza transmission in long-term care facilities. In addition, infected but asymptomatic health care workers can still transmit the virus to the patients they care for.
- Decrease in resident mortality: A randomized trial showed a 44% decrease in overall resident mortality rates in facilities where health care workers were vaccinated (2) compared to those in which they were not.
To minimize the risk of influenza outbreaks, both long-term care residents and health care workers should receive annual influenza vaccination. One study showed a 60% decrease in the risk of an outbreak when staff vaccination rates were greater than 55% and resident vaccination rates were greater than 89% (3).
Health care worker influenza vaccination rates are low
- Despite the available evidence and recommendations, only about 38% of health care workers receive influenza vaccinations annually (4).
Source: CDC: National Health Interview Survey
- Even with aggressive vaccination campaigns, only 50-70% of health care workers are vaccinated (5).
Influenza vaccination rates can be increased by providing easy availability to vaccination, educational campaigns which stress the importance of vaccination and dispel misconceptions about the vaccine, and by the use of measurement and feedback.
References:
1. Bridges CB, Thompson WW, Meltzer MI et al. Effectiveness and Cost-Benefit of Influenza Vaccination of Healthy Working Adults: A Randomized Controlled Trial.
JAMA 2000; 284: 1655-1663
2. Potter J, Stott DJ, Roberts MA, et al . Influenza vaccination of health care workers in long-term care hospitals reduces the mortality of elderly pts. J infect Dis 1997;175:1-6.
3. Shugarman et al.. The Influence of Staff and Resident Immunization Rates of Influenza-Like Illness Outbreaks in Nursing Homes. J Am Med Dir Assoc. 2006 Nov; 7(9):562-7.
4. Harper SA, Fukuda K, Uyeki TM, et al. Prevention and Control of Influenza Recommendations of the Advisory Committee on Immunization Practices. MMWR 2004; 53(RR06):1-40.
5. Centers for Disease Control. Interventions to Increase Influenza Vaccination of Healthcare Workers – California and Minnesota. MMWR 2005; 54(08): 196-199.
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