Flu vaccination still a challenge for hospitals

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Source: http://www.cidrap.umn.edu/cidrap/content/influenza/panflu/news/apr0908shea.html

Flu vaccination still a challenge for hospitals

Maryn McKenna * Contributing Writer

Apr 9, 2008 (CIDRAP News) ? Healthcare institutions still face significant hurdles in getting their staff members vaccinated against seasonal influenza, and fear of flu infection and caring for sick family will keep many staff home during an influenza pandemic, according to research released this week,

Four teams of researchers reported at the 18th Annual Scientific Meeting of the Society for Healthcare Epidemiology of America, held in Orlando, Fla., that large proportions of hospital staff believe that flu vaccine causes influenza or triggers other side effects. Others believe that previous bouts of flu have made them immune to contracting the flu again.

On average, only 40% of healthcare workers receive flu shots each year, according to the Centers for Disease Control and Prevention.

At Emory University School of Medicine and Emory Healthcare of Atlanta, intensive campaigns have raised flu vaccination coverage from 43% to 67% of the staff, but pockets of resistance remain, according to a report by Sarah E. Smithson and colleagues. An anonymous online survey of the academic medical center's 9,700 employees, which garnered responses from 1,994 workers or 21% of the staff, found that 50% of those who did not take the flu shot believe vaccination is a "personal decision," 31% did not take it for fear of side effects, and 20% had confidence in their own "natural immunity."

Concern about vaccine side effects was also common at Our Lady of Mercy Medical Center in the Bronx, NY, where the 40% of staff were vaccinated in 2007?more than three times the number who accepted the shot in 2003, according to Rajitha Ambuti, MD, and colleagues. "Declination forms" filled out by staff who refused the shot revealed that 53% feared adverse effects, 10% believed the vaccine does not work, and 9.6% believed they were at no risk for flu.

At the University of California?Irvine, where staff who decline vaccination are required to report electronically, researchers reviewed 1,160 refusals and also polled a convenience sample of 300 healthcare workers waiting to be vaccinated. The report by Kathleen A. Quan, RN, and others revealed a complex mix of attitudes toward the flu shot. A high proportion of those who agreed to be vaccinated?47%?believed it would cause flu symptoms, whereas only 29% of those who refused the vaccine shared that belief. And though 84% of those waiting for the shot had taken it in earlier years, only 61% said they intended to take it the following year, and 2% said they would be relieved if the vaccine supply ran out before they reached the end of the line.

Finally, at the University of South Alabama in Mobile, 50% of the staff responded to an anonymous 10-question survey on seasonal and pandemic flu that was distributed to all hospital employees on all shifts, and 49.6% of those responding revealed that they do not receive flu vaccine.

Staff in that hospital also said they would have difficulty coming to work in a flu pandemic, said the report by William K. Green, MD. Only 13.7% of employees expected to report as usual. Among those who said they would not come to work, 13.9% said they were afraid of becoming sick, 30% said they could not come to work if someone else in their household were sick, and 48.1% said they would not be able to report if schools and daycare centers were closed as a protective measure.

Despite educational efforts by the hospital, 15.7% of the staff said they did not know what pandemic influenza was.

 

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Re: Flu vaccination still a challenge for hospitals

Source: http://www.nctimes.com/articles/2008/11/30/health/z366b21cc5bb13b30882574e40075cc8a.txt

Flu shots a tough sell to some health care workers

By MELANIE S. WELTE - Associated Press | Sunday, November 30, 2008 12:13 AM PST ∞

DES MOINES, Iowa ---- Operating room nurse Pauline Taylor knows her refusal to get a flu shot is based on faulty logic.

But ever since she got sick after getting a shot a few years ago, she's sworn off the vaccine.

"I rarely get sick. The only thing I could narrow it down to is that I had gotten this shot," said Taylor, who works at University Hospitals and Clinics in Iowa City. "I know that it's not a live virus. It just seemed pretty coincidental."

Such stories frustrate Dr. William Schaffner.

As chairman of the Department of Preventive Medicine at Vanderbilt University, he hears that kind of talk frequently and knows it's in part to blame for a surprising statistic ---- nearly 60 percent of health care workers fail to get a flu shot.

That's despite recommendations from the Centers for Disease Control and Prevention that all health care workers get vaccinated, from hospital volunteers to doctors.

"It is a professional obligation on the part of health care workers to make sure that they are as protected against influenza as possible," Schaffner said.

Schaffner argues that getting vaccinated for the flu should be standard for doctors and nurses, just like washing their hands. That's because the flu virus can be spread so easily.

"Being in close proximity to patients, having conversations with them, bending over their bed, seeing them in the clinic while you're doing procedures, you would be breathing out viruses and spreading influenza into your patients," said Schaffner, who is also president-elect of the National Foundation for Infectious Diseases.

The nonprofit group educates the public and health care industry about the causes, treatment and prevention of infectious diseases. It gets about 75 percent of its budget from major vaccine makers, but executive director Len Novick said the money comes with no strings attached.

Despite the attention given to the problem, there are few well documented cases of flu outbreaks caused by health care workers.

Schaffner said that's because it's tough to prove sick health care workers are to blame for hospital outbreak.

According to the foundation, likely cases of flu outbreaks between health care workers and patients include:

-- 19 babies in a neonatal intensive care unit in Ontario, Canada, infected in 2000; one died. Health care workers, only 15 percent of whom were immunized, were the likely source.

-- 65 residents of a nursing home in New York got the flu during the 1991-1992 flu season, and two died. Only 10 percent of health care workers had been vaccinated before the outbreak, according to a report by the CDC.

Schaffner said health care workers opt not to get vaccinated for the same reasons others are hesitant. Some also don't realize how easily they can spread the disease, sometimes before they know they're infected or even if they have only a mild case.

And, he said, there's the "myth" that you can get flu from the vaccine.

The CDC recommends that health care facilities offer free flu vaccines to employees annually at work, and that hospitals obtain signed statements from workers who refuse.

The CDC also recommends a flu shot for people age 50 and over, the chronically ill, and women who will be pregnant during the flu season. This year virtually all children from 6 months to 18 years were added to the list.

Several states have laws requiring hospitals to make the vaccines available.

In Iowa, University Hospitals requires documentation that all health care workers were offered the vaccine, but workers are free to decline, as Taylor, the ER nurse, did. Dr. Patrick Hartley, who heads the hospital's employee health clinic, said in the last flu season, 84 percent of employees got their flu shots.

At Allen Hospital in Waterloo, Iowa, the flu shot is mandatory for those with direct patient contact and recommended for everyone else. Those with allergies to the vaccine or other conditions can take a pass, but they must supply a note from their doctor. The hospital says the vaccination rate is 93 percent.

Some hospitals take a tougher stand on vaccinations.

In Seattle, at Virginia Mason Medical Center, even sales reps, vendors and volunteers must be vaccinated unless they seek exceptions for religious or medical reasons. Even then, those who don't get a shot must wear a mask whenever they are in the hospital during the flu season.

About 99 percent of the hospital's more than 5,000 employees were vaccinated.

Dr. Joyce Lammert, the hospital's chief of medicine, said they lost around seven employees when the policy took effect four years ago.

"A lot of reasons we heard about people not wanting flu shots was all about them ---- it's my freedom, I don't want to get it, I get sick when I get it," Lammert said. "Now, the culture has really changed to thinking about patients. This is what we do to protect our patients."

Lammert said patients should ask their doctors if they've gotten their flu shot.

"I wouldn't go to anybody who didn't," she said.