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You get flu vaccinations. What about your staff?


Annual influenza vaccination rates for physicians often are significantly higher than for their office staff members, even nurses, according to a recent Centers for Disease Control and Prevention (CDC) report. That could be a problem when your waiting room is filled with sick patients this winter. CDC offers four easy-to-implement recommendations to get your practice employees to line up for the vaccine, without your actually having to require it.

It may be an issue of do as I do as well as do as I say, but the annual influenza vaccination rates for physicians often is significantly higher than for their clinical office staff members, according to a recent report from the national Centers for Disease Control and Prevention (CDC).

The 84.2% vaccination rate for physicians was slightly higher than the 82.6% rate for midlevels. The rate for nurses in all healthcare setting was considerably lower at 69.8%, with allied health professionals and technicians coming in at about 64%. The overall flu vaccination rates for ambulatory/outpatient facilities, such as physician offices, was 61.5%, compared with 71.1% for hospitals.

The Advisory Committee on Immunization Practices and the Healthcare Infection Control Practices Advisory Committee have recommended that all U.S. healthcare personnel (HCP) get an annual influenza vaccination, and the vaccination rate appears to be slowly increasing. During the 2009-2010 influenza season, 61.9% of HCP received seasonal influenza vaccination. To gather data to create an estimate for the 2010-2011 influenza season, the CDC did a Web-based survey of 1,931 HCP, which suggested that the rate had edged up to 63.5%.

“Vaccination of HCP against influenza has been shown to reduce illness and absenteeism and to reduce transmission of influenza to HCP, their families, and their patients,” according to the report.

Short of making it an outright requirement, how can you increase the influenza vaccination rate in your practice? The study suggested that the follow methods were effective:

making the vaccination available onsite;
offering a personal reminder to get vaccinated;
providing the vaccination at no cost to employees; and
arranging for the vaccine program to be available for more than one day.

Persuading staff to be immunized also may require overcoming some biases, the report said. The CDC found that the greatest differences in prevalence were among HCP who believed getting vaccinated was worth the time and expense (vaccinated: 94.7%, unvaccinated: 45.8%), those who believed getting a vaccination would better protect persons around them (vaccinated: 89.1%, unvaccinated: 44.6%), those who believed vaccination could protect them from getting influenza (vaccinated: 92.7%, unvaccinated: 54.2%), and those who believed influenza to be a serious threat to their own health (vaccinated: 70.1%, unvaccinated: 34.2%)

Vaccine safety also was a concern, even though all of the survey respondents were healthcare workers. Some 66.2% of those who were not vaccinated said they believed the vaccine to be unsafe. Conversely, 94.8% of those who received the vaccine believed it to be safe.

Since 2007, the Joint Commission has required accredited critical access hospitals, other hospitals, and long-term care centers to establish an annual influenza vaccination program to offer onsite influenza vaccination, monitor vaccination coverage, and provide education to staff members and licensed independent practitioners. Beginning in 2013, the Centers for Medicaid and Medicare Services may start requiring hospitals to report HCP influenza vaccination coverage as part of its Hospital Inpatient Quality Reporting Program.

Although the CDC's National Healthcare Safety Network has provided a Web-based tool for surveillance of vaccination of HCP in voluntarily enrolled healthcare facilities, making sure that staff members are vaccinated against influenza has remained voluntary for physicians’ offices.

Go back to the current issue of eConsult.

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Jennifer N. Lee, MD, FAAFP
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health