With the annual influenza season underway, the Food and Drug Administration (FDA) is urging health care organizations to ensure that influenza vaccination programs are available for health care personnel (HCP).
Because unvaccinated HCP can be a primary cause of outbreaks in health care settings, annual workplace immunization programs decrease the likelihood of contracting influenza and the chance of infecting others. Therefore, the mission to ensure patient safety in each health care setting should include influenza vaccination of personnel.
Despite the benefits of immunization, CDC estimates that only 40% of the nation’s HCP are vaccinated each year. Studies have shown that low vaccination rates among HCP contribute to influenza outbreaks in hospitals and other health care settings, needlessly putting patients at an increased risk of contracting influenza and suffering from its potential major complications. Annual immunization of caregivers protects employees, their families and patients, and may reduce influenza-related deaths among persons at high risk for complications from influenza.
HCP refers to all paid and unpaid persons working in health-care settings who have the potential for exposure to patients and/or to infectious materials, including body substances, contaminated medical supplies and equipment, contaminated environmental surfaces, or contaminated air.
HCP might include (but are not limited to) physicians, nurses, nursing assistants, therapists, technicians, emergency medical service personnel, dental personnel, pharmacists, laboratory personnel, autopsy personnel, students and trainees, contractual staff not employed by the health-care facility, and persons (e.g., clerical, dietary, house-keeping, laundry, security, maintenance, billing, and volunteers) not directly involved in patient care but potentially exposed to infectious agents that can be transmitted to and from HCP and patients.
These recommendations apply to HCP in acute care hospitals, nursing homes, skilled nursing facilities, physician’s offices, urgent care centers, and outpatient clinics, and to persons who provide home health care and emergency medical services.
One hospital evaluated the impact of vaccination on HCP and hospitalized patients and saw an increase in immunization coverage from 4% to 67% over 12 flu seasons. During that timeframe, laboratory-confirmed influenza cases among HCP decreased from 42% to 9%. In addition, nosocomial (hospital-acquired) influenza cases among patients decreased from 32% to 0%.
Studies have shown that some of the primary deterrents to immunization are concerns related to the safety and efficacy of the influenza vaccine. But, each year the vaccine undergoes a review by FDA to assure its safety and potency before it is approved for immunization of the public. The misconception that the vaccine causes influenza, and the mistaken belief that they are not at risk is also another reason why many HCP don’t get vaccinated.
The fact is that healthy adults can pass the influenza virus to someone else one day before symptoms begin, and they can continue to infect others up to five days after getting sick. Therefore, it is possible for a healthy adult to unknowingly spread the virus to patients at high risk for serious complications from influenza.
This risk has been one of the primary factors in motivating many major professional medical societies to endorse and publish recommendations requiring HCP with direct patient care to be immunized. In fact, some states and health agencies have adopted mandatory immunization programs to help decrease the likelihood of contracting influenza and the chance of infecting others.
The initiative to improve influenza vaccination for HCP is supported by the Department of Health and Human Services (HHS), the National Foundation for Infectious Diseases (NFID), the Infectious Disease Society of America, the American College of Physicians, and the Joint Commission on Accreditation of Health Care Organizations (JCAHCO).
FDA urges health care facilities to educate their HCP regarding the benefits of influenza vaccination and potential health consequences of influenza illness for themselves and their patients. Health care systems are encouraged to implement or expand immunization programs for patients and staff. In an effort to improve vaccinations rates among HCP, HHS has developed the Health Care Personnel Initiative to Improve Influenza Vaccination Toolkit. This kit offers health care systems a comprehensive educational packet designed to help implement, or enhance existing, annual influenza vaccination programs.