More flu vaccines urged for health care workers

Recommendation for health care worker vaccination

In response to unacceptably low influenza immunization rates among health care workers, the Association for Professionals in Infection Control and Epidemiology (APIC) has issued specific recommendations to health care facilities to develop and implement comprehensive influenza vaccination programs for employees. APIC is a nonprofit professional association comprising more than 10,000 members whose responsibility is the prevention and control of infections and related adverse outcomes in patients and health care workers. APIC’s new recommendations were published in the May issue of the American Journal of Injection Control.

Health care workers at risk for flu

Only 36% of health care workers receive an annual influenza vaccination, despite longstanding recommendations by the Centers for Disease Control and Prevention (CDC) and other organizations. Health care workers are at high risk for acquiring influenza infection due to their exposure to ill patients as well as their exposure in the community. (Health care workers are defined here as all personnel who have contact with patients, both medical and nonmedical, because when these staff are infected with influenza they can spread the virus to patients in their care.) Research, in fact, suggests health care workers can be a key source of institutional outbreaks, contributing to increased morbidity and mortality among vulnerable patients.

"Greater emphasis needs to be placed on improving influenza immunization rates among health care workers to help ensure patient safety and protection — especially for patients at increased risk of influenza-related complications," says APIC president Jeanne A. Pfeiffer, RN, MPH, CIC. "Immunization also provides personal protection for health care workers and minimizes work force absenteeism during the influenza season."

Health care workers encounter patients throughout the influenza season in many settings, including general hospitals, specialty hospitals, long-term care facilities, pediatric hospitals, emergency departments, medical practices, ambulatory care settings, rehabilitation facilities, and home care.

Studies show health care workers are more likely to work through illness and return to work sooner when they are ill, thus increasing the likelihood of virus transmission to patients in their care and co-workers. In addition, institutional influenza outbreaks can have serious implications for both the patient and the health care provider. These events can put patients at risk, result in or exacerbate existing staff shortages, curtail admissions, and increase health care costs.

Vaccination is the primary means of reducing influenza transmission and preventing infection from the influenza virus. Each year, the infection causes an average of 36,000 deaths and 114,000 hospitalizations in the United States.

"Health care facilities have an important role to play in maximizing influenza vaccination rates in health care workers," says Pfeiffer. "Every facility should develop and implement comprehensive influenza vaccination programs for employees."

APIC initiated a multifaceted initiative in January 2004 aimed at increasing influenza immunization rates among health care workers. As a result, APIC is completing a membership survey to assess the state of employee influenza immunization programs at members’ institutions across the country. In addition, APIC is developing new resources for infection control professionals and other health care providers that will help encourage institutions to implement formal influenza control policies. APIC’s initiative, including the survey results and new professional resources, will be highlighted at its 31st Annual Educational Conference in Phoenix on June 9, 2004.

[Editor’s note: More information on APIC’s position statement on health care worker influenza immunization can be found on-line at For the most current CDC Advisory Committee on Immunization Practice recommendations for influenza immunization, go to]