Strategies key to boost health provider flu shots

APIC: Educate staff as well as patients

Health care workers need an annual influenza vaccine to protect themselves and their patients, advise national infection control officials. The Association for Professionals in Infection Control and Epidemiology (APIC), based in Washington, DC, has added its voice and power to that message. APIC recently released a position paper on influenza immunization and is urging hospitals to improve their rates. Only 36% of health care workers receive the vaccines annually, according to the National Health Interview Survey.

"With other preventable diseases, we’ve placed much more emphasis on making sure we have immunity," says Jeanne Pfeiffer, RN, MPH, CIC, APIC president, who is infection control program coordinator at Hennepin County Medical Center in Minneapolis. APIC joins other organizations, including the National Foundation for Infectious Diseases and the Centers for Disease Control and Prevention, in making a greater push for influenza immunization. It won’t be easy, acknowledges Pfeiffer. "Even in our facility, where we’ve had an active program in place for about 10 years, we are at a little over 50%," she says.

The recommendations issued by APIC include the following:

1. All health care facilities should prepare a written policy stressing the importance of influenza vaccination among health care workers. This policy should strongly recommend that health care workers receive annual influenza vaccination to prevent spread of the virus to vulnerable patients. Every organization, regardless of size or type, should demonstrate its commitment by creating and distributing the policy to all employees.

2. Influenza immunization programs should be designed and implemented annually to increase vaccination rates. These programs should be designed to:

  • Educate health care workers about the importance of influenza immunization in health care settings and the low risk of adverse events associated with immunization.
  • Increase vaccine demand among health care workers.
  • Reduce barriers to health care worker immunization by developing programs that increase access to immunization and reduce cost of the vaccine.
  • Facilitate the influenza vaccination process, such as through the use of standing orders issued by the occupational health program for health care worker influenza vaccination.

3. Monitor annual immunization rates of employees, and provide feedback through the infection control and patient safety programs.

4. Monitor and track health care-associated influenza, in comparison to the health care worker immunization rates. Providing this information may stimulate health care workers to seek vaccination.

5. Track community incidence of influenza with public health officials using data from emergency departments, physician offices, and clinics. As the incidence increases, infection control and hospital administration should work together to identify pending admissions of potential influenza cases and to establish parameters for visitor restrictions. Specific interventions facilities should consider include:

  • Holding vaccine clinics in easily accessible locations and at varied times, so clinics are convenient for workers on all shifts.
  • Bringing vaccine to employees, wherever they might be, via a rolling cart. Areas to consider include cafeterias, employee entrances, medical records department, medical wards, and grand rounds.
  • Educating employees, through a variety of channels about the need to be vaccinated, and dispelling myths. For example, employee newsletters, e-mails, posters can be used to address the misconception that inactivated influenza vaccine can cause the flu, and other similar myths. Employees should be educated about prevention of transmission, as well as benefits of vaccination.
  • Removing all costs associated with vaccination. As a patient safety measure, institutions should provide employees with influenza vaccination just as they do other infection control interventions, such as personal protective equipment and hand hygiene products (e.g., soap or alcohol hand rubs).
  • Conducting a public health campaign with media coverage.
  • Adding influenza immunizations to the standard curricula in teaching institutions. Immunizations should be available to students at the academic institutions and paid for through student fees.
  • Implementing additional mechanisms as necessary to facilitate the administration of vaccinations to health care workers in all settings.

(Editor’s note: For a copy of the APIC position paper on influenza vaccination of health care workers, go to and click on "Protect Your Patients. Protect Yourself." )