Opinion: Why Not a Flu Shot?
Monday December 3, 2007
Pam Meredith, RN, NP
It wasn't easy. But with a great deal of planning, inconvenience, and $25, I hunted down my annual flu shot. It shouldn't have to be this hard, but it has become the norm for me every year. If I were not so determined, I probably never would get a flu shot.Could a similar lack of access be one of the reasons why the average annual influenza vaccination rates in healthcare workers are so low? With a vaccination rate goal of 90%, statistics from the Centers for Disease Control and Prevention (CDC) tell us that in 2005, only 34% of healthcare workers received flu shots. This was down 19% from the previous year when 53% of us were vaccinated.It seems this is not unusual. The CDC says the average annual influenza vaccination rates in healthcare workers is commonly 36%. This means that in most years, 64% of us go unvaccinated against the flu. Do you find these statistics hard to believe? I do.So, thinking these numbers were not the norm, especially among the educated and savvy with whom I come in contact, I took a very informal, totally unscientific poll of people around me, both healthcare providers and lay people.Egad! I learned that the CDC stats are not only right on, they might even be an overestimation of the real picture. Only two out of the almost 30 people I asked had received flu shots and of the others, none had plans to get vaccinated.With the threat of a deadly influenza pandemic hovering over us, if nothing else, you would think fear would be the great motivator to get immunized. But the statistics tell us this is not happening.According to the CDC, scientific literature offers several reasons for low immunization rates among healthcare workers — a mistaken belief that getting the shot will give the flu; concern about side effects or safety of the vaccine; the perception of low personal risk for getting the flu; ignorance of CDC recommendations; dislike of needles; feeling that getting immunized against a constantly mutating organism is futile; and plain, old inconvenience.It is difficult to believe these reasons come from this select group of people. One would think healthcare workers would be the first in line when it comes to flu shots.Think about it. Who is more susceptible to influenza than healthcare workers, especially nurses? We are at the center of where the influenza virus will emerge and are among the most vulnerable to contract and spread it. We work in environments where we constantly come in contact with high-risk patients throughout the influenza season, whether in offices, clinics, schools, long-term care centers, hospitals, or in individual homes.The problem with influenza is that it is sneaky as well as contagious. Because our patients — and we — can shed and spread the virus 24-48 hours before symptoms occur, we might not even know who is infected until it is too late.The Joint Commission (formerly JCAHO) is doing its part to make flu shots more accessible to healthcare workers. In 2007, it mandated that facilities that provide 24-hour-a-day care have to make flu shots available to all employees. This makes sense and probably will help increase vaccination rates among healthcare workers.I have read about facilities that are even taking it a step farther than The Joint Commission's mandate. They deliver the flu vaccine on mobile carts to their employees during work hours. Innovative solutions such as this one, plus continuous, aggressive, and ongoing vaccine education emphasizing the seriousness of influenza and addressing misconceptions about influenza and the vaccine, are what is needed now.Not only is it important to raise the appallingly low influenza immunization rates among healthcare workers, but we also need to make sure the general public gets protection. Making it easier, cheaper, and more convenient for people to get a flu shot every year will do much to help keep us all safe.As nurses, we can help in this effort. At the very least, we should make sure each of us gets our own flu shot. Let's have it be said that nurses are part of the solution, not part of the problem.Pam Meredith, RN, NPEditorial Director, DC/Maryland/Virginia edition of Nursing Spectrumpmeredith@gannetthg.com
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