Patients Can Join the Fight Against Flu Without Firing a Shot

Last month at a luncheon marking International Infection Prevention Week at the National Press Club, some speakers reminded me of a shameful and frightening statistic: Almost 60 percent of American health-care workers do not receive the flu vaccine.

Let me put that in context: Influenza, commonly called the flu, strikes 5 to 20 percent of Americans annually. In an average year, more than 200,000 people are hospitalized with flu complications; nearly 36,000 die, either from the flu itself or from complications such as pneumonia or a heart attack.

A flu shot is the best defense.

Obviously, health-care workers -- a category that includes not only doctors and nurses but also such hospital personnel as dietary and cleaning staff -- are likely to come into close contact with a lot of highly vulnerable patients. That's why such workers are one of the specific population groups, such as pregnant women and adults older than 50, that the Centers for Disease Control and Prevention recommends get the vaccine every year.

Yet, as the CDC showed in a 2006 study, only 41.8 percent of health-care workers surveyed got a flu shot. A back-of-the-envelope calculation shows that if 58.2 percent of the 11 million health-care workers in America are unvaccinated and if a modest 10 percent acquire the flu virus, then we have more than half a million potentially contagious workers in our hospitals and clinics.

"It is a patient safety issue," says William Schaffner, chairman of the department of preventive medicine at Vanderbilt Medical Center in Nashville and a nationally known expert on immunization. "It is inexcusable for health-care workers not to be vaccinated."

Simple logic would make you think that health-care workers, most of whom have more education in health and medical issues than other people, would be more likely to be vaccinated. But since 1997 the vaccination rate among health-care workers nationwide has remained around the same depressing 40 percent. That is more than 20 percentage points lower than the average for the largest at-risk group, adults older than 65.

For a decade, as chairman of the infection control committee at my hospital, I have cajoled and pleaded with my fellow health-care workers to get vaccinated. This year, after I came home from the infection prevention meeting, I decided to ask my colleagues about the issue.

One day I struck up a conversation around the nurses station in the intensive care unit.

"I know people believe you get the flu from a flu shot," one nurse said. "But I still get one."

Another nurse emerged from a room where he'd been tending a ventilated and sedated patient, his gloves and isolation gown evidence of our concern about transmitting disease. "What kills me is that people still believe that stuff" about getting sick from the vaccine, he said. "But it's made from a dead virus."

Another nurse chimed in defiantly: "I got a shot last year and got sick. I'm not sure if I am getting it this year."