Flu Shots: Why Don't More Nurses Get Them?
By Jennifer Larson, contributor
The CDC estimates the rate of influenza immunization among health care professionals is less than 50 percent.
Flu season is fast approaching. Have you gotten a flu shot yet? If not, you are currently among the majority of nurses who choose not to get immunized annually, despite the urging of public health officials and nursing leaders.
The Centers for Disease Control and Prevention (CDC) recommends that the following groups of people be immunized against influenza:
* Children between the ages of six months and 18 years
* Pregnant women
* People age 50 and older
* People with certain chronic medical conditions
* People who live in long-term care facilities
* People who live with or care for people at high risk for complications related to the flu, which includes health care workers.
The rate of influenza immunization among health care professionals is dismayingly low, according to infectious disease experts. The CDC estimates the rate is less than 50 percent, well below the 2010 national health objective goal of 60 percent.
“It’s highly recommended for health care professionals to get the flu immunization,” noted Andrea Witt, flu prevention coordinator for the Visiting Nurse Association in Omaha, Nebraska. “We encourage our nurses to get the flu immunization, and I think providing it and making it accessible for them works.”
The American Nurses Association (ANA) does not support mandatory vaccination, but it strongly urges nurses involved in patient care to get an annual flu immunization. ANA leaders have expressed concern about the low flu vaccination rate among nurses and other health care workers, and have issued a position statement that advocates nurses get vaccinated unless they have a valid reason not to.
“It protects the patients that they’re caring for,” said Katie Slavin, MS, RN, senior staff specialist for the Center for Occupational and Environmental Health for the ANA. “There are definitely a lot of reasons for the nurse to get vaccinated.”
In addition to patients, Slavin pointed out a number of other beneficiaries: the nurse, the nurse’s own family at home and the nurse’s employer, who benefits from reduced absenteeism. She also pointed out that some people may not come down with flu symptoms themselves but may be carriers who unknowingly transmit the disease to others; getting immunized would reduce that likelihood, as well.
Despite the benefits, many nurses still resist getting vaccinated. Witt said some people repeat what she calls “the old wives’ tale” that they’ll get sick by getting vaccinated. She also knows of nurses who justify not getting vaccinated by claiming they never get the flu anyway so they don’t want to bother getting immunized.
“It just takes one time, and then they become a believer,” she said wryly.
Experts admit that the vaccine isn’t perfect, but it does work most of the time. According to the CDC, the flu shot and nasal spray vaccines typically have a 70 to 90 percent effectiveness rate among healthy young adults.
Some nurses may have a good reason for not getting immunized if there are signs of problems in their medical history. For instance, anyone who has had a severe allergic reaction to eggs or a previous flu vaccine or has a history of Guillaim-Barre Syndrome should consult with his or her physician before receiving a flu shot.
This year’s trivalent vaccine strains are A/Brisbane/59/2007 (H1N1)-like, A/Brisbande/10/2007 (H3N2)-like, and B/Florida.4.2006-like antigens. Source: National Center for Immunization and Respiratory Diseases.
When considering immunization, nurses should also be aware that the nasal spray vaccine is not for everyone. Some populations are encouraged to receive a flu shot but to forego the nasal spray vaccine. According to the CDC, these groups include pregnant women, people with asthma or other chronic pulmonary disorders and health care professionals who care for certain patients with severely weakened immune systems who required a protected environment. The CDC also now recommends that children between six and 23 months and adults 50 years and above receive the flu shot instead of the nasal spray vaccine.
If you are a nurse who has no risk factors and still don’t plan to be vaccinated this year, Witt and Slavin point out that it may be time to reconsider your decision. They also urge health care facilities to make the process as easy as possible.
Both Witt and Slavin said their employers are offering free flu shots to their employees and volunteers. They noted that employers that make the shots easily accessible to their employees may boost their vaccination rates. These efforts might include offering free shots, taking a vaccination cart directly to each unit and offering immunizations at off-times for people who work night or evening shifts.
“It’s reducing another barrier,” said Slavin.
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