Flu vaccination low among long-term care workers

Those working in healthcare settings are putting themselves and those they care for at risk if they don't get vaccinated against the flu, and those working in long-term care (LTC) settings are the worst offenders, health officials said at a Sept. 18 press conference. Employers can help, however, by mandating vaccination and making it available on-site at no cost, they added.

LTC workers have the lowest influenza vaccination rate among all healthcare workers, except when employers require vaccination, according to new data released by the Centers for Disease Control and Prevention (CDC). Sixty-three percent of LTC personnel were vaccinated during the 2013‒2014 flu season, compared with 90 percent of hospital workers, the healthcare setting with the highest rate of vaccination, the CDC said. The findings are similar to last year’s data and data from the year prior to that one as well.

“We still are seeing numbers lag in places like nursing homes…so there’s more to be done there,” CDC Director Tom Frieden, MD, MPH, said at the press conference, held by the National Foundation for Infectious Diseases (NFID) in collaboration with the CDC and several other organizations.

Flu vaccination among workers in long-term care settings, 2013-2014 flu seasonResearchers looked at hospitals, physician offices/ambulatory care settings, LTC settings and other clinical settings. The overall vaccination rate for all settings was 75 percent. For LTC settings, the data include assistants and aides, other clinical personnel and nonclinical personnel (see chart). The findings are published in the Sept. 19 Morbidity and Mortality Weekly Report (MMWR) and on the CDC's FluVaxView website.

The MMWR authors provided several potential reasons for the low rate of flu vaccination among people working in LTC settings:

  • Most LTC workers surveyed were assistants or aides, the occupational group with the lowest vaccination rates in the report across all healthcare settings.
  • LTC workers were most likely to report that their facilities neither required nor promoted vaccination.
  • LTC workers were the least likely to report that their employers offered free vaccinations over several days.

Flu vaccination rates when required or promoted in long-term care settings, 2013-2014When LTC employers required vaccination, according to the MMWR report, the vaccination rate jumped to more than 98 percent among employees. Offering the vaccine at no cost to employees for more than one day also improved vaccination rates, to more than 71 percent. (see charts).

“Influenza vaccination is a patient safety issue,” Frieden said. “The easier we make it for people to get a flu vaccination, the more likely it is that they will get vaccinated.”

Long-term care worker flu vaccination rate by cost/availability, 2013-2014Paul A. Offit, MD, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, shared at the press conference his organization’s mandatory flu vaccination policy for employees, which in its first year (2009) led to the firing of nine people who refused vaccination without having a valid medical or religious reason. Since then, he said, the hospital has seen full compliance with the policy. “If you choose to work in a healthcare situation—in our case, among a vulnerable population…it’s your duty to make sure you don’t spread that virus,” he said.

William Schaffner, MD, professor of preventive medicine and infectious diseases at the Vanderbilt University School of Medicine and past president of the NFID, added: “Staying home when you’re sick is only a partial solution, because the day before you become sick, you’re already breathing out influenza virus, and you then could cover your patients with the influenza virus. So the only way we can try to prevent that is by immunizing ourselves in advance.”

Healthcare workers should start getting vaccinated now, Frieden said. The CDC offers flu vaccination information for healthcare workers on its website.

To see the charts in a larger format, click on the flu shot graphic, upper left.

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