CDC targets holdout health workers on flu shots

Federal health officials want physicians to top the 86% vaccination rate they achieved during the previous flu season.

By Charles Fiegl amednews staff — Posted Oct. 8, 2012

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All health care workers should receive the influenza vaccine for the upcoming flu season, not just the roughly two-thirds of them that did so during the previous season, federal health officials recommended. Still, physicians, nurses and other health workers do better on flu vaccination rates than the entire U.S. public, nearly all of whom are urged to receive the shots but fewer than half of whom actually do.

The Centers for Disease Control and Prevention issued its general recommendation for most of the U.S. population to be vaccinated against the influenza virus during a Sept. 27 briefing sponsored by National Foundation for Infectious Diseases in Washington. Data in the CDC’s Morbidity and Mortality Weekly Report show an overall 42% vaccination rate, representing 128 million administered flu shots, during the 2011-12 season, which was a slight improvement upon the 123 million vaccines distributed during the previous flu cycle. An estimated 135 million flu vaccines will be produced and made available during the upcoming flu season.

The 2012-13 seasonal vaccine protects against three viral strains, including two that were not present in the previous vaccine. As of Sept. 14, more than 85 million doses of influenza vaccine had been made available to health care workers and the public.

When and where the flu will spread is difficult to predict, said Daniel Jernigan, MD, MPH, deputy director of the CDC’s influenza division. The health care system will have enough supply to meet demand, but the CDC has received a few reports of clinics turning away patients because they ran out of the vaccine temporarily. This represents an inconvenience to a patient who needs to make another trip back to a physician’s office or seek out the shot elsewhere. Still, the patient population should look for flu shots early and take the opportunity to receive them when they are available, he said.

Physicians are encouraged not only to advise patients to get vaccinated but also to obtain the vaccination themselves, said American Medical Association Medicine and Public Health Director Litjen Tan, PhD. The vaccine protects the individual and improves the overall health of his or her community.

“A physician’s recommendation can be the deciding factor for patients who are sitting on the fence over whether or not to get vaccinated,” he said.

For instance, pregnant women who were recommended to be vaccinated were five times as likely to do so, Tan said, citing CDC data. Nearly 45% of adults older than 55 who did not intend initially to get the vaccine received it after a physician’s recommendation.

It’s not just primary care physicians who should suggest the influenza shot to patients, Tan said. Specialists managing high-risk patients, such as those with multiple chronic conditions, also should counsel those under their care about the benefits of the flu vaccine.

“Every physician has an opportunity this flu season to remind their patients to get vaccinated,” he said. “Physicians such as cardiologists, obstetricians and gynecologists, pulmonologists and endocrinologists will all have high-risk patients and should encourage their patients to get vaccinated as soon as it is available in their communities.”

All pregnant women are urged to get the vaccine, said Laura Riley, MD, director of obstetrics and gynecology infectious disease at Massachusetts General Hospital in Boston. Studies have shown that there is no link between birth defects and the vaccine. Women should be confident that the flu shot will protect their unborn children, she said.

“Pregnant women should understand that they are helping themselves and helping their babies,” Dr. Riley said. “There are studies that show the vaccine gives the mom the antibodies, and mom then passes the antibodies through the placenta to the baby. And it allows the baby to be protected against influenza for the first six months of the life, which is the time period when the baby is vulnerable and unable to be vaccinated.”

Physicians also must protect their patients by getting flu shots, Tan said. Campaigns to educate and encourage health workers have helped increase the number of vaccinated health care workers in the office and inpatient settings. The percentage of health care workers who got the flu shot increased during the previous flu season to 67% from 64% during the 2010-11 season. The survey found 86% of physicians and 78% of nurses received the vaccination.

“Getting vaccinated also sets a good example when recommending the vaccination to patients,” Tan said.

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Flu shots missing some patient populations

View in PDF

Click to see data in PDF.

A review of the 2011-12 influenza season shows that more patients received a flu vaccine than during the previous flu cycle. Physicians play a vital role in encouraging patients to protect themselves and their families against the flu, but some patient categories tend to be reached better than others.

Age bracket Vaccination coverage
6-23 months 74.6%
2-4 years 63.3%
5-12 years 54.2%
13-17 years 33.7%
18-49 years 28.6%
50-64 years 42.7%
65 years and older 64.9%

Source: Influenza Vaccination Coverage by Age Group, National Foundation for Infectious Diseases, Sept. 27 (link)

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