Healthcare Workers Have Less Vaccine Protection Against Pandemic Influenza Virus Than Against Seasonal Influenza

April 01, 2010

April 1, 2010 — Although 62% of healthcare workers had gotten vaccinated for seasonal influenza by mid-January — a record high — only 37% of them were vaccinated against the pandemic influenza A (H1N1) virus, the US Centers for Disease Control and Prevention (CDC) announced today.

The immunization gap may partly stem from how healthcare workers view the value and safety of the 2 vaccines: 74% believe that seasonal influenza vaccination was worth the time and expense compared with 63% for pandemic influenza vaccination, according to survey results published in the April 2 issue of the Morbidity and Mortality Weekly Report. In addition, although 81% consider the seasonal influenza vaccine safe, only 67% say that about its pandemic influenza counterpart. The CDC has said the 2 vaccines are equally safe.

Seventeen percent of healthcare workers say their failure to get immunized against the pandemic influenza virus was a result of the vaccine being unavailable. "The two most frequently cited reasons for nonvaccination with either vaccine were 'I don't need it' and 'I may experience side-effects,' " the report states.

Although the pandemic vaccination rate for healthcare workers might disappoint public health authorities, it still exceeds the 24% rate for the general population, according to the CDC. Meanwhile, the rate of vaccination against seasonal influenza among these workers has hit an all-time record. During the 2008 to 2009 influenza season, their immunization rate ranged from 49% to 53%, although the report noted that different survey methods were used at that time.

The improved performance of healthcare workers when it comes to seasonal influenza vaccination suggests that the industry may be at a tipping point, said Anne Schuchat, MD, director of the National Center for Immunization and Respiratory Diseases at the CDC, at a press conference today.

"Maybe it's a time when consumers and patients will demand that healthcare workers be vaccinated, and institutions will pay attention to their [vaccination] practices. We would love to see healthcare institutions report the progress they've achieved and really start competing with each other and publicizing their results, so that patients can know, 'Yeah, that's a hospital that received a high rate for protection from their healthcare workers.' "

Clinicians Treating Sickest Patients Had Highest Immunization Rates

The vaccination rate for the pandemic virus among healthcare workers was the highest in hospitals (51%) and the lowest in long-term care facilities (20%). Physicians, physician assistants, nurse practitioners, dentists, and nurses were better than average about getting their shot or nasal spray, posting a 45% vaccination rate.

On top of the list were workers in intensive care, burn, and obstetrical units, with a 48% rate of vaccination for the pandemic virus. Such workers deal with the sickest patients, noted Dr. Schuchat. Their immunization rate "emphasizes the idea that influenza vaccination is a patient safety issue, and it is a good idea for healthcare workers to be vaccinated to protect their patients," she said.

The report stated that the rate of pandemic influenza vaccination was 8 times higher for healthcare workers whose employer required it. Likewise, an employer recommendation along these lines produced an almost 4-fold increase in the coverage rate.

Morb Mortal Wkly Rep. 2010;59:357-362.

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