CDC Expert Commentary

Healthcare Workers Must Be Vaccinated Against Influenza

Eric Kasowski, DVM, MD, MPH


November 17, 2010

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Hello, I'm Dr. Eric Kasowski. I'm a physician in Center for Disease Control's (CDC's) Influenza Division. I'm happy to speak with you as part of the CDC Expert Video Commentary Series on Medscape. I want to talk to you about how important it is for healthcare workers to get an annual influenza vaccine.

This season, the Advisory Committee on Immunization Practices (ACIP) and CDC have recommended universal influenza vaccination, meaning that all people 6 months and older without a contraindication to influenza vaccine should be vaccinated each year. However, the ACIP has retained the list of people for whom influenza vaccination is especially important. This list includes healthcare personnel and people in training for healthcare professions, because of the role they play in protecting their patients, many of whom are vulnerable to severe outcomes from influenza.

People working in healthcare settings who should be vaccinated yearly for influenza include physicians, nurses, and other workers in both hospital and outpatient care settings, medical emergency response workers like paramedics and emergency medical technicians, employees of nursing home and long-term care facilities, and students in these professions who will have contact with patients.

Unfortunately, studies have shown that just over half of healthcare workers in the United States report getting an annual flu vaccine. Reasons for not getting vaccinated include doubts about the risks for influenza and the need for vaccination, uncertainty about vaccine effectiveness, concerns about side effects, and dislike of injections.

I'd like to take a couple of minutes to address these concerns.

Influenza can be a serious disease -- it can cause mild to severe illness, and at times can lead to hospitalization and death. Most otherwise healthy adults who get influenza can infect others beginning 1 day before symptoms develop to 7 days after becoming sick. Also, some people can be infected and have no symptoms but still spread the virus.

While not perfect, the flu vaccine is by far the best defense we have against influenza. How well the flu vaccine protects can vary, depending in part on how good the match is between the influenza vaccine and the types of flu viruses that are circulating that year. Past studies have shown that in years when the vaccine and circulating viruses are well-matched, the vaccine can reduce the chances of getting the flu by 70%-90% in healthy adults.

It's important to know that the viruses in the vaccine are inactivated or attenuated, so you cannot get the flu from any influenza vaccine. Also, serious problems from the flu vaccine are very rare. Hundreds of millions of doses of influenza vaccines -- including more than 80 million doses of monovalent 2009 influenza A (H1N1) vaccine last season -- have been administered safely.

Those who don't like injections can get the nasal spray flu vaccine as long as they are healthy, 2-49 years of age, and not pregnant. Healthcare personnel can get the nasal spray flu vaccine even if they come into contact with newborn infants, pregnant women, persons with a solid-organ transplant, persons receiving chemotherapy, and persons with HIV/AIDS. Only healthcare workers in close contact with someone whose immune system is so weak they require care in a protected environment (such as a bone marrow transplant unit) should not get the nasal spray vaccine.

Facilities that employ healthcare workers should try to vaccinate 100% of their staff who do not have medical contraindications to the vaccination. The benefits of high vaccination rates among healthcare workers have been demonstrated. Studies have shown that higher vaccination rates among healthcare workers have been linked to reduced influenza-like illness among both patients and workers, and even reduced deaths among patients in settings like nursing homes and hospitals.

So this season, be sure to get your flu vaccine and encourage your coworkers to get their vaccine, too -- for yourself, for your family, and for your patients.

For additional information about influenza vaccination during the 2010-2011 season, please visit Thank you.

Web Resource

CDC Seasonal Influenza

Eric J. Kasowski, DVM, MD, MPH, received his Doctor of Veterinary Medicine in 1990 from the University of Illinois. He served in the Army as a public health veterinarian from 2001-2004, focusing on zoonotic and foodborne illness control in the military operational environment. He received his MD from the Uniformed Services University of the Health Sciences in 1998 and returned to USUHS for his residency in Preventive Medicine and Public Health, graduating in 2003. He practiced as a public health physician in the Navy where he was instrumental in shaping military humanitarian missions to focus on public health interventions, reformulating the US Navy's public health system in Asia, and strengthening the Navy's preparedness for and response to pandemic influenza. He is currently a commissioned officer in the US Public Health Service serving as the Chief Preparedness Officer in the Influenza Division at the Centers for Disease Control and Prevention.


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