Why Healthcare Providers Must Receive a Flu Vaccine

Carolyn B. Bridges, MD


November 16, 2015

Editorial Collaboration

Medscape &

The Centers for Disease Control and Prevention (CDC) recommends that everyone aged 6 months and older become vaccinated against influenza each year. This recommendation is especially critical for healthcare personnel. However, the latest data show that there is room for improvement for vaccination of healthcare personnel, especially among assistants and aides working in long-term care (LTC) facilities.

According to the latest coverage estimates, influenza vaccination coverage among healthcare personnel has increased to 77% in the 2014-2015 season, which is an increase of 14% since the 2010-2011 influenza season.[1,2] Influenza vaccine coverage was lowest in LTC settings during the 2014-2015 season at 64%. Among healthcare personnel working in all settings, influenza vaccination coverage was lowest for nonclinical personnel, such as food service workers, housekeeping staff, maintenance staff, janitors, and laundry workers (75%) and assistants and aides (64%). Lower rates of vaccination mean that healthcare personnel are at risk for infection, and those personnel can spread flu to their families, other staff, and their patients.

Low vaccination among LTC staff is troubling because people aged 65 years and older are at greater risk for serious complications from the flu. Flu vaccine effectiveness is generally lowest in the elderly, making vaccination of close contacts, including healthcare personnel, even more critical.

Studies have shown that during an outbreak of influenza in a LTC facility, as many as 1 in 3 residents and 1 in 4 staff members can become sick.[2] Studies have also shown that influenza vaccination of healthcare personnel in LTC settings can reduce the risk for illness and death among LTC facility residents and reduce the risk for outbreaks.

Resources for increasing influenza vaccination rates among LTC staff can be found online. Several flu vaccine options are available for the 2015-2016 season, including the trivalent vaccines, which protect against two influenza A viruses (an H1N1 and an H3N2) and an influenza B virus, as well as a quadrivalent vaccine that also protects against an additional B virus. Note that injectable vaccine rather than live virus nasal spray vaccine is preferred for healthcare workers who are in close contact with severely immunocompromised patients who are being cared for in a protective environment.

It is important for the clinical leaders of practices and LTC facilities to encourage all personnel to be vaccinated. All staff, regardless of job duty, should be vaccinated against influenza to protect the health of LTC residents, other healthcare personnel, and their own families. Clinical leaders can also take this opportunity to encourage their staff to get up to date on other adult vaccines as well because they are at risk for exposure to other serious, and sometimes deadly, diseases. Getting the appropriate vaccines will reduce the chance that staff will get or spread vaccine-preventable diseases, protecting themselves, patients, and family members.

Web Resources

Recommended Vaccines For Healthcare Workers

Influenza Vaccine Options

Dr Carolyn Buxton Bridges is the associate director of adult immunizations in the Immunization Services Division, National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention (CDC). An internal medicine physician, Dr Bridges was in clinical practice before joining the CDC as an epidemic intelligence service officer in 1996 working primarily on influenza. She has held a number of different positions at the CDC working on influenza and other vaccine-preventable diseases and transitioned to her current position in 2011 as the associate director of adult immunizations.

Her career in public health has included research and policy on influenza prevention and control, vaccine effectiveness and transmission, vaccination coverage, and improving coverage for recommended adult vaccines. She has over 100 publications, including authoring or coauthoring the ACIP influenza vaccine recommendations for 7 years and the ACIP adult immunization