CDC - Why Most Nurses Don't Get the Flu Vaccine

  1. this article is from the centers of disease control (cdc)

    influenza vaccination rates for nurses need a boost

    with all the news coverage in the last few years of people scrambling to find a flu shot, it is interesting to note that not everyone recommended for annual vaccination and able to access it chooses to do so. surprisingly, one such group that avoids flu shots is the people administering the vaccines. in fact, only 40 percent of all health care workers were vaccinated in 2003.[1]

    health care professionals-and nurses in particular-are key to preventing the spread of influenza, a debilitating and highly contagious respiratory infection. it is caused by a virus and leads to an average of approximately 200,000 hospitalizations and 36,000 deaths in the u.s. each year.[2] because of their frequent and direct patient contact, nurses can spread the virus to patients in their care.[3] this is problematic for the many patients at high risk for influenza-related complications that could lead to hospitalizations and even death. influenza can also be spread from one healthcare worker to another or from patient to healthcare worker. in an era of nursing shortages, understaffing and mandatory overtime, nurses do not want to burden their co-workers by taking sick days related to something as easily preventable as influenza.

    the influenza vaccine remains the best way for nurses to protect themselves, their families and the patients in their care during the annual influenza epidemic. an annual intramuscular vaccination, the influenza vaccine is one of few immunizations that are recommended for all health care professionals, regardless of any special conditions such as pregnancy, hiv infection, severe immunosuppression, renal failure, asplenia, diabetes, and alcoholism/alcoholic cirrhosis.[4] another option for most healthcare providers is the live intranasal influenza vaccine. this live vaccine is approved for use by healthy persons 5-49 years of age who are not pregnant and do not provide care for severely immune-compromised persons requiring care in a protected environment.

    since 1984, the cdc and the advisory committee on immunization practices have recommended that health care professionals (inclusive of doctors, nurses and other staff who work directly with patients) receive an annual influenza vaccination. because the vaccine is altered nearly every year to match the circulating strain and because immunity from the vaccine wanes over time, the vaccine must be given each year -- ideally in october or november.

    vaccine myths abound


    despite the established benefits of the influenza vaccine, however, several misconceptions exist in the nursing community. the most common myth is that the influenza vaccine can actually cause influenza. in reality, the vaccine cannot cause influenza. some nurses also mistakenly believe that they are automatically immune to influenza or have stronger immune systems merely because they work around sick people every day. because influenza viruses are constantly changing, past exposure to influenza will not provide protection against newly emerged strains.

    yet another misconception is that the side effects of the vaccine are worse than getting influenza itself. the truth is that the most serious side effect is an allergic reaction in people who have a severe allergy to eggs (the vaccine viruses are grown in eggs). for this reason, influenza vaccination is contraindicated for persons with an egg allergy. the most common side effects are redness at the injection site and a sore arm. these symptoms are mild and resolve in one to two days.

    finally, some people might argue that because the influenza vaccine is not 100 percent effective (it is 70-90 percent effective in healthy adults), they will get influenza anyway. even if the vaccine does not prevent all individuals from getting influenza, they are still likely to be far less sick than they would have been without the shot. the vaccine also greatly reduces the chance of hospitalization and death. people at greatest risk for influenza-related complications include: people 65 years and older; residents of nursing homes and other chronic care facilities; people with chronic pulmonary or cardiovascular conditions; people with diabetes mellitus; and children less than two years of age.

    influenza 101

    although influenza is primarily spread by droplet transmission, the virus can also live on objects such as doorknobs, telephone receivers, utensils and food trays, beds and medical equipment for possibly up to one day. some people infected with influenza may not develop symptoms at all, but may be infectious to others. for infected persons who do develop symptoms, they can be contagious the day before they get symptoms. so nurses can transmit the virus even before they realize they are infected. the period of greatest contagion is during the first three days of illness, and can last for five to seven days in otherwise healthy adults.

    influenza usually starts suddenly and may include the following symptoms:

    • fever (usually high)
    • headache
    • tiredness (can be extreme)
    • cough
    • sore throat
    • runny or stuffy nose
    • body aches
    • diarrhea and vomiting also can occur infrequently but are more common in children.


    general treatment for influenza includes bed rest, drinking plenty of fluids and taking over-the-counter medicines such as acetaminophen. children suspected of having influenza should not be given aspirin as this may increase the risk of a complication known as reye syndrome. in addition, there are several prescription antiviral medicines (such as amantadine, rimantadine and oseltamivir) that can help to prevent influenza infection and, when used within the first 48 hours of illness, can reduce duration and severity of the influenza illness. some persons infected with influenza may also need antibiotics if their healthcare provider suspects a secondary or concomitant bacterial infection.

    nurses have long played a key role in preventing much influenza-related morbidity and mortality by ensuring that at-risk patients, particularly elderly patients and young children, are vaccinated against influenza every year. the time is long overdue for nurses to take care of themselves as well, and protect against the influenza virus by getting a vaccination.

    for more information about influenza and the influenza vaccine, visit www.cdc.gov/flu or call 800-cdc-info (800-232-4636).

    [font='times new roman'][1]cdc. prevention and control of influenza: recommendations of the advisory committee on immunization practice (acip). mmwr. 2004;53(rr06):1-40.

    [2] centers for disease control and prevention, "influenza: the disease" november 15, 2004 (http://www.cdc.gov/flu/about/disease.htm)

    [font='times new roman'][3] national foundation for infectious diseases, "improving influenza vaccination rates in health care workers. strategies to increase protection for workers and patients." 2004

    [4] [color=#231f20]cdc, mmwr. 2004;52(rr06):1-40.[color=#231f20][font=frutiger-light]
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  2. 156 Comments

  3. by   Marie_LPN, RN
    .
    Last edit by Marie_LPN, RN on Sep 20, '06
  4. by   canoehead
    Hmmm, get the shot for a definite few days of flu symptoms, or not get the shot and maybe get away with not getting sick. I'll take my chances. Besides, everyone knows ER nurses have the immune systems of a fleet of Hummers.
  5. by   flashpoint
    LOL...I have always been in the same boat as Marie...they offer shots for a short time for jsut a few days and the times they offer just don't work for some people. We were expected to get them when we were off duty so care wasn't interrupted and it seemed like I was always on the clock or doing silly things like sleeping so I could function properly at work or dropping my kids off at school. It's a good thing I have a doctor who understands the red tape and lets me stop in at his office when it is convenient and writes my shot off.
  6. by   joyflnoyz
    My reason for not gettingthe flu shot? The CDC makes a "guess" as to what strain of flu is coming about 2 years ahead of time and the manufacturers make the vaccine for that strain. I'd like to see the stats as to how often the "guess" is incorrect
  7. by   MarySunshine
    I've never met a nurse who thought that the flu vaccine could cause the flu. That's really condescending for the author to say that. Usually we're throwing caution to the wind and gambling our chances because the flu shot DOES make lots of people feel crappy. I figured I should let the more susceptable folks get first dips at flu shots -- I'm young and healthy.
  8. by   SmilingBluEyes
    I Have had a flu shot every year since I was 18 (back then I was in the USAF and it was mandatory for all members). I have had good results....thank Heaven. I have not had a case of flu in years. I rarely get sick----one major cold per winter is it-----

    I will keep on getting the vaccine. It seems to help me, at least. But I do respect that people should always have a CHOICE here.
  9. by   nurseT
    I have never got the shot because I just don't want it. I have never had influenza. I got sick for the first time in march of 05 for the first ime in 27 yrs. My husband and my teen dtr and myself all became very ill each within 24 hrs of each other. Severe fatigue, bad headache, sudden violent vomiting. It only lasted 48 hrs for each one of us. It was viral, but was it the flu? Who knows. We never went to be tested. It was so short lived. Besides, I'm not getting injected with any cooties on purpose. People are nuts over the flu vaccine. Did you know it only offers immunity for about 3 months anyway? And where I live, everybody, including the doctors want to start vaccinating in october, and the flu doesn't even hit the east coast until jan through march. Except for a few scattered early cases. I found out all this stuff from a sales rep for the vaccine and just observing.
  10. by   suzanne4
    And I will keep getting it as well. More for the protection of my patients.
  11. by   Spidey's mom
    Quote from MarySunshine
    I've never met a nurse who thought that the flu vaccine could cause the flu. That's really condescending for the author to say that. Usually we're throwing caution to the wind and gambling our chances because the flu shot DOES make lots of people feel crappy. I figured I should let the more susceptable folks get first dips at flu shots -- I'm young and healthy.

    I actually have met nurses and others in the medical field who think that the flu vaccine causes you to get a smaller case of the flu.

    I got the flu shot for the first time when I was in the nursing program 11 years ago. I try to get it every year but I haven't gotten it in the last two years.

    One reason was the shortage a couple of years ago - I figured others more susceptible should have first dib's.

    steph
  12. by   ZASHAGALKA
    Quote from suzanne4
    And I will keep getting it as well. More for the protection of my patients.
    I agree, not that you would likely know, but I am mortified at the mere thought that I could give my patients the flu.

    I have and I will take the shot. I consider it patient advocacy - to and for myself.

    ~faith,
    Timothy.
  13. by   lee1
    Quote from SmilingBluEyes
    I Have had a flu shot every year since I was 18 (back then I was in the USAF and it was mandatory for all members). I have had good results....thank Heaven. I have not had a case of flu in years. I rarely get sick----one major cold per winter is it-----

    I will keep on getting the vaccine. It seems to help me, at least. But I do respect that people should always have a CHOICE here.

    Here also, I have gottent the flu shot every year for at least the last 10 years. Normally it becomes available at our hopsital some time in Oct/Nov. we all have a lenthy period of time to go it, it is NOT just a few hours here and there. Those hospitals should think again about what their nurses need to be compliant.
    I always take a tylenol dose when I receive it, generally take it on a Friday or the day before I have off, but (knock on wood), have not had a reaction or felt fluish afterward.
    I remember one year, many years ago when 2 nurses I was aware of did get Guillian Bare, not sure if it really was connected with the flu shot.
    Working in critical care you never know what you are going to be exposed to, so just try to stay as healthy as possible.
  14. by   West_Coast_Ken
    I get a flu shot every year and have for about 15 years. Why? because I want the prevention the flu shot helps to provide, because I have never, ever had a reaction to a flu shot (TB tests cause more of a recation than the flu shot), and because I know the flu virus mutates and there is no such thing as anyone being immune to current virus from past exposures. And I knew all this long before entering this field... Now I have the added responsibility of protecting my pts so you bet, I'm gettin' mine this year.
    Last edit by West_Coast_Ken on Sep 14, '06

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