Immunization vital for health-care providers

Health-care providers have a well-deserved reputation of going the extra mile to promote health and protect and care for their patients. But each year many health-care providers (HCPs) miss the opportunity to do the one thing that best protects their patients, their families and themselves against the annual visitation of influenza.

Influenza, commonly called the flu, is a contagious respiratory illness that the World Health Organization has characterized as one of the deadliest viruses of all time because of the large numbers of people that can be affected. Symptoms of the flu include high fever, headache, extreme tiredness, dry cough, sore throat, runny or stuffy nose and muscle aches that can last from five to 10 days. In an average year in Canada influenza and its complications cause up to 1,500 deaths. In the US, it is estimated that 10-20% of Americans get influenza each year with an average of 114,000 people hospitalized for influenza related complications. Those at high risk for serious complications from influenza include those over age 65, children under 2, and people of any age with chronic medical conditions.

The single best way to prevent influenza is to get vaccinated each fall. Yet a number of studies have indicated that HCPs are among those with the lowest immunization rates. “Low immunization rates are a concern on two fronts; said Dr. David Allison, Co-Chair of the Canadian Coalition for Immunization Awareness and Promotion. “First because of the added risk health-care providers face in getting influenza, and second because of the potential for them to transmit it to patients in their workplace.”

Because influenza is a highly contagious disease that spreads from person to person in the respiratory droplets of coughs and sneezes, HCPs in close contact with patients are at greater risk of being exposed to the virus. Even healthy, fit HCPs may not be able to fend off an influenza infection. The HCP can then take that virus home, potentially exposing family and friends to this serious illness. Also HCPs will often continue to work when they feel ill, spreading the influenza virus through a vulnerable patient population.

The consequences of an influenza outbreak within a health-care setting include illness and absenteeism among HCPs and morbidity and mortality among patients, most of whom are at high risk of complications from the infection. Studies have shown that when outbreaks occur within a health-care facility absenteeism may approach 30-40% resulting in severe staff shortages, increased employment costs and the potential endangerment of health-care delivery. Vaccination of HCPs has been shown to effectively reduce the prevalence of influenza illness and patient mortality in health-care facilities.

HCPs may cite vaccine safety concerns as a reason to not be vaccinated, yet vaccines are among the safest tools of modern medicine, rigorously monitored by national and international experts and agencies. Millions of doses are administered each year with reports of only mild side effects such as sore arms and general malaise for a day. Serious adverse reactions are extremely rare. The consequences of contracting influenza far outweigh the minor side effects of the vaccine.

Diet, exercise, complementary health strategies, or supplements boost the immune system, but while these strategies can be helpful they do not provide sufficient protection against infection. Annual vaccination and frequent hand washing are proven to be the most effective means of protection and reduction of influenza virus transmission

Some may be concerned about what’s in the vaccine. Manufacturers grow the three most prevalent strains of the influenza virus, as predicted by the World Health Organization, in chicken’s eggs and then kill the virus so the vaccine cannot cause the disease. Sterile filtration purifies the vaccine. A minute amount of a preservative called Thimerosal is added (.01% to .004%) to ensure the vaccine remains bacteria free in its multi-dose vial. Antibiotics may be used in the manufacturing process of some influenza vaccines but gelatin is not used in any influenza vaccines used in Canada. Prior to release of each influenza vaccine lot, Health Canada requires tests for purity and effectiveness of the vaccine.

The National Advisory Committee on Immunization considers the provision of influenza vaccination for HCPs involved in direct patient care to be an essential component of the standard of care for influenza prevention. The 2004-2005 NACI Statement on Influenza Vaccination noted that HCPs have a duty to actively promote, implement and comply with influenza immunization recommendations in order to decrease the risk of infections and complications in the vulnerable populations for which they care.

Influenza immunization should be a key component of the infection control measures taken by health-care facilities to protect against outbreaks of influenza. “Our experience with the SARS virus heightened awareness of the importance of infection control and will hopefully encourage a greater number of health-care providers to get immunized this fall.” concluded Dr. Allison.