Health care workers need flu shots, too, but not all are getting them

Posted October 04, 2009 11:00 pm

By Robert McCoppin Daily Herald Staff

Magdalena Scanlan, manager of volunteer services at Advocate Lutheran General Hospital in Park Ridge, shows off her flu shot surrounded by the Flu Man Group, which promotes flu shots for health workers. Courtesy Advocate Lutheran General Hospital

Could your local health care worker give you the flu?

Out of concern that many health care workers don't get flu shots, and could spread the flu to patients, Chicago area hospitals are stepping up the pressure on employees to get vaccinated against both seasonal and swine flu.

Many hospitals are surveying workers to find out who refuses the shot and why, and trying to convince them otherwise. Loyola University Medical Center in Maywood, however, is requiring employees to get the seasonal flu shot or lose their jobs. The swine flu shot is recommended as well.

Rather than force workers, most suburban hospitals are using promotion, education and incentives to increase compliance.

The new measures are in response to federal surveys that show fewer than half of health care workers get seasonal flu shots. Since 70 percent or more of nurses and doctors, who are well-versed in the importance of vaccinations, do get the shots, hospitals are pushing to also reach other employees, from janitors to volunteers.

But some nurses are resisting efforts to require shots. The Illinois Nurses Association encourages flu shots for nurses, but opposes making them mandatory.

"It really is a personal decision," said nurse Sharon Canariato, the association's director of nursing practices.

It's a decision that may have greater public implications this season, because officials warn that the H1N1 virus - the so-called swine flu - could add substantially to flu outbreaks.

The Association of Professionals in Infection Control and Epidemiology warns H1N1 could infect half the U.S. population. Its president has described health worker vaccination rates as "appallingly low," and urged hospitals to require flu shots for those with direct patient contact, and hold employees accountable.

New York State has gone so far as to require all health care workers to get seasonal and swine flu shots or face dismissal. Health care workers, civil libertarians and anti-vaccine groups rallied against the mandate last week.

Nurses know how to protect patients from getting sick by taking routine precautions like washing hands and wearing gloves and masks when necessary, said Nancy Webber, spokeswoman for the New York State Nurses Association.

"If you're really trying to stop the spread of infection by inoculating one group of people," she said, "public health experts have told me it's not the most effective way unless you inoculate everybody."

Answering concerns

In online nurse chat rooms and private conversation, some nurses worry about getting the swine flu shot, saying it hasn't been tested enough.

Vaccines can pose risks. Protesters point to a 1976 vaccine against an earlier strain of swine flu, which raised concerns it was causing Guillain-Barre syndrome, a rare immune disorder, though no link was proved.

But health officials say the H1N1 flu shot is just another variation on the seasonal flu shot, which has been used with annual variations for years without significant problems. Seasonal flu is blamed for an estimated 36,000 deaths a year - compared with no known deaths from the vaccine - and the new H1N1 virus so far appears to have similar virulence.

So hospitals are promoting prevention. At Advocate Lutheran General Hospital in Park Ridge, employees formed the Flu Man Group, a takeoff on the Blue Man Group, with three men in blue paint traveling through hospital floors doing skits to promote flu shots, accompanied by a flu cart to get them done immediately.

The goal is to get at least 60 percent of workers vaccinated, which can prevent widespread worker absences due to an outbreak, Advocate spokesman Nate Llewellyn said.

Northwest Community Hospital in Arlington Heights has offered raffle prizes, including a free trip to Disneyworld and a flat-screen television.

But officials have found the most effective way to get people to take their shots is educating them to the risk versus benefits, which got compliance up to 63 percent last year.

Mandatory trend?

At Loyola, where the shots are now mandatory, exceptions are made for those with egg or other allergies.

But Dr. Jorge Parada, director of the infection control program, noted that health care workers have long been required to have vaccinations against such diseases as measles and mumps, but typically get them in childhood, so it's not an issue.

"We have a responsibility to protect ourselves and our patients," he said. "The switch to mandatory vaccination is the beginning of a trend that's a long time coming."

For the first time, Rush University Medical Center in Chicago is making vaccinations a "loose" mandate, according to Dr. John Segreti, infectious disease specialist there.

Excuses will be allowed for religious or personal reasons, but those who don't get the shot will be required to wear masks whenever near patients or face disciplinary measures up to dismissal.

Some employees objected that the hospital "can't tell them what to do," Segreti said, but they were a distinct minority.

Many suburban hospitals, like the Adventist Midwest Health, require employees to fill out forms if they decline the vaccination, then have health officials try to answer each employees' concerns.

At Central DuPage Hospital in Winfield, compliance reached 62 percent compliance last year, but officials are making a push to increase that because of H1N1 flu this year, Dr. Kevin Most said.

"We don't expect to see a lot of new hospitalized patients from H1N1," Most said. "Our concern is the spread in our work force. So we're making a big push to protect our employees. The biggest concern of every hospital is, if 20 percent of your work force gets H1N1, how do you do the staffing?"

Still, polls in Britain and France have suggested some health professionals are resisting swine flu vaccines out of concern it's being rushed into use.

Staff members at Northwest Community, like chief resource manager Monica Nation, said they haven't heard such concerns, but instead a clamoring for the shots, expected in mid-October.

"I've heard more people asking, when are we going to get it?"

Nurse Rosario Slater gets a flu shot from nurse Karen Wallace at Northwest Community Hospital in Arlington Heights on Thursday. Joe Lewnard | Staff Photographer

Flu Man Group member Mark Maroney, project/construction manager, plays musical sticks for Sue Schall, inpatient imaging services manager, while she gets her flu shot from nurse Cari Selzer at Advocate Lutheran General Hospital in Park Ridge. Courtesy Advocate Lutheran General Hospital

Common excuses The most common reasons employees give for not getting the shot: 1. It doesn't work. 2. I don't get sick. 3. The shot will make me sick. Dr. Deborah Foley, an internist and employee health physician at Northwest Community Hospital in Arlington Heights, answers those concerns with the following: 1. Flu vaccines don't protect against every strain of flu, but they are proven effective against the most prevalent flu strains. "Even if it only works 50 percent of the time," she said, "that's a lot better than nothing." 2. Even if a worker doesn't get sick, he or she may carry and transmit the virus. One study found that many of those health care workers who said they weren't sick had flu symptoms. 3. The shot contains a dead virus, so it can't give you the flu. Some say it can prompt an immune response that includes mild flu-like symptoms, but Foley said studies have shown the only statistically significant side effect is a sore arm. Many infectious disease specialists say vaccination compliance of 60 percent is a reasonable goal. After answering employee objections, Northwest Community raised compliance to its highest level ever - 63 percent.

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