Flu Vaccination Called an 'Ethical and Professional Responsibility'



WASHINGTON – Approximately 42% of the U.S. population and 67% of health care workers received influenza vaccinations last year, according to data from the Centers for Disease Control and Prevention.

Since the CDC’s 2010 recommendation for universal flu vaccination for everyone aged 6 months and older, "we seem to be on track in protecting the nation against influenza," Dr. William Schaffner, past president of the National Foundation for Infectious Diseases, said at a press conference.

But there is room for improvement, and clinicians play a key role, said Dr. Schaffner, who also serves as a professor and chair of preventive medicine at Vanderbilt University in Nashville, Tenn.

"I believe that the immunization of the health care provider community is both an ethical and professional responsibility," he said. "It is for two reasons: The first and most important is a patient safety issue, so we do not transmit our influenza infection to our patients."

"The other reason is, when influenza strikes, we need to be vertical, not horizontal," he continued. "We need to be ready to provide health care during that period of great community stress."

Dr. William Schaffner

"There are many factors that make it easier than ever for everyone to receive flu vaccination," including a plentiful vaccine supply and a variety of venues, including workplaces, where individuals can be vaccinated, said Dr. Schaffner. Proper handwashing, cough and sneeze etiquette, and the prompt use of antivirals also are important to prevent and limit the spread of the flu.

"A physician’s recommendation can be the deciding factor for patients who are sitting on the fence" about getting a flu vaccination, said Litjen Tan, Ph.D., director of medicine and public health for the American Medical Association.

Recent CDC data indicate that pregnant women whose doctors recommended flu vaccination were five times as likely to get a vaccination, and 44% of adults above age 65 who didn’t intend to get vaccinated did so when a doctor recommended it, Dr. Tan said.

"Every physician has an opportunity this flu season to remind their patients to get vaccinated," he said. "Physicians such as cardiologists, obstetricians and gynecologists, pulmonologists, and endocrinologists, who all have high-risk patients, should encourage their patients to seek influenza vaccinations as soon as they are available."

Approximately 85 million doses of flu vaccine have been distributed so far this season, with more on the way, for a total of about 135 million doses, said Dr. Daniel Jernigan, deputy director of the influenza division in the CDC’s National Center for Immunization and Respiratory Diseases.

"The best time to get vaccinated is before the flu season starts," he said. "It is hard to know when the flu will start and where it will start," but vaccination is still recommended throughout the flu season.

This year's vaccine contains a new A virus and a new B virus.

"The few strains we have seen so far match what’s in the vaccine," Dr. Jernigan said.

Although last year’s flu season was the mildest since 1982, clinicians should not be complacent about vaccination for themselves and their patients, said Dr. Howard Koh, assistant secretary for health at the U.S. Department of Health and Human Services.

"The last few years have demonstrated that the flu is predictably unpredictable," Dr. Koh said. The flu pandemic of 2009-2010 was followed by an unusually mild flu season in 2011-2012, but flu-related hospitalizations and deaths occur every year.

"We can’t look to the past to predict the future," he emphasized.

Dr. Koh highlighted data on the recent progress in vaccination coverage, which appeared in Morbidity and Mortality Weekly Report online Sept. 27 (2012;61:753-63).

Overall, 52% of children aged 6 months to 17 years were vaccinated during the 2011-2012 season, approximately the same rate as the previous year, with a rate of 75% among children aged 6 months to 23 months.

However, vaccination of adolescents remains a challenge; 34% of children aged 13-17 years were vaccinated, said Dr. Koh. Adults aged 65 years and older had a 65% vaccination rate last year, but this was a drop from 74% in 2008-2009.

Vaccination coverage among pregnant women was consistent with the previous year, at 47%, remaining significantly higher than the 30% rate before the 2008-2009 flu season.

For the second year in a row, no racial or ethnic disparities were seen in vaccination rates for children, although these disparities persist among adults, Dr. Koh said.

The press conference was sponsored by the National Foundation for Infectious Diseases. For the complete report on flu vaccination in health care personnel and in pregnant women, visit the MMWR website here.

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