Earlier this year, the Centers for Disease Control and Prevention released a study saying that less that 40 percent of the population of the United States got vaccinated against the seasonal flu last year. That number in and of itself is surprising, given that the flu kills an astonishing 36,000 people every year, putting it squarely in the top 10 annual causes of death in the United States. The distinction between the flu and other top 10 causes, like heart disease and cancer, is that there’s something incredibly easy and quick you can do to keep the flu at bay: get vaccinated.
So you would think that health care workers – the hundreds of thousands of us who spend our time at the bedside, in the operating room, escorting patients to appointments, cleaning hospital rooms, serving food and on and on – would do the easy thing to slow the spread of the flu: get vaccinated and spare ourselves and the patients we spend time with the potentially deadly ramifications of getting the flu.
Alas, no. Health care workers have proven themselves to be just as recalcitrant as everyone else when it comes to getting the flu shot. In fact, despite the public concern and hand-wringing over H1N1, the World Health Organization recently found that more than 52 percent of health care workers in Hong Kong said they wouldn’t get vaccinated for it. Who knows what that number would look like if they surveyed U.S. health care workers, but I have a sneaking suspicion that it would be pretty similar.
So why don’t those of us on the health care front lines get vaccinated for seasonal flu? I often hear the same excuses from my colleagues here at Children’s that I do from the parents of my patients:
- The vaccine causes the flu: The injectable vaccine used for hospital staff contains killed virus. It’s impossible for it to cause the flu. Let me say that again: impossible.
- I never get the flu: Studies have shown that flu is extremely common and that no one is naturally immune. And even if you had the flu last year, its genetic make-up changes every year, which means you can get it again.
- The vaccine isn’t effective: Immunization is 70 to 90 percent effective.
- I’m pregnant. The vaccine might hurt my baby: There’s no evidence that the flu vaccine is harmful to pregnant women or the fetus. In fact, most OB/GYNs recommend the vaccine because the flu and the pneumonia it can cause are potentially very dangerous to expectant moms and their babies.
- The side effects of the shot make me miss work or they’re worse than flu: You might get a sore arm, but that’s usually about it. Muscle aches and fever occur in only a fraction of those who get vaccinated and are almost always mild and short-lived.
This last point is particularly troubling for people like me who have to make sure that we have enough staff to care for every patient who needs our help. Even if you missed a day or two of work because the shot made your arm sore or gave you a slight fever, that’s nothing compared to the amount of time you’d be required to stay out of work if you got either the seasonal flu or H1N1. Think about it this way: If you’re a nurse who works on a busy inpatient floor, doesn’t get vaccinated, then gets the flu and passes it along to two colleagues who also didn’t get vaccinated, and who in turn pass it along to two each of their colleagues, in no time at all you’d have seven nurses out of work for potentially a week each (possibly more if symptoms linger). Imagine the impact that would have on your hospital’s ability to care for patients – and imagine the risk you’d be exposing your patients to.
Now I’m not picking on the nurses here; my fellow physicians are among the worst offenders when it comes to skipping the flu vaccine. I just wanted to illustrate how easy it is for extremely important cogs in the health care wheel to get knocked out of commission.
There’s a lot of information out there about the upcoming flu season, especially if you work at a hospital, which makes it hard to know what’s really important. It got even more complicated this week when we learned that tens of thousands of doses of seasonal flu vaccine are being held up while vaccine companies focus on packaging and shipping H1N1 vaccine – resulting in a temporary, nationwide shortage.
But here’s what I can tell you today:
- The seasonal flu vaccine is safe, and, as far as we know from early testing, so is the H1N1 vaccine. It’s important to note that the H1N1 vaccine is made in the same way that seasonal vaccine is made, so while the H1N1 vaccine is new, the process to create it and ensure that it’s safe is not.
- Some doses of the H1N1 vaccine will contain thimerosal, the preservative wrongly linked to autism. When we talked earlier this week on this blog and our Facebook page about whether people should have their children vaccinated for H1N1, several readers on our Facebook page, including several clinicians, chimed in to say that they would not get the H1N1 vaccine if it contained thimerosal. But I would tell you that the overwhelming scientific evidence (here and here) shows that thimerosal does not cause autism. If you want more information on this topic, the CDC has a lot of great information on their site.
- Adults and kids 10 and over will require only one H1N1 shot; younger kids may need two doses, but more information should be available soon.
- You could get both the seasonal and H1N1 injectable vaccines on the same day, in different arms. But with the difference in timing between the release of the two vaccines, we’d prefer that everyone with patient contact get vaccinated for seasonal now, then get vaccinated for H1N1 later in the fall. Please don’t delay getting the seasonal vaccine in order to save yourself a trip to a flu shot clinic.
I’ll say one more thing that should be obvious after reading all of this, then I’ll get off the soapbox: This year of all years, it’s extremely important that everyone in the health care industry gets vaccinated for both the seasonal and H1N1 flus. Last year, 67 percent of Children’s staff got vaccinated for seasonal flu, which is above the national average, but it’s still not good enough. Here at Children’s and across the country, unless you have a medical reason not to, you should get vaccinated every year. To borrow from our Apollo 11 friends during this 40th anniversary of the moon landing: It’s one small shot for health care workers, one giant thing you can do to help humankind.
So that’s it for now. I’ll leave you with something a little bit fun. By now, you know all the things you need to do to keep the flu at bay, but below is a great rap song about hand hygiene that was written and performed by a physician. It just won the Department of Health and Human Service’s H1N1 video PSA contest.
If you have a few more minutes, read an ICU doctor’s reasons why you should get your child vaccinated for H1N1, the five things you need to know about H1N1, the new iPhone app (which I downloaded last week) developed at Children’s that lets you track disease outbreaks in real time and why swine flu parties are a bad idea.
For more information on Flu (seasonal and H1N1) from Children’s Hospital Boston, visit http://www.childrenshospital.org/patientsfamilies/Site1393/mainpageS1393P385.html