## *Article for RNs and LPNs*

*Words: 1065*

**On the Front Line: Nurses Urged To Get Influenza Vaccination**

It's been said that "nurses are the heartbeat of the health care
system." Without them, the system could not survive.

Sometimes, however, in their dedication to caring for others, nurses may
forget *to take care of* *themselves*. This, too, can significantly
burden the healthcare system, especially when nurses catch the flu.
Statistics show that fewer than half (41.8 percent) of all health care
workers were vaccinated against the flu during the 2005-2006 influenza
season.[^1] In an era of nursing staff shortages and mandatory overtime,
nurses may be heaping additional responsibilities on their co-workers
when stricken with flu and unable to work.

But there is a quick and easy fix for this problem: a flu vaccine. In
fact, the Centers for Disease Control and Prevention (CDC) and the
Advisory Committee on Immunization Practices (ACIP) recommend that *all*
health care professionals who work directly with patients get an annual
influenza vaccination. Because flu illness is caused by flu viruses that
change constantly and the vaccine is updated every year, annual
vaccination is needed for protection to remain current.

***Fact vs. Fiction***

So why *aren't* nurses, and other health care professionals protecting
themselves?

It may be because even within the medical community, research indicates
there's a great deal of misinformation circulating about the flu
vaccine. Despite the well-known benefits of the influenza vaccine,
common misconceptions persist.

-   **Fiction:** The influenza vaccine can *cause* the flu.

> **Fact:** This is untrue. The flu shot contains inactivated viruses
> and the nasal spray contains weakened strains that are too
> insignificant to cause flu illness. Many studies confirm this. If a
> person gets the flu following a flu vaccine, it means that person had
> been exposed to the virus at least 3 to 5 days prior to showing
> symptoms. It can take up to two weeks from the time the vaccine is
> administered for immunity to kick in.

-   **Fiction:** Nurses are immune to influenza, or have stronger immune
    systems, because they work around sick people every day.

> **Fact:** Because influenza viruses are constantly changing, past
> exposure does not provide protection against new influenza virus
> strains.

-   **Fiction:** The vaccine's side effects are worse than getting the
    flu itself.

> **Fact:** The most common side effects are redness and mild soreness
> at the injection site. These symptoms usually resolve themselves in
> one to two days. Persons who chose to get the nasal vaccine can avoid
> these injection--related problems, but can have nasal congestion or a
> runny nose for a day or two. The most serious side effect is an
> allergic reaction by those who have a severe allergy to eggs (the
> vaccine viruses are grown in eggs). For this reason, getting an
> influenza vaccination is not advised for people with an egg allergy.
> But egg allergies are rare, and severe allergic reactions are even
> rarer.

-   **Fiction:** The flu vaccine is not effective.

> **Fact:** When there is a good match between circulating influenza
> virus strains and those in the vaccine, effectiveness rates have been
> as high as 70%-90% in healthy adults. Although the vaccine does not
> prevent *everyone* from getting ill, vaccination can make your illness
> milder. Plus the vaccine greatly reduces the chances of
> hospitalization and death.

***The Scoop on Flu***

Although influenza is mainly spread by droplet transmission, the virus
can also infect others by remaining infectious on contaminated
objects---such as doorknobs, telephone receivers, food utensils and
trays, beds and medical equipment---for hours. Also, people can spread
the flu for a day or so before they even develop symptoms.

The period when an infected person is most likely to transmit the virus
to others is during the first three days of illness. The chance of
transmission wanes over five to seven days in otherwise healthy adults.

Influenza usually starts suddenly and may include the following
symptoms:

+----------------------------+-----------------------------------------+
| -   Fever (usually high)   | -   Runny or stuffy nose                |
|                            |                                         |
| -   Headache               | -   Body aches                          |
|                            |                                         |
| -   Tiredness (can be      | -   Diarrhea and vomiting also can      |
|     extreme)               |     occur, but are more common in       |
|                            |     children.                           |
| -   Cough                  |                                         |
|                            |                                         |
| -   Sore throat            |                                         |
+----------------------------+-----------------------------------------+

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 prescription antiviral medicines that can help
prevent influenza infection and, when used within the first 48 hours,
can reduce the duration and severity of the illness.

The role that nurses and other health care workers play in helping
prevent influenza-related illness and death---especially in at-risk
elderly patients and young children---cannot be underestimated.

Patients of nurses and health care workers who are at the greatest risk
for influenza-related complications include people 65 or older;
individuals with chronic pulmonary or cardiovascular conditions; people
with chronic illnesses such as diabetes mellitus, cardiovascular
disease, kidney disease, cancer, AIDS/HIV and asthma; pregnant women;
infants; children ages six months through 5 years and residents of
nursing homes and other chronic care facilities. In addition to high
risk groups, CDC recommends vaccination for all children aged 6 months
through 18 years; people age 50 or older; and all healthcare workers to
help curb the spread and possibly severe complications of influenza

***Two Easy Options***

The influenza vaccination remains the *best way* for nurses and others
to protect themselves, their families and their patients during the
annual influenza epidemic. All they need to do is choose the method of
delivery.

**Intramuscular influenza vaccination:** Administered by shot, this is
one of few immunizations that is recommended for *all* health care
professionals, regardless of any special conditions (i.e., pregnancy,
HIV infection, severe immunosuppression, renal failure, asplenia,
diabetes and alcoholism/alcoholic cirrhosis.)[^2]

**Live intranasal influenza vaccine:** This live vaccine is approved for
use in healthy persons 5 to 49 years of age, who are not pregnant, and
do not provide care for severely immuno-compromised people when they are
in a protective environment, such as a bone marrow transplant unit..
Most healthcare workers who are younger than 50 years of age can receive
the intranasal vaccine if they choose to.

***Safe, Not Sorry***

The role that nurses play in helping others is well known. Now, it's
time for nurses to consider how protecting *themselves* against the flu
will also help them in their mission to protect others.

For more information about influenza and the influenza vaccine, visit
[www.cdc.gov/flu](http://www.cdc.gov/flu) or call 800-CDC-INFO
(800-232-4636).

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[^1]: CDC. Prevention and control of influenza: Recommendations of the
    Advisory Committee on Immunization Practice (ACIP). *MMWR.*
    2008;57(Early Release);1-60

[^2]: CDC, *MMWR*. 2004;52(RR06):1-40.