# Presentation: 514438

## InfluenzaBackground and Importance of Vaccination

**Marc Traeger, MD**
**October 23, 2008**

**IHS Open Door Forum:**
**Influenza Vaccination of**
**Health Care Personnel**

## Objectives

**Refresher on influenza disease and recommendations**
**Understand the importance of influenza vaccine**
**Understand the importance of vaccination in health care personnel (HCP)**
**Understand national achievements and goals for influenza vaccination**

## InfluenzaWhy do we vaccinate?

**PEOPLE DIE **
**FROM INFLUENZA**
** “****THE FLU”**

## InfluenzaBackground

**Accounts for 36,000 deaths annually (U.S.)**
**Only *****S. Pneumoniae***** accounts for more**
**	****vaccine-preventable deaths in the U.S.**
**Deaths from pneumonia & influenza are 40% higher in American Indians/Alaska Natives (AIs)**
**AIs aged ****≥****65 years: 20% higher mortality**

## U.S. Infectious Disease Mortality:The Impact of Influenza and AIDS

**1945: Influenza vaccine**

**1957: “Hong Kong**
** ****flu” pandemic**

**1928: Penicillin discovery**

**1918-1920**

## InfluenzaBackground

**Every year**
**5 – 20% of the population get the flu**
**More than 200,000 people are hospitalized from flu complications, including 20,000 children**
**Increased work absenteeism/decreased productivity due to influenza**

## InfluenzaClinical

**Illness:**
** ****Abrupt onset**
** ****Fever**
** ****Myalgia**
** ****Headache**
** ****Malaise**
** ****Non-productive cough (may persist >2 weeks)**
** ****Sore throat**
** ****Rhinitis**
** ****May resolve after 3-7 days**
** ****May progress to pneumonia and other complications**
** ****Children: otitis media, nausea, vomiting common**

## InfluenzaClinical

** ****Spread from person-to-person**
** ****Large particle respiratory droplet (cough or sneeze)**
** ****Incubation period: 1- 4 days (average 2 days)**
** ****Infectious period:**
** ****1 day before symptom onset to 5 days after illness onset**
** ****Young children may shed virus several days before illness to ****≥****10 days after illness onset**

## InfluenzaBackground

**Infection rates highest among children**
**Serious illness & death rates highest among:**
**Persons ****≥ 65 years**
**Children ≤ 2 years**
**Persons of any age with medical conditions placing them at higher risk (diabetes, asthma, renal, hepatic, hematologic, neuromuscular, immune-suppressed)**

## Influenza Vaccination Background

**Additional conditions placing persons at increased risk for complications of influenza**
** ****Children ****≤****59 months of age (<6 months ineligible for vaccine)**
** ****Persons aged 50 and older**
** ****Pregnant women**
** ****Residents of nursing homes or group homes**

## Influenza Vaccination Background

**Others recommended to receive the flu shot**
**Health Care Personnel (HCP)**
** ****Children 6 years – 18 years **
** ****Persons who have a baby or take care of a baby under 6 months age**
** ****Persons who live with or take care of anyone in the high risk groups**
** ****Anyone without contraindications that requests the flu shot**

## Reference

**Reference**

- _[http://www.cdc.gov/mmwr/PDF/rr/rr5707.pdf](http://www.cdc.gov/mmwr/PDF/rr/rr5707.pdf)_

**Found at **
- _[http://www.cdc.gov](http://www.cdc.gov/)_
**Or**
- _[http://www.cdc.gov/mmwr/](http://www.cdc.gov/mmwr/)_

## Healthy People Goals:

**Influenza vaccination**
***	******	******	******Age ******18-64******:    60%***
***	******     ******	******	****** ******Age ******≥******65: ******	******    90%***
***Health Care Personnel: 60%***
***	*****Overarching Healthy People 2010 goal:**
***Eliminate Health Disparities***

## Receipt of influenza vaccination during the previous 12 months by race/ethnicity among persons >65, 1989-2005, National Health Interview Survey

**Healthy People 2010 Goal**

**Survey Year**

## Healthy People 2010†

**Healthy People 2010****†**

**Percentage of persons aged 18 – 64  years who reported receiving influenza vaccination during the preceding 12 months, by race/ethnicity and survey year – National Health Interview Survey, United States, 1989 – 2004**

## Influenza Vaccination 2005-2006, 2006-2007

|  | Flu vaccination coverage (%)
 |  |  |
| --- | --- | --- | --- |
| Population group | 2005-6 season* | 2006-7 season* | WRSU FY 2006† |
| Aged ≥65 years | 64.5 | 65.6 | 82 |
| Aged 50-64 years | 31.6 | 36.0 | 68 |
| Health care personnel | 41.8 | - | 86 |

*** National health interview survey, National Immunization Survey**
**† ****Whiteriver Service Unit, IHS, Fiscal year 2006**

## Who are “Health Care Personnel”?

**All employees who work in a health care facility, regardless of their job category**
**Including but not limited to:**
**Physicians ****	****	****• Nurses**
**Nursing assistants ****	****• Pharmacists**
**Clerical****	****	****• ****Housekeeping**
**Dietary****	****	****• ****Maintenance**
**Security****	****	****• ****Billing**
**CHRs****	****	****• Ambulance crews**
**Contractors and volunteers **

## Health Care Personnel(HCP)Why do they need vaccination?

**HCP care for patients that are at risk for death from influenza**
**Patients entrust their health and lives to health care personnel**
**HCP are exposed to patients with influenza**
**An infected person is infectious 1 day before symptom onset**

## Influenza Vaccination Whiteriver Service UnitHealth Staff Information

**Message boards**
**Verbal communications**
**E-mail**
**Provider & infection control officer encouragement**
**Influenza updates**
**CDC influenza website link**

## WRSU Employee Influenza Vaccination Program

**Vaccination begun upon vaccine arrival**
**Provided without charge**
**Vaccine brought to employee work stations, all shifts**
**Electronic health record prompts**
**Standing orders**
**Refusals require signature**

## Thank you

## The single best way to protect against the flu is to get vaccinated each year

**Influenza****Why do we vaccinate?**