# Presentation: 175686

## Why should I get the flu vaccine?

**Notes:**
Why should I get the flu vaccine?

## Effects of Influenza

- 5% to 20% of the population gets the flu each year
- 226,000 hospitalizations each year due to influenza
- 36,000 deaths each year due to influenza
- American Indian/Alaska Native population is 1.7 times more likely to die from pneumonia and influenza than U.S. Whites 1

- 1. 2000 – 2001, Trends in Indian Health

**Notes:**
Note variation by age groups – AI/AN people 25 – 44 years and 45 – 54 years are 3.9 times more likely to die compared to U.S. Whites

## Influenza Virus Transmission

- Mainly from person to person through coughing or sneezing
- Touching something with flu viruses on it and then touching your mouth or nose
- You can pass on the flu to someone else even though you do not have any flu like symptoms

**Notes:**
Influenza Virus Transmission

## Communicability is highest 1-2 days before symptoms start and up to 4-5 days after onset of symptoms

- Communicability is highest 1-2 days _before_ symptoms start and up to 4-5 days after onset of symptoms

**Notes:**
This illustration demonstrates how influenza is usually spread through coughing or sneezing

## 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

**Notes:**
Health Care Personnel
	All employees who work in a health care facility, regardless of their job category

## Reasons to vaccinate HCP

- Protect yourself
- Reduces sick days by 28%1
- Protect your family
- If you are infected with influenza you will also expose your family
**PROTECT YOUR PATIENTS**
- Ethical imperative “First do no harm”

- 1. Infection Control & Hosp Epidemiology 2005:26:883

**Notes:**
Influenza vaccines has been shown to reduce sick days by 28%
“First do no harm” - ensuring that health care workers vaccinate and are vaccinate	

## Types of influenza Vaccines

- Inactivated subunit (TIV)
- Intramuscular injection (Flu shot)
- Trivalent
- Killed virus
- Yearly vaccination
- Live attenuated vaccine (LAIV)
- Intranasal spray
- Trivalent
- Live weakened virus
- Yearly vaccination

**Notes:**
Types of influenza Vaccines

## Influenza Vaccination of HCP

- In 2006, only 42% of HCP were vaccinated against influenza1
- Healthy People 2010 Goal: 60%

- 1. CDC.MMWR. 2007;56(RR-6):1-54

**Notes:**
Healthy People 2010 Goal Objective no. 14-29g

## Influenza Activity

- There is plenty of time to get vaccinated before peak influenza activity!

**Notes:**
It takes about 2 weeks for the vaccine to become fully effective.

## HCP vaccination

- Reasons for **accepting**
-     vaccination:
- Protect self
- Protect patients
- Convenience
- Peer influence
- Prior positive experiences with receiving the flu vaccine

- Reasons for **rejecting**
-     vaccination:
- Concerns about vaccine safety or efficacy
- Not at risk (healthy immune system)
- Not at risk (do not understand transmission of influenza)
- Fear of needles
- Not convenient (real or perceived)

- Source: Hofman F, Ferracin C, Marsh G, Dumas R. Infection 2005;34:142-147

**Notes:**
HCP vaccination

## Addressing HCP concerns

- Concern: Vaccine safety
- You cannot get influenza from the vaccine
- Vaccine is safe – allergic reactions are RARE
- A sore arm is the most common adverse reaction
- Persons with chronic illnesses CAN and SHOULD receive influenza vaccine
- Pregnant women CAN and SHOULD receive influenza vaccine

**Notes:**
Allergic reactions are very rare, and most likely due to residual egg protein, which is why people with a severe egg allergy should not receive the vaccine. 

## Addressing HCP concerns

- Concern: Vaccine efficacy
- When vaccine and circulating viruses are well matched, vaccine is 70% - 90% effective in healthy adults <65 years1
- Vaccine can provide cross protection against different, but related viruses2

- CDC.*MMWR*.2006; 55(RR-2): 1-16.
- Jefferson, et al. Cochrane Database Syst Rev. 2007 Apr 18;(2):cd001269

**Notes:**
Addressing HCP concerns
	 Concern: Vaccine efficacy

## Addressing HCP concerns

- 1*. JAMA *1999;281:908-13

- Concern: Not at risk (perception of having a healthy immune system)
- In one study1, 23% of HCPs had serologic evidence of influenza infection after a mild influenza season
- 59% could not recall being sick
- 28% could not recall any respiratory infection
- Suggests a high proportion of asymptomatic illness

**Notes:**
Addressing HCP concerns
	 Concern: Not at risk (perception of having a healthy immune system)

## Addressing HCP concerns

- Concern: Not at risk (do not understand transmission of influenza)
- Virus is spread from person to person, primarily by coughing and sneezing
- Virus is shed 1-2 days _**before **_symptoms start and up to 4- 5 days _**after**_ onset of symptoms
- Asymptomatic or mild cases _**are**_ contagious
- HCP often work while ill, thus exposing patients and colleagues

**Notes:**
Addressing HCP concerns
	Concern: Not at risk (do not understand transmission of influenza)

## Addressing HCP concerns

- Concern: Fear of needles
- A nasal spray is available for healthy* people 2-49 years of age
- Check with your health care provider and see if you can get this vaccine
- Nasal spray is not available for pregnant women
** A healthy person is someone who does not have a medical condition that may lead to influenza complications  - check with your health care provider*
- Concern: Not convenient (real or perceived)
- Check with your Employee Health Nurse and/or Infection Control Coordinator to find out where and when you can receive a flu vaccine

**Notes:**
Addressing HCP concerns
	Concern: Fear of needles
	 Concern: Not convenient (real or perceived)

## What facilities can do

- Identify an influenza vaccination coordinator
- Educate HCP in your facility about the importance of influenza vaccination
- Provide information during staff trainings, new employee orientations, through email, posters in the facility, etc.
- Provide vaccine to all HCP in your facility
- Free of charge
- Convenient (multiple locations/times, mobile vaccination cart)
- Consider having employees who refuse the vaccine sign a declination form
- Monitor coverage of your employees
- Friendly competition between departments

**Notes:**
Some ideas of what you/your sites can do

## Resources

- For more information:
- 	Dept. Health and Human Services Influenza Toolkit _[www.hhs.gov/ophs/programs/initiatives/vacctoolkit/index.html](http://www.hhs.gov/ophs/programs/initiatives/vacctoolkit/index.html)_

**Notes:**
Resources