Hospitals urge workers to get flu shot; usually half don't

Tracy Crayton has worked in health care 15 years, and even helped organize flu vaccine campaigns at Sentara Norfolk General Hospital.

Yet this marks the first year the 43-year-old occupational health tech has stepped up to the needle herself.

"I was a little iffy about it, but I thought with all the different things going around, this would be the year to get one," Crayton said Wednesday.

It may come as a surprise to some, but 50 percent of health care workers don't get a flu vaccine, according to national studies by the Centers for Disease Control and Prevention.

It's a percentage hospitals are trying to change this year, with a pandemic flu virus bearing down on the country. Cases of the H1N1 virus, more commonly know as the swine flu, began appearing in April, circulated throughout the summer, and are on the upswing now that schools and colleges have reconvened.

The swine flu vaccine is not yet available, but local hospitals have started pushing the seasonal flu vaccine for their employees. That vaccine doesn't offer protection against H1N1, but it's still recommended to reduce illness among staff members and lower the risk for their patients.

Children's Hospital of The King's Daughters has instituted its first mandatory policy for employees to get the seasonal flu vaccine unless they have a verified reason not to, such as an egg allergy or a religious objection.

The hospital will begin giving free vaccinations Tuesday to employees, who will have until Dec. 1 to get the vaccine or provide a signed exemption request. The policy applies to hospital workers and those in CHKD affiliated practices, such as pediatric offices.

"We do consider this a duty to protect our vulnerable population," said Patricia Higazi, occupational health director at CHKD. "The swine flu is the type of flu that targets the young, so we have to be out on the forefront on this."

Also for the first time, Sentara Healthcare hospitals have asked employees to get the seasonal flu vaccine or fill out a "declination" form. The form has a list of 10 reasons for declining a vaccine, such as "I do not like needles," or "The last time I got a flu shot, I got sick," or "I never get the flu."

The form also requires employees to read and check a statement that says they understand that not getting the vaccine increases their risk of getting the flu and "exposing my already fragile patients to this possibly fatal disease."

Employees who refuse a vaccine may be required to wear surgical masks or respirators during the entire flu season if they work with patients.

The concern is twofold: reducing patients' exposure to viruses, and making sure there are enough employees to care for them when the flu season is in full swing. The CDC recommends that health care workers stay home for seven days after flu symptoms start or until all symptoms go away.

June Duck, manager of occupational health at Sentara Norfolk General Hospital, said vaccinations have been given to employees on-site for the past two weeks. The clinics are being used as a drill for mass vaccinations when the H1N1 flu vaccine becomes available next month.

Roving occupational health workers have given vaccinations on the spot, particularly in places with high-risk patients, such as the emergency department, radiology and intensive care.

Portsmouth Naval Medical Center has vaccinated 83 percent of its staff against the seasonal flu, having started in August. Service members are required to have flu shots.

Chesapeake Regional Medical Center and Bon Secours Hampton Roads hospitals have recommended that their employees receive the seasonal flu vaccine, and are providing the shots for free, but they do not require it.

Sentara and CHKD hospital officials said they don't yet know how much H1N1 vaccine will be available in October, so they haven't yet established employee policies for that vaccine.

Dr. Edward C. Oldfield, an infectious disease specialist at Eastern Virginia Medical School, said that past surveys of health care workers have shown that the two main reasons they don't get a flu shot are safety concerns and a belief that it won't work.

Oldfield said there's plenty of scientific evidence to refute those reasons. Some people, though, remember a different swine flu threat. In 1976, the government vaccinated 43 million people to ward against a strain of swine flu.

The outbreak never happened, but 500 Americans came down with a neurodegenerative condition called Guillain-Barre syndrome, which experts believed to be linked to the vaccine.

"That stopped the vaccine program cold," Oldfield said. "It was a public relations nightmare." He said studies since have shown that people are more likely to get Guillain-Barre after the flu than after getting the vaccine.

Oldfield said vaccination rates among doctors and nurses tend to be higher than among other health care workers. One CDC study, for instance, showed that 70 to 80 percent of doctors and nurses in hospitals get the vaccine.

Among the general U.S. population, 37 percent were vaccinated in 2008.

Oldfield said he hopes the declination forms, which EVMS also is using for the first time, will encourage health care workers to get vaccinated.

"I think they will get people thinking twice about their moral responsibility."

Barbara Loe Fisher, co-founder of the nonprofit National Vaccine Information Center, sees the issue differently.

The northern Virginia-based organization, which works to prevent vaccine injuries and deaths, has been fielding concerns from health care workers who feel pressured to get the vaccine.

A new regulation went into effect in New York in August that requires hospitals and other health facilities to provide proof that workers are vaccinated or face fines.

Loyola University Medical Center, near Chicago, and Charleston Area Medical Center in West Virginia have made seasonal flu shots mandatory.

"We defend the right of the health care worker to make an informed, voluntary decision, because these are pharmaceuticals that can injure or lead to death," Fisher said.

At a seasonal flu vaccine clinic at Sentara Norfolk General Hospital on Wednesday, Virginia Stewart, a 31-year-old medical resident in the emergency department, welcomed the chance to get her shot. She said she's been getting one every year anyway, so it was convenient to get one at work.

Shanita Barkley, though, a licensed practical nurse there, had a different stance.

She declined the offer.

"I've just never gotten one before in my life," said Barkley, who is 32. "I don't get that sick. I have a good immune system."

Elizabeth Simpson, (757) 446-2635, elizabeth.simpson@pilotonline.com