Influenza vaccination of healthcare workers: institutional strategies for improving rates.

The nosocomial transmission of influenza has been well documented since the 1970s with both direct and indirect effects of outbreaks in healthcare settings. Outbreaks can directly increase morbidity among patients and residents of long-term care facilities. Indirect effects include disruption of normal operations of healthcare institutions, shortages of healthcare workers (HCWs), fewer elective admissions, and income loss due to absenteeism. Influenza vaccination of United States HCWs remains below 40% despite the availability of a safe, effective vaccine and a long-standing recommendation for vaccination of HCWs. New strategies to improve the rate of influenza vaccination among HCWs are needed as the percentage of those receiving yearly vaccination has changed little in the past 20 years. Increasing HCW influenza vaccination coverage calls for a paradigm shift, institutions should view vaccination of HCWs as a crucial part of a comprehensive infection control program designed to protect patients and staff. Administrators of hospitals, long-term care facilities, and other health agencies should respond to this challenge by developing programs to improve yearly influenza vaccination of their staff Such efforts would put these employees into compliance with national recommendations and also benefit the institution by reducing absenteeism, nosocomial influenza transmission, and the associated economic losses and disruption of routine operations.