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Posted by Ishani Ganguli January 15, 2013 11:00 AM
Patients expect their doctors to espouse the same good habits that we foist upon you in the form of expert advice. We aren't always great at following through. But when the habit is getting a flu shot every year - and the repercussions clearly extend beyond our own health - I'd say we have a larger-than-usual responsibility to comply.
This year's Flupocalypse has hit harder than expected, prompting our mayor and others to declare states of emergency and journalists to beg Americans to get their flu shots (as of November, 65% hadn’t) with varying degrees of politeness. Of all people, those of us who have pledged to care for and protect vulnerable patients should get that message, so it still amazes me when I hear excuses to the contrary.
The primary care clinic where I work treats Massachusetts General Hospital (MGH) employees, many of whom have direct contact with patients themselves. We've been offering the vaccine to our clinic patients since September and while most pull up their sleeves at the suggestion, I get rejected sometimes despite my most fervent appeals. Some worry it will give them the flu (it won't) or a pesky side effect (for the shot, a sore arm is common and some recipients get a low grade fever with mild flu-like symptoms for up to a day afterwards). Others tell me that it's okay, they never get the flu. Once, a patient was worried about contracting autism.
As vaccines go, the flu shot isn't the surest bet against its intended target. By Centers for Disease Control and Prevention (CDC) calculations, the version of the vaccine created for this season's predominant flu types is about 62% effective. But it is far better than no protection at all against an illness that kills as many as 49,000 people each year and leaves many more weak and hospitalized. While health care workers are better than average at getting the vaccine (about 63% had as of this November), their rates are far from ideal.
Last year, the CDC found in a survey of more than 2,000 health care workers that only 67% had gotten vaccinated during the preceding flu season. Doctors responding to the poll were most conscientious (86% of them got the shot), then nurses (78%). Hospital workers did much better (77%) than those working in long-term care facilities (52%). Of the health care workers who opted out, 28% reasoned that they did not need it, 26% questioned its effectiveness, and 25% were concerned about side effects.
Some workers have lost their jobs over such convictions. The Associated Press reports that at least 15 hospital employees across four states have been fired in the last two months for refusing to get the vaccine and others have quit. More than 1,000 health care workers in Rhode Island are petitioning to oppose the state’s required vaccine policy.
To be fair, we don't have much evidence on the impact of vaccinating health care workers in the hospital, mainly because it's difficult to study. But in nursing homes, researchers have found lower rates of illness and death among residents when workers are vaccinated. Across settings, the benefits of vaccinating employees have clearly outweighed the costs.
Like many others who work at MGH and wouldn't see their own doctors during flu season, I got my vaccine by standing in line at an on-campus walk-in clinic. Afterwards, I got a colored sticker on my employee ID badge to advertise my status (the adult version of a lollilop). Those who haven't taken the shot are now required by hospital policy to wear a mask when caring for patients since influenza is contagious up to a day before symptoms arise (Vaccine naysayers have pointed to this as stigmatizing. I call it Protecting Patients). The system has worked pretty well for MGH in a hectic flu season with 618 confirmed cases to date: As of Friday, at least 85% of active employees received the vaccine, according to MGH spokesperson Kristen Stanton.
Health professional or otherwise, if you’re still trying to find out how to get the vaccine, you can use this nifty resource. In the meantime, you don’t have to eat your broccoli but at least follow your mother’s advice on hygiene: wash your hands often, cover your mouth and nose when you cough or sneeze, and stay home if you have the flu.
The author is solely responsible for the content.
About the authorIshani Ganguli, MD, is a journalist and a second-year resident physician in internal medicine/primary care at Massachusetts General Hospital. She studied biochemistry and Spanish at Harvard College and received her More »
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