Shame campaign gets hospital staffers vaccinated

A boring video and the stigma of wearing a face mask may have led to a 90 percent vaccination rate for flu at New-York Presbyterian Hospital last year, doctors said Thursday.

The rare success story is part of an encouraging trend – more people are being vaccinated against influenza. Record numbers of health care workers and children got flu vaccines last year – although numbers in pregnant women are still disappointing, the Centers for Disease Control and Prevention reports.

“Last season more people were vaccinated in the United States than in previous seasons,” said CDC’s Dr. Anne Schuchat.

A CDC survey released Thursday shows that 57 percent of children were vaccinated last flu season, which is five percentage points higher than the 2011-12 season. And 72 percent of health care staff got the vaccine.

“We also saw an increase in adults,” Schuchat told a news conference. ”We saw 42 percent of adults were vaccinating against influenza.” That’s a 3 percentage point increase.

What made a difference? Maybe creative campaigns like the one taken at New York-Presbyterian, says Dr. Richard Liebowitz, chief medical officer there.

“At my hospital, 90 percent of my medical staff gets immunized and that is great,” Liebowitz said. Vaccination rates went up 10 percentage points after the hospital started an opt-out policy that included a couple of sticks.

Public health officials say all medical personal should be vaccinated against flu every year, not only to protect themselves from sick patients, but to protect vulnerable patients they are caring for. But rates remain less than optimal.

Hospitals like New York-Presbyterian are finding that requiring on-the-spot vaccination for hospital workers helps, but not enough. So they took an extra step.

“Last year we started a new intervention,” Liebowitz told reporters. Any staffers declining the vaccine had to sign a sheet acknowledging they knew the risks they were taking. “They then had to had to sit through a 25-minute video that explained the risks,” he added. Anyone still refusing the vaccine had to wear a mask at work during flu season.

“What I hope is that rather than avoiding the stigma of wearing a mask that people will do the right thing,” Liebowitz said.

There were some low spots. Only 59 percent of people working on long-term care facilities were vaccinated against flu last year -- in a place where the patients are the most vulnerable. "We really want everyone working around patients to be vaccinated," Schuchat said.

Only 51 percent of pregnant women got vaccinated, when the goal is 100 percent, so more work is needed. Pregnant women are more vulnerable to flu. The vaccine also protects a woman’s newborn, who cannot get the vaccine until age six months. "Let's get the other half," Schuchat said. 

The survey showed that when a pregnant woman's doctor offered a flu vaccine on the spot, 70 percent got one. Just 46 percent were vaccinated if their doctors recommended it but didn't offer it then and there. "Pregnant women really look to their caregiver to provide advice for themselves and their baby," Schuchat said.

Influenza kills anywhere between 3,000 and 49,000 people a year, CDC says, depending on the strains circulating. Last year, flu killed 164 children, and the H1N1 swine flu pandemic in 2009 killed 1,300 kids.

The CDC says companies will make 135 million doses of flu vaccine available this year, and there are several different formulas, including egg-free for people with allergies and a high-dose formula for the elderly, whose immune systems need a little extra boost for the vaccine to work well. Schuchat says she hopes that will encourage more people to get vaccinated.

"I want to do a shout out to Rhode Island," she said. That state got 82 percent of children vaccinated. "That shows it can be done," she said. 

Some myths are still keeping people from being vaccinated, the experts said. "Some still believe the vaccine -- ha -- can cause the flu," said Dr. William Schaffner of Vanderbilt University, an expert on infectious diseases. "That is simply not true." 

It does take 10 days to two weeks for the vaccine to protect people, and people often catch viruses during that time and mistakenly blame the vaccine, he said.

And Liebowitz says even health care workers come up with excuses. "The most common response I get is 'I never had the flu before and I don't feel like I need a flu shot'," he said. Or they don't like being told what to do. "People have a libertarian streak, and we get answers like 'I am not going to do it because you are requiring me to do it', which is a very interesting philosophy to have," he said.