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Hospital Beats Flu Vaccine Procrastinators With In-Your-Face Effort

An in-your-face flu vaccination effort has boosted staff immunization rates from 65 percent to 93 percent at a Delaware hospital system.
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Walk into Christiana Care Health System’s flagship hospital in Wilmington and there’s no doubt about what you are supposed to do. Banners direct patients and staff alike to their first stop – the flu shot station.

The doses of flu vaccine are loaded and ready and it takes only a few minutes to get vaccinated and go. There’s little room for excuses.

“There's a lot of advertising, a lot of excitement, there's a lot of peer pressure,” says Dr. Marci Drees, the infection prevention officer and hospital epidemiologist for Christiana Care Health System.

“We all wear these tags that, you know, so everyone knows who's been vaccinated and I think it just increases the visibility of the program and the excitement about it.”

It’s worked. The national vaccination rate for health care workers is consistently below 65 percent, according to the Centers for Disease Control and Prevention. That’s even though the CDC and experts in infectious disease say every health care worker should be vaccinated.

At Christiana Care, the vaccination rate is 93 percent, Drees says.

They’ve done it with an in-your-face approach that uses both carrots and sticks to get staff to vaccinate.

“I’m protecting myself as well as my patients.”

The first step – making it hard to say no. The hospital didn’t want to force staff to get vaccinated, but they made it an opt-out system.

Staff who decline to be vaccinated must wear face masks at all time when interacting with patients. That protects them – and vulnerable patients. People can infect others with flu a full day before they even feel sick themselves and there is no way of telling who’s coming down with the virus.

Vaccinated doctors, nurses and technicians not only get to skip the shame of the face mask – they’re given visible “I’m vaccinated” badges, and credit toward an annual bonus.

Finally and perhaps most important, the hospital makes it easy. Flu vaccine stations are set up in visible, open spaces, and staff also visit the floors, offering vaccines to patients.

In the front lobby of the Wilmington hospital, staff in blue scrubs cycle through the station on their way to start shifts or on quick breaks.

“So I got vaccinated today because Christiana Care makes it convenient with their multiple flu stations that they set up and the different time frames for busy nurses like us to come down just for a few moments to get vaccinated and still be able to continue on with our day ,” says James Turner, a registered nurse.

“I’m protecting myself as well as my patients.”

CDC says it only makes sense for medical staff, who interact with both sick and well patients all day long, to be vaccinated.

“They can spread it among their coworkers. They can spread it to their patients. They can bring it home and spread it to their family. We also obviously vaccinate our inpatients and people who are hospitalized they're automatically offered flu vaccine as long as they haven't already gotten it,” Drees said.

"We wanted to make some dramatic changes in how we did the program."

“I don’t want to bring home anything from the hospital, any more germs to my family, so getting vaccinated also protects them as well,” says RN Jamie Ayala, whose son is in day care.

Christiana Care, the largest private employer in Delaware, has 11,000 employees and was concerned about a fairly mediocre vaccination rate of between 57 and 75 percent a year.

“I think we were just frustrated we weren't really making progress and we wanted to make some dramatic changes in how we did the program,” Drees told NBC News.

Christiana starts the vaccine program in October, just at the very start of the annual flu season. The effects of the flu shot wear off after about six months and the virus mutates every year, so people must get a fresh vaccine every season to be protected.

Even when the vaccine isn’t a good match for the dominant virus – it wasn’t a good match last season – it protects against other strains. In any given year, several strains of flu will circulate and the vaccine is reformulated for each season.

This year, about 98 million doses of flu vaccine are already available with more to come. CDC says everyone over the age of 6 months should be vaccinated, but in reality, only about half the population does.

The result is millions of cases every year. Flu usually hits the very young and the very old the hardest.

Depending on the season, it kills anywhere between 4,000 and 50,000 people a year in the United States.