More than 400,000 New Jerseyans could get the flu this year, according to an estimate from the state Department of Health, which wants to see everyone over the age of six months vaccinated. But it's likely that far fewer will heed the advice: about 43 percent of the U.S. population and just over 63 percent of healthcare workers get the flu vaccine, according to estimates from the federal Centers for Disease Control and Prevention.
The CDC's goal is to get 90 percent of healthcare workers vaccinated, and a bill that passed the state Senate Health Committee last month requires healthcare facilities to offer flu vaccine to their workers. The University of Medicine and Dentistry of New Jersey (UMDNJ) is among a number of hospitals that have boosted compliance by offering on-site flu vaccinations around the clock, according to Dr. Iris G. Udasin, director of employee health at the UMDNJ Robert Wood Johnson Medical School in Piscataway.
Udasin sends nurses with mobile vaccination units throughout the medical school, and individuals who get the shot get a green dot affixed to their identification badge -- so patients and colleagues know who's been vaccinated.
"Virtually all our healthcare workers take the flu vaccine," Udasin said. So far this season her staff has dispensed more than 1,000 doses, and she expects several thousand healthcare workers to be vaccinated throughout the winter flu season on UMDNJ's campuses "We do everything we can to make it convenient for people," Udasin said. "We bring it to you -- you don't have to come looking for us. If the department of surgery is having a conference, we go to the conference and vaccinate all the surgeons."
Udasin, a professor of environmental and occupational medicine, said "We absolutely impress on our medical students and residents that you're not just taking the vaccine for yourself, you're taking it for your patients. You went to medical school because you want to take care of people."
Kerry McKean Kelly, spokesperson for the New Jersey Hospital Association, said while the rate of flu vaccination for healthcare workers overall is about 63.5 percent, the rate for hospital workers is 71 percent. But she added "No one is satisfied the numbers. There is a great deal of room for improvement."
Under Senate bill 2984, healthcare facilities would be required to offer flu vaccinations to their employees, but workers are free to decline. The bill would apply to hospitals, nursing homes and home healthcare agencies.
Flu vaccines aren't recommended under the age of six months, and yesterday state Health Commissioner Mary O'Dowd recommended that everyone older than six months get a flu shot this winter. Flu outbreaks tend to peak in January and February, so there is still time to get vaccinated, O'Dowd said. "Now that flu season has arrived, the best way to protect yourself, your family, and your coworkers is to get a flu shot." She said the vaccination is especially important for at-risk groups including pregnant women; those under five and over 50; residents of nursing homes; and people with chronic ailments like HIV, asthma, heart disease, cancer, and diabetes. The flu shot isn't recommended for anyone who has ever had a severe allergic reaction to the vaccine or is allergic to eggs.
Last year five children died of the flu in New Jersey, according to the health department, which did not have figures on adult deaths. The same year saw 69,510 individuals visit the emergency room for flu-like illness, with 6,510 hospitalizations for flu-like illness, according to the department.
Bernie Gerard is a registered nurse and vice president of the Health Professionals and Allied Employees union, which represents 12,000 nurses and other healthcare workers at 15 New Jersey hospitals and nursing homes. "We encourage our members to get the flu vaccine," he said. A successful hospital flu vaccine effort requires "putting in the resources to get it to the staff on the floors," he said. "It can't be 'come to cafeteria and we will vaccinate you.'" And he said hospitals need to create a "comprehensive program that includes education, so people can ask questions and have the opportunity to speak to a qualified individual and talk about their concerns." He said some healthcare workers decline vaccinations out of a fear of the vaccine, or the needle, or for religious and cultural reasons.
Gerard said vaccinating healthcare workers "is a matter of patient safety. We take care of patients [whose health is] compromised, as well as the populations of geriatric and pediatric patients, where the flu can have the most effect."
Catherine Purnell, a former emergency room nurse, is director of policy and clinical advocacy for the New Jersey Health Care Quality Institute. She said the institute supports the bill, including the provision that healthcare workers be allowed to opt out and decline the vaccine. "I think there are people who worry about side effects," Purnell said, adding, "There is a common misconception that the vaccine can cause the flu, and that is not true." She said the bill respects the individual's objection to being vaccinated, noting that the goal of public policy should be to encourage voluntary compliance.
Brian McGuire, associate state director of AARP said "we strongly encourage our members, and the general public over six months old, to be vaccinated; this is a public issue health and a personal health issue." He said Medicare covers flu shots, and about half of AARP members are still in the workforce, and many have health insurance plans that cover flu shots. He said AARP is encouraging use of the new, higher-dose flu vaccine that is "delivered with a shorter and more narrow needle" and is less uncomfortable. "For people who are squeamish, this is an alternative," he said.