"If a [person] is not ready to take the vaccine themselves, they are not ready to become an advocate for the vaccine among patients," Schaffner said.
Still, as a nurse in the intensive care unit at Scripps, Ludwick finds she treats people who are already very sick and cannot handle a flu shot. Overall, Ludwick says staff are encouraged to get vaccinated, rather than required, and that most nurses she works with do.
Still, the influenza vaccine is not 100 percent effective against the virus.
"We understand that the vaccine is not perfect," Schaffner said. "But we're working to make the vaccine better."
Strong support for getting vaccinated is often the key to achieving vaccination rates above 40 percent.
Dr. David Hooper, chief of the Infection Control Unit at Massachusetts General Hospital in Boston, received his vaccine in October, the beginning of the flu season.
Hooper says he and other administrators encourage hospital staff to get vaccinated through monthly newsletters, updates and by making it as easy as possible to get vaccinated for free by occupational services. The hospital also makes an effort to document who is not getting a flu shot on the premises and who may be getting it elsewhere or not at all.
"A health care worker, annoyingly, could be incubating influenza and transmitting to any number of people," Hooper said. "Vaccines are the single best public health tool we have for managing influenza."
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