Docs Talk the Talk, But Do They Take Flu Shots?

Health care workers reflect on the pros and cons of getting flu vaccines.

December 8, 2008, 5:11 PM

Dec. 9, 2008 — -- Every fall, the public is barraged by messages from doctors, nurses and other health care providers to get a flu vaccination to protect against the influenza virus.

But the truth is, some doctors and nurses might talk the talk without walking the walk.

According to the most recent data from the Centers for Disease Control and Prevention, a significant chunk of health care professionals declined to get vaccinated against the influenza virus during the 2006-07 flu season, with only about 40 percent opting for a jab. It's an "abysmal and profoundly sad" statistic, according to Dr. William Schaffner, chairman of the department of preventive medicine at Vanderbilt Medical School in Nashville, Tenn.

"Both the professional and ethical responsibility of all health care workers is to be vaccinated annually against influenza," Schaffner said.

Vaccination serves to protect both patient and health care provider from becoming infected with influenza, as well as from transmitting the contagious virus to others.

One in five Americans get the flu every year, according to the CDC. Of these, 200,000 are hospitalized and about 36,000 die.

Schaffner added that, in the midst of an influenza outbreak, it is crucial to have healthy people on hand to take care of patients.

"We need health care workers on the line delivering medical care," Schaffner said. "We don't need them home sick."

There are legitimate reasons to steer clear of the needle. People with an egg allergy might avoid getting the vaccine because viruses for the flu shot are grown in eggs. People with Guillain-Barre syndrome -- a disease that results in nerve damage -- should avoid getting vaccinated as well, since respiratory illnesses can trigger an episode.

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But for healthy individuals, the CDC recommends that all health care personnel, students in training for those professions, and other high-risk groups such as employees of assisted living communities be vaccinated against the influenza virus.

Professionals make a variety of excuses for not getting the influenza vaccine, chief among which are that they are too busy or that getting vaccinated is inconvenient. Others don't like needles or believe, mistakenly, that the vaccine will result in a bout of the flu.

To those professionals, Schaffner said, "Get over it."

No Shot for Me

But for others, a history of good health can justify declining vaccination.

Nancy Ludwick, a registered nurse at Scripps Memorial Hospital in La Jolla, Calif., has had flu vaccinations in the past, particularly after Scripps began to require formal declination for those who chose not to receive the vaccine.

After her last vaccination, Ludwick said she got sick. But this year, Ludwick is experimenting with not getting vaccinated.

"I haven't had the flu in ... [11] years," Ludwick said. "I don't like to take anything. I barely take a vitamin. ... I'm doing my own trial to see how I would feel or not."

Ludwick said she feels more protected than the public, since nurses wear gloves and wash their hands constantly.

But experts could be concerned about the ability of doctors and nurses who choose not to get vaccinated to talk up the vaccine to patients.

"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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