“Don’t forget to get your flu shot, would you like one today?”

I say this hundreds of times during the cold and flu season. The shots are usually available in late August, and everyone is encouraged to get one. Pharmacies stock the shot, supermarkets have it, schools and nursing homes administer the vaccine, and the hospitals usually have a ‘flu shot blitz’ for the employees.

Most people who want the shot will get it, since it’s readily available in so many different places, and we all hope that this will protect us from getting sick. Some people have strong feelings against the shot, and aren’t going to get it no matter what I say.

However, one of my patients wanted to know if I had gotten my shot, and if it was required since I work in a hospital. After all, I was recommending it to everyone else, but did I take my own advice? Given my potential to see sick patients who test positive for influenza, shouldn’t it be mandatory to be vaccinated?

Vaccination Flu shot 2017 syringe.

About 83 percent of medical workers in Hawaii get flu shots.

Cory Lum/Civil Beat

This year, the flu season has been particularly vicious. The final stats aren’t yet in, but the numbers of people who have gotten the flu is expected to surpass the 2014-2015 season, when 34 million people across the United States got sick, 710,000 were hospitalized, and 56,000 died.

For all of these people who are in the hospital, this increases the chances that others will be exposed, and prevention is the key to preventing further spread of the virus.

In a study published recently in the journal Infection Control and Hospital Epidemiology, the answer to the ever-contentious debate about mandatory flu shots for hospital workers finally was answered.

Three hospitals in Colorado that mandated the vaccine were compared to four VA hospitals that encouraged, but did not require vaccination, over three years of flu seasons. In each case, the vaccine was readily available at the hospitals for all employees.

Naturally, more workers got the vaccine in the places where it was mandatory. During the three years of the study, the rates of vaccination for the facilities where it was optional saw a steady decline.

Perhaps the best way to increase the rates of immunization might come from the very patients who are sick, challenging those around them to do what’s right to protect the rest of the community.

Major findings included a 30 percent reduction in the rates of absenteeism amongst vaccinated workers compared to those who did not get the vaccine.

There was also a 6 percent reduction in the absenteeism in the workers of the mandatory flu shot facilities, and the number of days absent were also lower.

Given the needs of hospitals often increase during the cold and flu season, and that translates into more staffing requirements, having a way to reduce the numbers of days workers are out sick is an advantage to any organization, particularly hospitals.

So, why isn’t it mandatory at our local hospitals and health care facilities?

Nationwide the rate of influenza vaccination among healthcare workers is 88 percent, which is already quite good. However, here in Hawaii the rate is 83 percent. Each hospital has it’s own rate of employee vaccination, easily searchable on the medicare.gov website.

I figured that the rates should be high, especially given the warnings about the recent flu epidemic.

However what I found was surprising. According to the Centers for Medicare and Medicaid Services section known as Hospital Compare, the highest rates were at Kahuku (95 percent), followed by Castle (93 percent), Kuakini (90 percent), and Queens (88 percent). Still in the 80s were Hilo (85 percent), Maui (85 percent), and Kaiser (83 percent). The lowest rates were at Wahiawa (78 percent), North Hawaii Community Hospital (75 percent), Straub (74 percent), Pali Momi (69 percent) and Wilcox (65 percent).

Efforts to make flu shots mandatory for all employees of a hospital have had various levels of success across the mainland. Last November, 50 employees of a Midwest hospital chain were fired for not getting their flu shot.

In December, a judge struck down a request from the Massachusetts Nurses Association to block the Brigham and Women’s Hospital mandatory flu shot policy. This required all employees to get a flu shot or wear a mask when doing any patient care.

That seems quite radical, and I doubt it would work here in the islands. So, what can be done to increase the flu shot percentages in Hawaii’s hospitals?

Several suggestions can be found online, from a weekly email to managers regarding the vaccination status of their staff, to public displays of C-suite hospital executives getting their shot, to flu shot champions in each department, to even employee videos, like the unusual one done for Zappos a few years back.

If I’m going to recommend a flu shot for my patients, they have every right to ask me if I have gotten mine. After all, the shot might not protect everyone completely, but until a universal flu shot is available that will protect against all strains, yearly immunization is the recommended course of action.

I have diagnosed quite a few cases of influenza in the past few months, and each time, although it’s not 100 percent effective, I am at least reassured that I have had the shot myself, and I have whatever protection it can provide, especially after getting the shot for the past few decades.

The flu shot might not yet be mandatory for hospital employees, but that doesn’t stop anyone from asking whomever is taking care of them if they have gotten the shot themselves. If not, perhaps the best way to increase the rates of immunization might come from the very patients who are sick, challenging those around them to do what’s right to protect the rest of the community.

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