Getting your flu shot is a smart thing to do. It assures nothing, but you do it anyway. It’s like throwing the deadbolt on your front door, putting air in the car’s tires or seeing your doctor for a checkup. None of these guarantees you won’t be robbed, get a flat tire or contract some horrible disease, but your odds of avoiding them are much better. In the case of the flu vaccine, it guards against a serious illness that, at its worst, can be fatal.

Deciding not to get a flu shot — as 44% of the population in Massachusetts and 48% in New Hampshire have done so far this season — usually puts at risk yourself and those immediately around you. It’s largely a personal choice. But for health care workers, there’s a different set of risk packed into that individualized decision. Those around them have compromised immune systems, may already be ill, or may be so frail that a bad bout of the flu is likely to be deadly. A health care employee making a decision about whether they really need a flu shot makes a decision for those people as well.

It is incumbent upon them and their employers, then, to ensure they are vaccinated. Unfortunately, according to a report released recently, they seem to be falling down on the job.

The state Department of Public Health revealed that a surprising number of health care facilities — including nursing homes, rehab centers, rest homes, health clinics and dialysis centers — have far fewer employees getting flu vaccines than is recommended. At a dialysis center in Beverly, for example, just two-thirds of the health care staff had gotten a flu shot so far this season, down considerably from last year when the participation rate was 100%, according to the report. Four in five workers at a Peabody dialysis center had gotten shots, slightly better than the three-quarters participation from last year. At a family clinic in Lawrence, just one in four were vaccinated. The list goes on and on.

Overall 86% of the state’s health care workers are vaccinated this season, according to the report, with 9% declining a vaccination and 1% refusing for medical reasons. State health officials encourage each provider to have a vaccination rate of 90%. The collective, statewide rate should be at least as high.

“First and foremost, health care personnel are directly interacting with residents and patients,” Katherine Fillo, director of clinical quality improvement at the Department of Public Health told the Boston Globe, which reported on the study. “They could be transmitting influenza to them, and we want to prevent that from happening.”

Health care workers are far more likely to get a flu shot than the general public, but that’s not surprising. Vaccination rates are notably much higher in the state’s acute care hospitals; nearly 94% of the 270,000 health care personnel in those facilities have gotten flu shots, according to the Department of Public Health. Only a small portion have refused a shot for medical or other reasons.

Of course, those facilities are far more likely to require workers to either get a shot or wear masks and protective equipment to prevent the spread of the virus. If logic, peer pressure and the employee handbook won’t sway them, maybe the convenience of not having to worry about those other precautions will.

The state does not require health care workers get a flu shot. Instead the Health Department makes hospitals and health care facilities offer flu shots to employees for free, and to submit updated vaccination information.

As the Globe notes, the state spent years focusing on how to get more hospital workers vaccinated. As recently as a decade ago, the newspaper reports, vaccination rates in those facilities hovered around 70%.

Clearly the state and health care providers now need to turn their attention to other health care settings. It’s important to protect health workers and the people with whom they interact, be they nursing home residents or dialysis patients or people recovering from surgery and illnesses whose conditions make them especially vulnerable to the virus.



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