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Healthy Outlook

Flu Shots Shouldn't Be Optional for Health Care Workers

By Dr. William Walker

Wednesday, October 3, 2012

In my 35-plus years as a family physician, I always urged my patients to get their annual flu shots. The reasons for getting vaccinated are compelling. Flu shots are a simple way of protecting yourself - and others - against a virus that hospitalizes and kills thousands of people in the United States every year.

After advising my patients to get vaccinated, some of them would turn the tables and ask me if I had gotten my flu shot. My answer was always a quick and emphatic "yes." What kind of hypocrite would I be to prescribe something for them that I wasn't willing to do myself?

Unfortunately, not all of my colleagues in the medical profession feel the same way. In fact, according to the California Department of Public Health, employee vaccination rates at hospitals in Contra Costa ranged from a measly 44 percent to a better-but-still-unsatisfactory 72 percent in 2010-11.

You may be surprised that so many health professionals don't get vaccinated against the flu. You'd think they should know better. But health care workers are human beings, and they skip their flu shots for the same misguided reasons other people do such as fearing that getting vaccinated will actually make them sick. Unless someone is allergic to a vaccine, this just isn't true. This simple truth is people are more likely to get sick when they don't get immunized.

While I think everyone should get their flu shots, it's absolutely critical for health care workers to do so. By not getting vaccinated, health care workers are risking the lives of their patients, especially those who are already seriously ill. Health care workers may be spreading the flu to their patients and coworkers without even realizing it; people with the flu are contagious up to one day before symptoms appear.

That's why, as the county's health officer, I recently issued an order requiring people working in licensed health care settings in Contra Costa who have direct patient contact or work in patient care areas to get vaccinated before the start of the flu season, which goes from Nov. 1 to March 31. Health care workers who decline vaccinations will have to wear a mask in patient care areas until flu season is over.

Contra Costa isn't the only county mandating flu shots. Health officers in San Francisco, Sacramento and Santa Clara County have issued similar orders in hopes of giving patient safety a shot in the arm. Mandatory vaccination or masking policies have been shown the increase vaccination rates among health care workers to 95 percent.

For years, hospitals and public-health regulators have avoided mandating flu shots for health care workers, hoping they could improve rates through education and outreach. That obviously hasn't worked. I don't believe requiring people working with patients or in patient care areas to get their flu shots is too much to demand. In my mind, it's no different than requiring tuberculosis tests or pre-employment physicals, which are already commonplace.

Health care workers do important work and care deeply about the well-being of their patients. That's precisely why they should get their flu shots.

To see my order mandating flu shots for health care workers and learn more about the requirements, go to

Healthy Outlook is written by the professional staff of Contra Costa Health Services, the county health department. Send questions to series coordinator Dr. David Pepper at For more health information, go to
About the Author
Dr. William Walker is health officer for Contra Costa County and the director of Contra Costa Health Services (CCHS), the county health department.