Government health officials say the nation's influenza vaccination rate has largely plateaued over the past few seasons and too few healthcare workers receive the vaccine, increasing the risk of an outbreak.
Figures released Thursday by the Centers for Disease Control and Prevention showed the vaccination rate among those six months and older was 46.8% during the 2016-17 flu season, a 1.2 percentage point increase over the 2015-16 season rate.
Since the 2013-14 flu season, the vaccination rate has remained around 59% among children under age 17 and around 43% among adults.
During a Thursday meeting with reporters in Washington, D.C., HHS Secretary Dr. Tom Price urged healthcare providers to do more to promote getting a flu vaccination among their patients, even during seasons when the vaccine may be less effective compared to previous years. Last season's flu vaccine had an efficacy rate of about 42%, but was estimated to have prevented more than 5.4 million flu cases, 2.7 million doctor visits and 86,000 hospitalizations, Price said.
"Doctors and other providers are incredibly important in this," Price said. "Your recommendations are crucial to motivating patients to get vaccinated."
But vaccination rates among healthcare workers have also been stagnant over the past few years despite the many gains that have been made over the past decade to boost coverage.
Influenza vaccination coverage among healthcare professionals has increased 15 percentage points since the 2010-11 flu season, to 78.6% in 2016-17. But there has been no significant increase over the past several years, with the coverage rate ranging from 75% to 79% since the 2013-14 flu season.
Physicians were the most likely to receive the flu vaccine, at 95.8% participation. Pharmacists, physician assistants, nurses and nurse practitioners followed, and all of those healthcare workers had vaccination coverage above 90%. Nonclinical staff, including food service workers, maintenance, housekeeping and administrative staff had the lowest coverage at 65%.
As seen in previous years, those who work in hospital settings accounted for the highest vaccination rates among healthcare professionals at 92.3% while workers at long-term care facilities had the lowest vaccination rate at 68%. Personnel working in clinical settings such as a dentist office, pharmacy, laboratory or outpatient clinic saw the biggest gain in coverage over the previous year, increasing from 69.8% in 2015-16 to 75% in 2016-17.
"These large institutions are really getting it done in terms of getting all of their personnel to vaccinate," said Dr. William Schaffner, medical director for the National Foundation for Infectious Diseases and moderator of Thursday's press conference.
A growing number of hospitals have required their staff to get flu shots, and those policies largely contribute to healthcare workers' higher vaccination rates. Officials said 96% of employees at facilities with vaccine mandates got their flu shot in 2016-17. Providers and care facilities with lower vaccination rates also saw their participation improve if they made vaccination a requirement of employment.
Ninety percent of workers at long-term care facilities with flu vaccine mandates got their shot.
The CDC study found vaccination rates were higher in places that did not require workers to get a shot, but rather made them available at work.
Facilities where vaccinations were available on-site for more than one day at no cost to an employee had a coverage rate of about 80% compared to 73% among settings that made it available for just one day, and 70% in places where vaccinations were promoted, but shots were not available on-site. Only 45% of workers were found to be vaccinated from flu who worked in settings that did not require vaccination, provide them on-site at no cost or promote them to get a shot.
Hospitalizations for flu in the 2016-17 season were nearly double that of the 2015-16, with higher rates across all age groups, according to the CDC.
An edited version of this story can also be found in Modern Healthcare's Oct. 2 print edition.