This is the time of year when health care experts urge us all to get flu shots.
But when it comes to practicing what they preach, some hospital workers do a much better job than others, statistics reveal.

Influenza vaccination rates vary widely at Bay Area hospitals, prompting some advocates to call for mandatory policies and stepped-up educational campaigns to prevent hospital workers from infecting others.

“Health care professionals come in contact with weak, vulnerable patients with incredibly compromised immune systems, people who are particularly susceptible to infections like influenza,” said Carmella Gutierrez, president of Californians for Patient Care, a Sacramento-based group that supports mandatory vaccination.

“By not doing something as minor as getting a flu vaccine, health care workers put their patients’ health at unnecessary risk,” Gutierrez said.

During an average year in the United States, nearly 36,000 people die and 200,000 are hospitalized because of flu-related illnesses. The elderly, young infants and those with weakened immune systems are particularly vulnerable.
In the East Bay, flu vaccination rates during the 2010-11 season ranged from highs of nearly 86 percent of employees at San Ramon Regional Medical Center and 83 percent at St. Rose Hospital in Hayward, to lows of 44 percent at Doctors Medical Center in San Pablo and slightly more than half of employees at Contra Costa Regional Medical Center in Martinez.

The statistics are contained in a new report issued by the California Department of Public Health.

In the South Bay, Good Samaritan Hospital in San Jose topped the charts with a 91 percent employee vaccination rate. Close behind was Regional Medical Center of San Jose at 89 percent, followed by Stanford Hospital at 80 percent.
On the low end, Saint Louise Regional Hospital in Gilroy had a 53 percent employee vaccination rate, and San Mateo Medical Center ranked only slightly better at 55 percent.

Statewide, 64.3 percent of hospital employees got a flu shot, up slightly from 62.6 percent during the 2009-10 flu season.

These numbers include all workers on a hospital payroll including many nurses, clerical, administrative and maintenance workers.

Most doctors are not included since they are typically not hospital employees. The study lists separate vaccination rates for non-employees, but these numbers are not considered as reliable because of monitoring difficulties.

Health experts consider it important that most hospital workers receive flu shots because even administrative and maintenance workers often pass patients in hallways or share elevators and other common areas with them.

Many people don’t realize they can spread the disease even before they begin to feel ill and develop symptoms, said Dr. Anthony Russell, a pediatric physician at Kaiser Permanente and a delegate for the California Medical Association.
“This isn’t just about nurses or front-line caregivers,” said Jan Emerson-Shea, a spokeswoman for the California Hospital Association. “This is about every employee in the hospital.”

In addition to protecting patients, a high vaccination rate helps ensure that enough hospital workers will be available to care for the ill during a major outbreak, experts say.

Earlier this month, the California Medical Association joined with the California Hospital Association, California Association of Physician Groups and other organizations in a letter to hospitals encouraging them to take steps to increase vaccination rates.

It isn’t clear why many hospital workers forgo flu shots, but some may have misperceptions about the importance of the vaccination and whether they can get the flu from a shot — they can’t — or simply may not make it a priority, experts say. Also, anyone who is allergic to eggs should not get the shots.
The Centers for Disease Control and Prevention released a study in August estimating that 84 percent of physicians get a flu shot and nearly 70 percent of nurses. However, rates plunge to about 57 percent for administrative workers and 64 percent for technicians.

California is the only state with mandatory public reporting of hospital flu vaccination rates. Beginning in January 2013, the federal Centers for Medicare and Medicaid Services will require nationwide reporting of such data.
Since 2006, California has required hospitals to offer free flu shots to employees and get signed forms from workers who choose not to be vaccinated.
Good Samaritan Hospital in San Jose is among the less than 5 percent of hospitals statewide with a vaccination rate that exceeds 90 percent. The hospital has nurses who travel throughout the hospital with carts and vaccinate employees on the spot.

“It’s hard to say no with a couple of nurses looking at you,” said Dr. Arthur Douville, chief medical officer. “We educate our employees. We make sure they have all of their questions answered.”

The hospital also has a policy that all employees who come within six feet of a patient and who have failed to get a flu shot must wear a mask during influenza season. Douville said only a tiny fraction of Good Samaritan workers fall into this category.

A national benchmark recommends that all hospitals obtain at least a 90 percent vaccination rate by 2020.

But the state report notes that to reach that goal, many hospitals may need to develop more aggressive policies. This could include a mask requirement, reassigning nonimmunized workers to areas where they won’t have patient contact, or placing an indicator on an employee badge if they fail to get vaccinated, said Loriann DeMartini, a consultant to the state’s Center for Health Care Quality.

San Francisco has taken it a step further. In September, Health Officer Tomas Aragon issued a memo requiring all health care facilities in the city to implement a masking program for the unvaccinated.

Doctors Medical Center, which had the lowest vaccination rate among East Bay hospitals last year, is conducting a “flu-buster” campaign this year and has a nurse going from department to department to deliver shots. So far this season, nearly 65 percent of employees have been vaccinated, an improvement from the 44 percent last year, spokeswoman Gisela Hernandez said.

At county-owned Contra Costa Regional Medical Center in Martinez, the hospital has increased its vaccination rates from as low as 30 percent in 2004-05 to more than 50 percent last year, but it still has much further to go, said Dr. Bill Walker, the county health services director.

“The bottom line is we have another vigorous effort going this year,” he said. He noted that the hospital is making shots available on every floor and is setting up an online monitoring system.

“What we’re struggling with is whether voluntary will ever be enough,” Walker said. “At the end of the day, we’re not doing well enough, and neither are most hospitals in the state.”

FLU Shot rates
Below are the percentage of East Bay hospital employees who received flu shots during the 2010-11 season. These numbers do not include many physicians and others who sometimes work at the hospitals but are not on the payroll.
To see the full report, including statistics for doctors and other non-employees, go to http://www.cdph.ca.gov/Pages/NR11-059.aspx.

FACILITY  % VACCINATED
Alameda Hospital 63.2
Alta Bates Summit, Oakland and Berkeley 54.2
Children’s Hospital Oakland 75.9
Contra Costa Regional Medical Center, Martinez 50.6
Doctors Medical Center, San Pablo 44.0
Eden Medical Center, Castro Valley 53.1
Highland Hospital, Oakland 58.1
John Muir Medical Center, Concord 70.8
John Muir Medical Center, Walnut Creek 72.1
Kaiser Permanente, Antioch 63.0
Kaiser Permanente, Fremont 74.1
Kaiser Permanente, Hayward 72.8
Kaiser Permanente, Oakland 61.8
Kaiser Permanente, Richmond 65.5
Kaiser Permanente, Walnut Creek 66.5
San Ramon Regional Medical Center 85.7
St. Rose Hospital, Hayward 82.8
Sutter Delta Medical Center, Antioch 67.4
ValleyCare Medical Center, Pleasanton 74.7
Washington Hospital, Fremont 73.9
Source: California Department of Public Health

FLU SHOT RATES
Below are the percentage of South Bay hospital employees who received flu shots during the 2010-11 season. These numbers do not include many physicians and others who sometimes work at the hospitals but are not on the payroll.
To see the full report, including statistics for doctors and other non-employees, go to http://www.cdph.ca.gov/Pages/NR11-059.aspx.

HOSPITAL % VACCINATED
El Camino, Mountain View————————69.5
Good Samaritan, San Jose————————–91.3
Kaiser, Redwood City——————————-71.2
Kaiser, San Jose————————————–74.3
Kaiser, Santa Clara———————————–72.5
Mills-Peninsula, Burlingame and San Mateo—–60.2
O’Connor, San Jose———————————-72.4
Regional Medical Center, San Jose—————-89.4
St. Louise, Gilroy————————————-52.6
San Mateo Medical Center————————–54.5
Santa Clara Valley, San Jose———————–60.7
Sequoia, Redwood City—————————–74.6
Seton, Daly City————————————–64.1
Seton Coastside, Moss Beach———————-78.4
Stanford, Palo Alto———————————–80.1

Source: California Department of Public Health