Douglas Noble on vaccinating doctors

douglas nobleAs I lay in Regents Park on Saturday 1 October showing my one year old daughter the falling autumnal leaves and conkers it hardly felt like winter was approaching. Not least because it was thirty degrees Celsius, and there was more ice cream on sale than climate change proponents could swallow. Yet, winter is on the way and unofficial reports suggest it may be as cold as last year. 

Winter brings with it another season of influenza and plans to vaccinate the masses are already underway. One group that has consistently snuck under the radar are doctors themselves. Mean vaccination rates for influenza amongst doctors was 37.2% in winter 2010/11. I don’t remember there being much of a fuss about this, but there might have been. It is, however, ironic. Those who ridicule the Wakefield sympathisers fail themselves to do the decent thing and reduce onward transmission to their patients. But, it’s not just about the cold data of benefit. Doctors set an important precedent when they swallow their own medicine with confidence. 

Last week a public health colleague, Oliver Mytton, wrote to me claiming this is a patient safety issue. It probably is. He claimed there are several reports of outbreaks of influenza in care settings, where healthcare worker transmission has been implicated. Cluster randomised studies back his claim showing that increasing vaccinated healthcare workers lowers mortality of patients, and their need to access health services. Mytton’s research (which is in press) analyses the attitudes of healthcare workers towards influenza vaccination. Sadly, for almost 40% of those who were not vaccinated – they either weren’t offered it or it wasn’t important to them. 

NHS Employers are running a campaign this year called “Flu Fighter” – quite a fun name, bringing the world of the superhero closer to the NHS. On a more serious note, it aims to make sure vaccination rates amongst frontline healthcare workers are higher than in previous years – presumably achievable given the dismal performance last year. 

I’m hoping this campaign might have some impact on doctors like my own. As I sat in front of her coughing my guts out a few weeks ago, I asked for advice about whether to cancel going to a meeting I was presenting at in Poland. She replied with deep professional commitment that she never takes time off work when ill: “because I’m a doctor, I just get through it and keep working.”  Brave on one hand, but could have disastrous consequences – I hope she gets her flu shot.

Douglas Noble has worked in surgery, emergency medicine, public health and for WHO. From 2006 to 2008 he was clinical adviser to the chief medical officer for England. You can follow him on twitter @douglasnobleMD