[INFLUENZA VACCINATION AMONG HEALTHCARE WORKERS - THE DATA AND THE DUTY]

Seasonal influenza is a significant disease affecting public health due to substantial morbidity and mortality and a high economic burden. in view of its high propensity for genetic mutations, the virus can easily evade preexisting immunity acquired from prior exposure to it, thereby causing severe seasonal epidemics. Influenza vaccination has been shown to be safe and effective. In many countries, including Israel, it is recommended to all members of the population aged 6 months and older, especially those with a higher risk of developing severe complications. Its adverse effects are mostly minimal, local and systemic. No evidence-based relationship between the vaccination and neurological syndromes was found. Infected health care workers (HCWs) may transmit influenza to patients, many of whom have serious underlying conditions that increase their risk of complications. Therefore, influenza vaccination among HCWs is recommended in the United States and in >40 other countries including Israel. In spite of that, the vaccination coverage rates remain low in Israel and in many countries. The reasons include low levels of awareness to the disease severity, to the safety and effectiveness of the vaccine and low levels of trust in authorities. The effectiveness and safety of the vaccine in preventing influenza among the recipients is well documented. High quality evidence on the effectiveness of the vaccine in preventing the disease among patients and family members of HCWs who receive the vaccine is limited. However, combining the existing evidence and the clear biological plausibility lead to the conclusion that the recommendation for vaccinating health care workers against influenza to protect patients is a well-based policy. This is the policy of the WHO, CDC and health authorities in most developed countries. The Ministry of Health in Israel will continue to promote programs to increase vaccine compliance rates among HCWs and to define the uptake of vaccination as a moral duty.