Fight the Flu with Onsite Vaccinations

By Roy Maurer Oct 15, 2013

Employers are undoubtedly dusting off their flu-prevention and vaccination policies in an effort to best protect their employees now that the dreaded flu season has begun.

The influenza season, which can begin as early as October and last until May, costs businesses approximately $10.4 billion in direct costs for hospitalizations and outpatient visits each year, according to the Centers for Disease Control and Prevention (CDC).

The CDC reports that, on average, 5 percent to 20 percent of U.S. residents get the flu each year and more than 200,000 are hospitalized.

And that’s not the worst of it.

“Every year thousands of people die from the flu,” said Dr. Derek van Amerongen, chief wellness officer at HumanaVitality, a Chicago-based wellness program sponsored by health insurance company Humana.

From 1976 to 2006 estimates of flu-related annual deaths ranged from a low of about 3,000 to a high of about 49,000, according to the CDC.

“Flu is predictably unpredictable,” Dr. Howard Koh, assistant secretary for health at the U.S. Health and Human Services Department, said during a recent news conference. “When it comes to flu, we can’t look to the past to predict the future.”

The CDC recommends that everyone 6 months of age and older receive a flu vaccination.

A flu shot is especially important for people with medical conditions such as heart disease, asthma or diabetes, Koh said, adding that vaccinating pregnant women and health care professionals should be the first priority.

“The best time to get the flu shot is right now,” said van Amerongen. It takes about two weeks after being vaccinated for the immunity to build up.

The flu’s impact on the workplace can be dramatic. Every year millions of people take time off to care for themselves or sick family members, or show up at work and are unproductive.

Health and safety officials advise employers to use this time to prepare flu-prevention programs to protect workers and reduce the transmission of the seasonal flu virus. According to the Occupational Safety and Health Administration (OSHA), companies should:

  • Promote vaccination.
  • Encourage sick workers to stay home.
  • Promote hand hygiene and cough etiquette.
  • Keep the workplace clean.

Debunking Flu-Vaccination Myths

Medical professionals say misperceptions about the flu vaccine keep people from getting flu shots.

A couple of frequent reasons given for not getting vaccinated:

“I’ve never had a shot and never got the flu; so why should I get one now?”

Van Amerongen warns that those people “have just been lucky. And sooner or later that luck is going to run out.” He explained that because the flu virus differs from year to year, everyone needs a new vaccination annually.

“I got a flu shot, and then a few days later, I got the flu.”

Van Amerongen really wants to put this argument to rest. “Flu shots do not give people the flu. They do not have a live virus. It’s impossible for someone to get the flu from the flu shot.”

The flu shot is not perfect, however. “It does not prevent flu 100 percent of the time,” he said. “But studies have shown that if you get the shot and then come down with influenza, that flu will be much milder than if you hadn’t gotten the shot.”

Setting Up an Onsite Flu-Vaccination Clinic

To minimize absenteeism, employers can offer workers onsite seasonal flu vaccination at no cost or for a low fee. This option may work well if the business has an onsite occupational health clinic, or health care providers can connect employers with pharmacies and community vaccinators to provide onsite flu shots. Flu-vaccination clinics are becoming increasingly common in U.S. workplaces.

That was not the case about 10 years ago, said van Amerongen. “It’s a great way to demonstrate to your workforce that you care about and value them and that you’re willing to invest resources and time to make sure that everyone is protected from something that is preventable.”

If you choose to host a flu-vaccination clinic, the CDC recommends the following:

  • Getting senior management buy-in.
  • Designating a flu-vaccination coordinator and/or team with defined roles and responsibilities.
  • Scheduling the clinic hours to maximize employee participation.
  • Measuring employee demand for flu vaccination.
  • Asking managers and supervisors to allow employees to visit the onsite clinic as part of their workday, without having to go off the clock.
  • Considering offering flu shots to workers’ families. “This has been a really positive trend,” van Amerongen observed. “If you can get everyone on the employee’s health plan vaccinated, that can have such a positive impact on the workforce.”
  • Giving workers incentives to get the flu vaccine, such as offering the shot at no or low cost, providing refreshments at the clinic or holding a contest for the department with the highest percentage of vaccinated employees.
  • Promoting the clinic.
  • Providing a comfortable and convenient location for flu-vaccination clinics, keeping in mind the demands of space and the need for privacy.
  • Setting an example by encouraging managers and leadership to get vaccinated first.

Mandatory Vaccination Policies

Some employers, generally hospitals and health care facilities, have implemented policies making flu shots mandatory, which can be controversial.

If an organization intends to create such a policy, it should first consider all the legal implications, said Jeanine Conley, a partner in the New York office of law firm BakerHostetler.

Employers should be prepared to work with individuals who object to receiving a mandatory flu shot for medical or religious reasons, she cautioned. “For example, an employer could be held liable if it forces an employee who claims she is allergic to the vaccination to take it or face termination and that employee later becomes ill.”

Additionally, anti-discrimination laws, such as Title VII of the Civil Rights Act of 1964 and the Americans with Disabilities Act, may prohibit the enforcement of a mandatory-vaccination policy. A collective bargaining agreement between an employer and a union may also prevent an organization from unilaterally instituting this type of policy.

Sick-Leave Policies

Avoid compounding the flu with a case of presenteeism, or showing up at work but being unproductive because of illness. To help keep the flu away from the workplace, employers should re-examine their leave policies to ensure that people can take off when they are sick, the CDC said.

The Health and Human Services Department recommends that workers who have a fever and respiratory symptoms stay home for 24 hours after their fever ends without the use of medication.

“First and foremost, stay home,” said van Amerongen. People really need to make sure they are better before coming back to work. Returning to the office on day 2 is not acceptable, as the flu typically runs its course between five and seven days, he said.

OSHA advises HR professionals to develop flexible leave policies that encourage workers to stay home—without penalty—if they are sick. HR should also communicate other related policies to staff, including administrative leave transfer between employees, the pay policy for sick leave, child care options and what to do when ill during travel.

Keep the Workplace Clean and Germ-Free

According to the CDC, up to 80 percent of flu cases are spread by touching contaminated surfaces and by direct human contact. Employers, therefore, should post signs outlining the steps for proper hand hygiene and cough etiquette, OSHA advises.

Employees should be instructed to cover their nose and mouth with a tissue when coughing or sneezing, to help keep germs from spreading. Used tissues should go into a wastebasket.

Hands should be washed often and scrubbed with soap and water for 20 seconds.

Employees should avoid shaking hands, or coming in close contact, with co-workers and others who may have a cold or the flu.

As cold and flu season ramps up, common breeding grounds for germs—such as telephones, elevator buttons, water fountains, computer keyboards, and bathroom faucets and door handles—show how easy it is to come in contact with viruses that cause influenza. Cleaning frequently touched surfaces is one way to cut down on the number of cold and flu germs that are passed from one co-worker to another, as is supplying employees with disinfectants and disposable towels to use in their work spaces.

Once you get sick, there’s not a lot you can do, even in the 21st century, said van Amerongen.

Other than staying home and resting, individuals with the flu should stay hydrated.

Roy Maurer is an online editor/manager for SHRM.

Follow him on Twitter @SHRMRoy.

Related Article:

Managing Through Flu and Other Epidemics in the Workplace, SHRM Online Templates & Samples, March 2013

Related Article:

The Economic Effect of Influenza on Businesses, SHRM Online Safety & Security, December 2012

Related Resources:

The Society for Human Resource Management Flu Resources Page

The CDC’s Seasonal Flu Information for Businesses and Employees

Business Planning Resource Page from

OSHA’s Guidance on Preparing Workplaces for an Influenza Pandemic

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