Patients are regularly advised by health care professionals to get timely flu shots, but how often do health workers follow what they advocate? A Saint Louis University study reveals that more than 25 percent of St. Louis area Emergency Medical Technicians (EMTs) do not get vaccinated against the flu.

Published in the American Journal of Infection Control, the study indicates that the seasonal influenza vaccine compliance for St. Louis EMTs still remains far below the 90 percent target outlined by the U.S. Department of Health and Human Services' Healthy People 2020 program.

"The Centers for Disease Control and Prevention (CDC) recommends that all health care personnel, including EMTs, receive the seasonal influenza vaccine every year," said Terri Rebmann, Ph.D., associate professor at the Institute for Biosecurity at SLU and co-investigator of the study. "There is a lot of evidence that indicates that vaccinating health care professionals protects workers and patients from influenza-related morbidity and mortality, and reduces sick leave."

The study, funded by the Saint Louis County Department of Health, gauged the seasonal and H1N1 influenza vaccine compliance and whether or not St. Louis EMTs planned to get vaccinated. It also measured the attitudes and beliefs of EMTs about the seasonal influenza vaccine. Sixty percent of EMTs who did not get vaccinated said they do not trust the public health authorities when they say the influenza vaccine is safe, and about a third said that flu vaccine has a lot of side effects and reported being afraid of them. More than half in this group also said they do not believe they can play a role in transmitting influenza to their patients if they are not vaccinated.

"It's a concern that so many EMTs who are educated in health care do not believe that the public health message regarding influenza vaccine safety and efficacy is reliable," said Kate Wright, Ed.D, MPH, associate professor of health management and policy and director of Heartland Centers at SLU, and co-investigator of this study.

Out of 265 St. Louis EMTs who were surveyed for this study, one-fourth said they do not believe that influenza is a serious disease that can cause death. This belief was higher among those who did not get vaccinated.

Influenza causes millions of cases of illness each year, and results in thousands of hospitalizations and deaths, investigators of the study say.

"Non-vaccinated health care personnel have been linked to influenza spread among their patients," Rebmann said. "The seasonal influenza vaccine is safe and effective, with very few side effects -- which are very mild in most individual. Annual vaccination is critical for all health care personnel, including EMTs, to prevent influenza spread in the community."

In order to increase the rate of flu vaccination among EMTs, Rebmann and Wright suggest that health care agencies should implement a mandatory vaccination policy and initiate an education campaign to communicate information about vaccine safety and effectiveness to ETMs.

This study stems from Rebmann and Wright's award-winning flu educational campaign No Flu for You, a collaboration between Saint Louis University School of Public Health and St. Louis County Department of Health. The campaign aims to increase vaccination rates among all groups of health care workers.

"Vaccination is critical," said Rebmann. "Getting vaccinated not only protects the worker, but also his or her patients and family members."