WASHINGTON (Reuters) - Hospitals and nursing homes should offer free flu vaccines to all their workers and make employees sign a form if they refuse to be immunized, the U.S. Centers for Disease Control and Prevention said on Thursday.
As part of a drive to vaccinate more healthcare workers the CDC also said in a statement that shots should be made available to employees day and night.
Influenza kills 36,000 people in an average year in the United States and puts 200,000 into the hospital.
Ensuring health care workers, including doctors, nurses, technicians, clerks and cafeteria workers, are vaccinated has taken on greater importance with the spread of H5N1 avian influenza and its potential to create a pandemic.
"When people who work in hospitals and healthcare facilities don't get vaccinated, they can pose a serious health risk to their patients," said CDC Director Dr. Julie Gerberding.
Surveys show that only between 36 percent and 38 percent of health care workers get an annual flu shot, even though they have a higher-than-average risk of being infected and can pass the virus on to vulnerable patients.
One recent study found that 23 percent of health care workers had antibodies to influenza in their blood after a mild flu season but 59 percent of these could not recall having had flu and 28 percent did not remember having been ill at all.
When asked, health care workers give the same reasons as most people for not getting flu shots - a lack of time, the belief that they will not get flu, fear of needles, and a belief that the shot carries risks.
The CDC, which does not have enforcement or regulatory powers, has long recommended that health care employees get the shots but experts now agree that hospitals will have to be prodded into action.
The American Medical Association, which represents about a third of U.S. doctors, applauded the recommendations. "The AMA encourages physicians and nurses to lead by example and get the flu vaccine," the group said in a statement.