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Worksite Wellness through Immunization

Adult Immunizations

Immunizations aren't just for children and adolescents. The Advisory Committee on Immunization Practices (ACIP) and Center for Disease Control and Prevention (CDC) recommend:

  • Seasonal influenza (flu) (for all adults)
  • Tetanus, diphtheria and pertussis (whooping cough) (for all adults who have not previously received the Tdap vaccine)
  • Shingles (for adults 60 years and older)
  • Pneumococcal disease (for adults 65 years and older and adults with specific health conditions)
  • Hepatitis B infection (for adults who have diabetes or are at risk for hepatitis B)
  • Travel immunizations (visit to see what immunizations are recommended based on your destination)

Flu Vaccine for Worksite Wellness
The CDC recommends that everyone ages 6 months and older receive a flu vaccine each year. Annual seasonal flu vaccination with either the flu shot or the nasal-spray flu vaccine is the best way to reduce the chances that you will get the flu and lessen the chance that you will spread it to others. When more people get vaccinated against the flu, less flu illness can spread through the community.

What does the flu cost a company?
Catching the flu can lead to a great loss in productivity. In 2010, the flu accounted for:

  • 200 million days of diminished productivity
  • 100 million days of bed rest
  • 75 million days of work absences
  • 22 million visits to healthcare providers

The total economic burden of the flu in the United States is estimated at $87.1 billion dollars. The flu can also cost companies billions in lost productivity and direct medical costs. On average, vaccination against the flu can save $30 per vaccinated person.

How to build Workplace Wellness through Immunization
Immunizations are a proven public health intervention and can be implemented at your workplace on varying scales. The four steps of the workplace health model can guide program planning.

Step 1: Assessment

  • What are the risks, concerns, current programs, capacity and needs
  • What services are currently being used? Is there a need for an onsite immunization program?
  • Have employees received the flu vaccine the past season? If so, what percentage received it?

Step 2: Planning

  • What will the program address, what are the goals and how will they be met?
  • An example goal is to have a set percentage of employees be immunized
  • Gain support of management/leadership for the immunization program
  • Support from management/leadership helps cultivate a culture of worksite wellness and shows their interest in the employee’s health
  • What resources are available for an immunization program?  
  • Do you have staff that can administer vaccines?
  • Can an outside organization be contracted to provide immunizations on-site?
  • Develop a communication plan to ensure all employees are aware of the immunization program
  • Use multiple channels such as e-mail and flyers
  • Include follow-up communication for progress toward goal and encourage participation if the employee has not been vaccinated yet

Step 3: Implementation

  • Provide education about the program
  • Promote your vaccination program
  • Provide educational information
  • Myths about flu vaccine (PDF)
  • Offer incentives for participation in the immunization program
  • Raffle for gift card
  • Meal for office with highest participation

Step 4: Evaluation

  • Review of merit (quality), worth (effectiveness), and significance (importance) of activity
  • Survey employees for feedback
  • Track outcomes from program
  • Increase in percentage of employees immunized
  • Number of sick days used during flu season

Resources for Workplace Wellness through Immunization
Although healthcare personnel (HCP) have been the focus of immunizations at the workplace in studies, immunizations for caregivers is just as important. Eleven states have legislation supporting influenza immunization for HCP and numerous hospitals and healthcare facilities have policies for influenza immunization.

Sample Documents for Worksite Adult Immunization Policy
The following can be used to implement your own worksite immunization policy focusing on influenza. These documents can be modified for other vaccines, such as Tdap, or to meet your business needs.

Additional Resources
Case Studies and Support Documents for Worksite Immunization Programs

Why Immunize?

Vaccination has been proven as an effective way to prevent illnesses such as influenza(flu), whooping cough (pertussis), and pneumonia. By increasing the number of immunized people, others are also protected by “herd immunity.”
Among vaccine-preventable diseases in adults, influenza has the greatest impact in the U.S. population.

  • An average of 36,000 deaths and over 200,000 hospitalizations associated with influenza occur each year in the United States1-2
  • The combination of influenza and pneumonia was the eighth leading cause of death among all persons in the United States in 2005, accounting for 63,000 deaths3 
  • The overall national economic burden of influenza-attributable illness for adults, age 18 years and above is $83.3 billion. Direct medical costs for influenza in adults totaled $8.7 billion including $4.5 billion for adult hospitalizations resulting from influenza-attributable illness4
  • Influenza is also responsible for substantial indirect costs ($6.2 billion annually), mainly from lost productivity. Each year, among adults age 18 to 64 years, 17 million workdays are lost to influenza-related illness5 (

Exposure to Disease Onset

With the varying times from exposure to disease onset, the best way to prevent getting sick is to get vaccinated.


Incubation Period


Seasonal Flu

1 - 4 days

24 hours before symptom onset to 3-7 days after


7 – 10 days (range of 5 – 21 days)

1 -3 weeks

Chicken Pox (varicella)

10 -21 days

1 – 2 days prior to rash onset


Varies, can be as short as 1-3 days

Unknown, can be under 24 hours after starting effective antimicrobial treatment

Vaccination not only protects you, it protects those around you. While the Code of Virginia requires immunizations for all children enrolled in school and daycare, they are not fully protected from disease until they receive all doses in the series. Until they can get all of the required doses, immunizing people around them (caregivers, parents, and grandparents) is the best option.

Resources for Exposure to Disease Onset

Article: Association Between Undervaccination With Diphtheria, Tetanus Toxoids, and Acellular Pertussis (DTaP) Vaccine and Risk of Pertussis Infection in Children 3 to 36 Months of Age Through a matched case-control study of patients age 3 to 36 months, it was found that under-vaccination with diphtheria, tetanus toxoids, and acellular pertussis (DTaP) vaccine increases the risk of pertussis. As children age 3 to 36 months cannot be fully vaccinated, it is important to immunize those around them such as parents, grandparents, and caregivers.

Blog: A Voice for Vaccines

Real-life example for how vaccination protected a family.

While attending the preschool class party, Karen Ernst’s son played with a classmate who was, unbeknownst to Karen, contagious with chicken pox. Following the party, the infected child fell ill as they were not vaccinated but Karen was glad she had her family vaccinated against the disease. Vaccination not only protected her son in school, it protected her newborn son whom was too young to be vaccinated. Had her newborn contracted chicken pox, the results could have been fatal.

Last Updated: 02-27-2014

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