Update: Flu Shots - The Healthy Choice, by Leanna Loy RN

On August 23, 2012, the B.C. Government introduced new influenza measures designed to protect patients and seniors from being exposed to influenza.  ARNBC has been discussing the importance of nurses getting flu shots for quite some time, and was pleased to publish a blogpost on the topic written by Board Member Leanna Loy (October 24, 2011).

In light of the changes initiated by government, we are pleased to re-post “Flu Shots – The Healthy Choice” to provide some context around the current discussion.  We encourage all nurses to reflect on this important issue and share your thoughts about the new policy in the comments section below.

The provincial news release and backgrounder can be found on the Ministry of Health website (Click to View)

 ARNBC’s Statement on B.C.’s new Influenza Protection Policy (Click to View)


By Leanna Loy (Originally posted on October 24, 2011)

Recent statistics from BC’s Provincial Health Officer tell us that less than half of the health workers in this province got their flu  shot last year.  Read the CBC News article here.

This should be of concern to all of us.  We know that many nurses have thoughtfully  considered the reasons why they do or do not want to receive a flu shot.  Still, it’s important to remember that the personal choices nurses make about flu shots also has the potential to significantly affect the health and lives of those we care for.

The BCNU encourages all of its members to get a flu shot in order to reduce their risk of developing serious illness (Click to View).  The College of Registered Nurses of BC, whose primary mandate is to ensure public safety, also recommends nurses receive a yearly flu shot and has published the Practice Standard Communicable Diseases: Preventing Nurse-to-Client Transmission (Click to View).

Evidence tells us that flu shot rates are like every other immunization – when higher proportions of the population are immunized it has a protective effect on everyone else, immunized or not.  Therefore, each of us is directly impacted by the decisions the people around us make regarding this personal choice.  We hope that nurses will weigh all of the options as they make important decisions around receiving a flu shot considering both public health issues and personal preference. As guardians of privileged, professional knowledge, we hope all nurses will recognize the importance of making personal choices that are consistent with the wider message we want the public to understand.

While we all acknowledge occasional individual exceptions, these should not be permitted to confuse the wider public message of health for all, and all for health. All three nursing bodies in BC agree that the best course is evidence-based encouragement for optimal immunization rates across all of our province’s diverse communities and contexts.

Let’s work together to role model the kind of social accountability for which our profession stands.  ARNBC calls on BC nurses to be proud champions for flu shots and to do everything they can to ensure immunization rates are as high as possible.  We can do this by encouraging healthcare workers and patients alike to receive a flu shot, by interpreting evidence if need be, and by supporting the systems that make it easier for people to get their shots.

For further information on flu shots, see www.gov.bc.ca/FluBC.  Flu shot access is easier than ever this year. Click on the clinic locations to access a complete list of settings and times. Did you know that flu shots are now readily available in your local pharmacies and even supermarkets?


Leanna Loy is a Community Health Nurse, Adult & Older Adult Services, with the South Community Health Centre in Vancouver.

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Tiffany Nurse from Vancouver Island

Thanks for this post Leanna! It's an important reminder to all nurses to get our flu shots. It's our job to protect and care for our patients. An equally important component is ensuring we are protected too.

Anonymous, Northern Health

As a culture we’re too heavily focused on immunizations. Yes, many are necessary but not all. Normal, healthy adults should be able to either fight the flu off and if unable to do so will not suffer long term serious consequences as a result of having the flu. Is it really necessary to suggest we’re being remiss if we don’t get a flu shot? Is this really a matter of public health? What about our personal choices, not only nurses but as individuals?

Leanna Loy

Thanks for your comment.

In my opinion, I do think flu vaccination is a matter of public health because I’m thinking about the entire population; the healthy, sick, elderly, children, etc. I’m also thinking about the “herd effect” where the greater proportion of individuals who are resistant, the smaller the probability that a susceptible individual will come into contact with an infectious individual. Therefore, if I as an individual get the flu shot, I am protecting myself by preventing the flu, and at the same time I’m not infecting other people in the population.

I agree that ultimately as individuals, we do have our own personal choices. However, it’s important to recognize that our own personal choices can and do impact other peoples’ health.


Hi Leanna,

I agree...this is a matter of public health. People tend to fear things that they don't understand. That is why we as nurses should educate ourselves and in turn educate others.
Because I work in chronic disease management I am always talking to people about the flu shot, (as well as tetanus, diphtheria, and pneumococcal vaccines), and I find that people's ideas of immunization are all over the map. One of the things I do to overcome this is to hold education sessions in part about the flu shots. So group by group my community is understanding that:
- it isn't a live vaccine and you can't get the flu from it.
-it doesn't harm your immune system, it enhances it in the same way it would if you caught the virus.
-you cannot pass the flu to others if you have been vaccinated, but you can pass it if you haven't - even if you don't feel ill.
-herd immunity protects those who cannot take it.

I read a report somewhere that herd immunity is what stopped the H1N1 virus from becoming the deadly pandemic that it could have been.



Hi Leanna,
Great blog. I am glad to see the conversation starting on this important topic. Education for both nurses and the individuals we serve is an important piece of this discussion. I spent some time today looking at the immunization competencies and clinical decision support tools outlined by the BCCDC. There are many resources on their website.

I look forward to hearing others comments.



I am also enjoying this important conversation as it is an area I personally remain conflicted about. I want to add another resource to Julie's. This series of reviews conducted by the Cochrane Collaboration summarizes the evidence for mass and targeted flu immunization strategies - which is not as strong as most of us would like to think. Having this knowledge can help nurses develop a balanced perspective about people who choose not to have flu shots.


Cecilia Roshia

Wonderful!!! Bookmarked this page. Will come back to see if there are any updates. I discovered your blog last week. It's really exciting to actually contribute to an article even if it's only in the comments of a blog. I really don't know exactly what to write other than I really enjoyed reading through these articles. I will keep visiting your blog. Thx!


Very good article.

Gertrude S

This is a really fantastic post. Appreciate your your provided information, especially the links to the clinics. I find though, that a lot of my nurse colleagues don't get flu shots because they don't believe there is evidence to prove that the right strains of flu are the ones that they come out with the shots for. So people feel like if they do it, it's another needle, but probably won't stop them from getting flu. On the other hand, they're more willing when it's something serious like H1N1. Even though that was too much. Do you think with something like H1N1 we might 'cry wolf' too quickly and terrify people for no reason? I don't know what the solution is, but we aren't doing this right I think. I don't think the government saying that we HAVE TO have flu shots is not the best approach. It's my right to choose. It's our responsibility to educate ourselves so that we choose what is right. I think most nurses want to do what's right for the population, or we wouldn't be nurses in the first place.

Rina D.

I really like the layout of your site. I appreciate the quality of the information. You have done a excellent job. Thank you very much


Thanks for this article and great website. I agree with the authors comments that the flu vaccine is important - especially for health care providers and those more vulnerable to infections. Sadly there seems to be much more apathy regarding the flu campaign this year (which is likely what set the PHO off in expressing his desire that the vaccine be mandatory). As many have already stated - it is a personal choice - but please make it an educated one!



This new policy is very smart.

As a health professional, our responsibility is to do the best we can for patients. If the evidence says that the best thing to do is get a shot or wear a mask, it would be disrespectful to my patients to not consider and adapt my own personal thinking to what has proven to be right and good. I don't ever want to be responsible for an elderly person's death if I could have prevented it with a few minutes of discomfort or by wearing a mask.


Does anyone know how or if this will be applied to the dental profession? Or is this just hospitals? What about community health nurses or people doing home visits?

If it's just a hospital policy, isn't that kind of like brushing only one tooth?

P. Goman

I have never had a flu shot. I don't think they help. And I've read that they can be dangerous.

But I will wear a maask without complaint. Because I might be wrong. And I would rather be wrong and look stupid than be wrong and get someone sick.

Maybe the mask will not only keep me from making someone sick. Maybe it will keep me from getting sick. The germs can't come in any better than they can go out right?


My personal belief is the shot is important to get, for both patient and my own safety and health. That said, what pisses me off is being told what to do. I am a professional. A smart person capable of making good choices both at work and in private. Nurses are professional people who are committed to ensuring our patients are well taken care of and safe. Those same nurses stay home when they're sick and follow proper procedure for infection control. Why should they be forced to have a shot if that's against their belief. This is another example of this government missing the point and bullying to get their way.


To me getting a flu shot is a good idea. I have no problem with this at all. It's a simple shot and getting it can only help us keep our patients safe.

Ellery Macneil

I just found your website thanks to a tweet from a friend. What a great blog! So well done.

This flu shot thing is a a no brainer to me too. As nurses we should be getting shots each year for our own sanity and good health (and for patients health too).

Why would I want to feel all sick and scratchy and flemmy if I can have a simple shot instead?

Joanne M.

Thanks for posting information around this newest policy and for Leanna's insightful follow up post. I think this is one topic that we as nurses need to generate lots of discussion around and I hope to see more factual information posted that will help inform those who don't already choose to have a flu vaccine. Nurses are creative problem solvers and I think that such a forum can help to identify some ideas and strategies for how to support nurses to support this policy.

John Morris

I understand why government and the health authorities would move in this direction, but I wonder if they know why some of us choose to not have flu shots? I also think they haven't really exhausted ways to get people to do it that are still voluntary. It seems we have gone from "do what you want" to "do it our way" without a chance to explore some other way s to get health providers to change their mind about not geting shots.

I myself chose to not get flu shots, for personal reasons that I think are very valid. I don't go to work sick. If I had been around sickness or was coming down with something I'd either stay home or wear a mask, becuase I do feel responsibility for patients and for other people around me like my own family. If someone had come to talk to me, laid out the facts about why it would be better to get a shot, I feel it would be my professional responsibility to at least consdier what they have to say.

So it feels like a step was missed, the one where people actually make the effort to not just stick up signs in bathrooms, but to educate, to inform and to provide evidence and education to change my mind. I hope there is room for further discussion.

Helen Vandenberg

That is great that you do not go to work when you are sick, but did you know that you can still spread the flu without any symptoms? From the CDC website:

" Most healthy adults may be able to infect others beginning 1 day before symptoms develop and up to 5 to 7 days after becoming sick. Children may pass the virus for longer than 7 days. Symptoms start 1 to 4 days after the virus enters the body. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick. Some persons can be infected with the flu virus but have no symptoms. During this time, those persons may still spread the virus to others."

See here:



I would like to understand better how the masks will work. Do we have to put one on upon entering the hospital and not take it off until we leave? That is a lot of mask wearing. Yes, nurses wear masks in surgery and other areas, but they are not forced to wear them for the duration of a shift. Are there exceptions? Can I remove my mask in the cafeteria for instance, even though there are patients around? Can I take it off if I am trying to talk to a patient about something personal or emotional? Do I have to wear it if I'm giving a presentation or meeting with my manager?

Alphabet Soup

I think it's important that everyone have the right to make their own choices. But as someone who is around illness all the time, I also appreciate when my colleagues and my patients make their best effort to keep me from getting sick. I owe them the same.

Deanna Lloyd

I'm not a government basher usually, but I find it kind of strange that the first time any of us who actually work in healthcare heard of this was through a big media storm. And there's been no other information, which is frustrating. I guess we are supposed to now learn how to do our job from the media? Government needs to roll these things out more respectfully.

But I am in favour of the policy mostly.

Bernie Garrett

Given the current state of evidence this immunization policy makes perfect sense, for both the well being of nurses and our clients. There is an awful lot of nonsense and misinformation based on either bad science or pseudo-science about immunizations, and as nurses we should support good science and evidence based practice here.



FINALLY! I've been looking everywhere to see if there's any sort of intelligent discussion happening on this topic. Don't bother looking at the comments on CBC or any of the other news sources - horrible and ignorant.

I wonder if the Association could work with government to develop some sort of bibliography that has all the most recent evidence and articles about this important topic? I would love to have that sort of information available to support the discussion.


It's great to see so many nurses willing to adhere to evidence based practices and deciding to get their vaccinations. It demonstrates a real professionalism which bases our decisions on research rather than pseudo-science, Dr. Google, media reports or celebrity "experts".

Our next step as nurses is to continue to educate our colleagues - especially the non-health care professional colleagues who often really trust our opinions on health matters. It is through our voice that good health care is maintained. Spread the word! 🙂


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