Flu and COVID-19 Shots Among U.S. Health Care Workers, 2024–25

Health care workers are exposed to influenza and COVID-19 at work. Vaccination protects them, cuts absenteeism, and for influenza may also protect patients by reducing their exposure. For the 2024–25 respiratory virus season, CDC's Advisory Committee on Immunization Practices recommended that all health care personnel get both a flu shot — as it does every year — and a COVID-19 vaccine.

The headline numbers

Flu coverage was about the same as the season before. COVID-19 coverage rose significantly.

The survey

CDC surveyed 2,650 health care workers online between March 26 and April 17, 2025, as it has every year since the 2010–11 season. Of 2,807 who started, 2,702 finished, and 52 were dropped because their workplace was not a health care setting.

• Who: clinicians — physicians, nurse practitioners, physician assistants, nurses, dentists, pharmacists, allied health staff, technicians, EMTs, paramedics and students — from Medscape's membership; assistants, aides and nonclinical staff (administrators, clerical workers, janitors, food service workers, housekeepers) from Dynata's general internet panels.
• Weighting: answers were weighted to the U.S. health care workforce by occupation, age, sex, race and ethnicity, work setting and region.
• Settings: hospital; ambulatory care; long-term care (LTC) — nursing homes, assisted living, other long-term care facilities and home health; and other clinical settings such as dental offices, pharmacies and emergency medical services.
• COVID-19 vaccine: counted if the person had received one since August 22, 2024, when the 2024–25 vaccine became available.

Influenza: stuck below where it was

Figure 1. Health care personnel who got a flu shot, by work setting, 2015–16 to 2024–25. CDC

From 2015–16 to 2019–20, flu coverage held steady, averaging 79.5% (range 78.4% to 80.6%). It fell to 75.7% in 2020–21, rose slightly to 80.6% in 2021–22, dropped the next season, and has been stable since; none of those changes was statistically significant. Compared with before the pandemic, the authors call coverage persistently low for the past three seasons.

Coverage was also significantly higher among Asian (89.2%) and "other" race (85.2%) workers, and among those with an associate or bachelor's degree (78.5%) or a master's, professional or doctoral degree (81.7%), than in their comparison groups. Long-term care stayed lowest, though it rose 5.3 percentage points on the season before.

COVID-19: up in every setting

Coverage rose by 9.7 to 13.0 percentage points depending on work setting, and was highest in long-term care (44.5%), the opposite of the flu pattern. A federal CMS rule requires certified nursing homes to offer COVID-19 vaccine to staff and residents and to educate them about its benefits and side effects, which may keep pushing coverage up there.

One likely reason for the rise: the 2024–25 vaccine arrived in August 2024, a month earlier than the previous season's, giving workers more time and more exposure to workplace campaigns. Delivering and promoting COVID-19 and flu vaccines together could lift both during the peak season.

What employers do matters most

Figure 2. Vaccination by employer policy and on-site vaccination, by work setting, 2024–25. CDC

• 38.7% of workers said their employer required a flu shot; only 14.1% said so for COVID-19.
• Flu requirements were least common in other clinical settings (17.1%) and long-term care (24.7%), against 35.8% in ambulatory care and 59.1% in hospitals. COVID-19 requirements were least common in ambulatory care (9.7%), against 15.5% in hospitals and 19.3% in long-term care.
• In every setting, a requirement pushed coverage to 92.4%–98.6% for flu and 79.9%–89.0% for COVID-19; with neither a requirement nor a recommendation it was 23.8%–49.0% and 16.0%–25.1%.

Offering the vaccines on site raised coverage even with no requirement — in line with The Guide to Community Preventive Services, which recommends actively promoting on-site vaccination for health care workers.

Recommendations

A multipronged approach could raise coverage and cut illness among workers and patients, especially in long-term care and during the respiratory virus season:

• educate workers about the benefits and the recommendations;
• employer requirements or recommendations;
• on-site vaccination, with flu and COVID-19 opportunities lined up together.

Limits

1. The sample was volunteers from two internet panels; weighting may not make it representative of all health care workers.
2. Self-selection could bias results if taking part is linked to vaccination.
3. Vaccination was self-reported, open to recall and social-desirability bias.
4. Statistical tests that assume random sampling were applied to a non-random sample, so differences should be read with caution.
5. Some subgroup estimates were based on too few people to meet CDC's reliability standards.

Sources

Based on Meghani M, Garacci Z, Razzaghi H, de Perio MA, Laney AS, Kriss JL, Black CL, "Influenza and COVID-19 Vaccination Coverage Among Health Care Personnel — United States, 2024–25 Respiratory Virus Season," MMWR Morbidity and Mortality Weekly Report volume 75, number 12, Centers for Disease Control and Prevention (as corrected); a work of the United States government in the public domain.