Perioperative Influenza Vaccination: opportunities and strategies to meet the global call to action

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Influenza vaccination is a proven strategy vital to the promotion of population health. Global, national, and local healthcare organizations advise broad administration of seasonal influenza vaccination to occur at every opportunity. Despite established benefits of influenza vaccination and the global call to increase vaccination rate, multiple barriers beyond vaccine hesitancy have produced a gap between goal and actual influenza vaccine coverage. Proposed solutions to address these issues include developing context specific strategies that integrate with other healthcare services to target sub-populations of patients. One such strategy is influenza vaccination during the perioperative period, which is the continuum of care during the preoperative, intraoperative, and postoperative phases of care. Historical approaches to perioperative vaccination have been two- fold. The first being a conservative approach, prioritizing the need to ‘first do no harm’, that avoids potential risks of misinterpretation of vaccine related adverse events as perioperative complications and immunomodulation impacting efficacy of immunization. The second being a liberal approach, prioritizing the global call to use every opportunity to vaccinate with individual and population health benefits of vaccination outweighing any low and theoretical risks posed by conservative concerns. Modern strategies balance these concerns and target context specific opportunities to apply perioperative influenza vaccination through evidence-based approaches in the preoperative and intraoperative phases of care. Additionally, opportunity to administer flu vaccine in the postoperative phase are also discussed. Global perioperative healthcare providers are called to action and encouraged to utilize and build upon these strategies to meet the global need of increasing influenza vaccination. The patients we serve deserve our advancements in protecting them.