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PHILADELPHIA -- CIGNA Corp. is expanding its voluntary fall flu shot program to all 37,000 employees nationwide, after previous experience demonstrated its effectiveness.

The program has helped the company be more productive because employees who have been vaccinated are less likely to get the flu and to need time off work to recuperate from the respiratory infection, according to Vicky Dickson, director of the insurance company's Working Well Department, which provides health services to employees.

In addition, the employer "found that people experience fewer colds and flu-like symptoms," according to Ms. Dickson, a nurse practitioner.

Influenza symptoms include chill and fever higher than 103 degrees Fahrenheit, muscle aches, weakness and fatigue, headache and eye pain, a dry cough and a sore throat.

For the past four flu seasons, CIGNA's clinical staff has administered flu shots to employees at CIGNA's main offices in four cities and studied a variety of measures to determine their effectiveness, according to a report from Philadelphia-based CIGNA.

During the 1995-1996 flu season, nearly 3,000 employees were vaccinated. Only 10% of those employees reported having flu-like symptoms, compared with 30% the year before among unvaccinated employees.

The company also saw a significant decrease in lost time due to colds and flu during that period: Employees who received the flu shots reported losing an average of 0.7 days, compared to 2.1 days the preceding year when they did not receive vaccinations.

During the 1996-1997 flu season, the program was expanded to include 3,176 employees at the four main locations and about 10 field offices.

While overall results were mixed, the Nashville, Tenn., office had a 90% drop in lost time to 0.22 days in 1996-97 from 2.15 days the season before. Physician office visits were reduced by 92% at that location.

In addition, emergency room visits for flu-type symptoms at all locations dropped to 0.32% in 1996-97 for employees receiving flu shots, compared with 5.54% the previous season, according to CIGNA's statistics.

"If our employees aren't getting sick, CIGNA certainly benefits from increased productivity," Ms. Dickson said.

In addition, "the benefits of providing flu shots far outweigh the costs," she said.

A shot at locations where CIGNA health staff can provide them costs CIGNA less than $2 each. The shot is free to employees at those locations.

A shot at other office locations may cost an employee as much as $6 to $8 because CIGNA contracts with other companies to provide them, but that is still less than what most individual doctors charge, Ms. Dickson said.

As of last week, 6,049 CIGNA employees in 12 states had received flu shots this year, which is a 91% increase over the 3,176 who received them last year. However, the final tally may be larger because the shots will be available through Dec. 15, she said.