Opinion: It’s time to take the gloves off during vaccination

Last October, as we stood in line for our annual flu shots at our respective health systems, we watched as technicians dutifully sanitized their hands, pulled on standard nitrile medical gloves, gave the shot, and immediately threw the gloves away.

It’s a scene repeated millions of times each fall, and it is driving an environmental crisis as well as unnecessary spending. As experts in infection prevention and clinical sustainability, we think there are several changes that can be made to reduce waste while keeping patients safe. Chief among them: In most cases, it is unnecessary to use gloves to administer a flu shot.

Though physicians and medical professionals pledge to “do no harm,” the health care system makes this pledge difficult when it comes to the environment and public health. In the United States, the health care industry is responsible for 8.5% of the greenhouse gas emissions and 9% of air pollutants. Climate change is the largest threat to public health in the 21st century, contributing to record temperatures, devastating hurricanes, droughts, floods, and wildfires — all of which we’ve seen this past summer. The day-to-day practices, procedures, and policies in U.S. medical care shape this footprint. Seemingly small changes could help reduce health care’s role in climate change. Many medical facilities have adopted mandatory flu vaccinations for all employees, per the Centers for Disease Control and Prevention’s recommendations.

In the medical facility flu clinic one of us attended in fall 2025, the technicians sanitized their hands with an antiseptic gel, put on standard nitrile medical gloves, removed the cap from the syringe, administered the vaccine, dropped the syringe in a plastic “sharps” box, and applied a cotton swab and bandage to each patient. Finally, they removed and disposed of the gloves to complete the patient’s paperwork. This is the process for vaccine administration in many places.

Assume a medical facility has 30,000 employees and requires everyone to be vaccinated. If they follow the process described above, the facility will use 60,000 gloves this year to administer the flu vaccine. Assuming each pair weighs 6 grams, that adds up to nearly 90kg of gloves. Every single glove must be manufactured, transported, and disposed (either landfilled or incinerated). Each step in this glove’s “life cycle” produces waste and pollutants, such as greenhouse gases, not to mention that global glove manufacturing has had long-standing issues with forced labor and other labor violations.

If they go to an incinerator after use, one pair of non-sterile gloves is estimated to release between 26g and 68g of carbon dioxide equivalents. For this facility, this unnecessary glove use emits 780kg-2040kg of greenhouse gases into our atmosphere. That equals emissions from a standard passenger vehicle driving between 2,000 and 5,200 miles — roughly the one-way distance between Seattle and Miami.

If all 18 million health care workers in the U.S. similarly receive a flu vaccine this year, that equals 36 million gloves, 108 metric tons of garbage, and between 468 and 1,220 metric tons of greenhouse gases. That’s like putting an additional 110 to 285 passenger vehicles on the road this year. This does not include other emissions or costs of administering the vaccine — the structure that physically houses the flu clinic, the electricity for the lights, the table and syringes, or the transportation to get everyone there. It’s just the gloves.

In addition, there is a significant cost to the glove use. Glove cost has risen to $29 per 1,000 with precursor materials in short supply.

And in many cases, gloves for vaccine administration simply are not necessary. Although hands must be disinfected or washed before preparing the vaccine and between patient contact, the Occupational Safety and Health Administration does not recommend wearing gloves for administering vaccines unless the person has open lesions on their hands or is likely to come in contact with the patient’s bodily fluids.

Infectious disease groups in the U.S. are now supporting wise use of gloves across all health care activities that maintain safety while balancing the negative environmental impacts of our resource use. Glove use is discouraged when staff are providing “dry” care — for example, when contacting intact skin; handling bed rails, IV poles, unsoiled patient belongings; charting; or delivering or collecting food trays. Initiatives like the Gloves Off! Campaign, originally started in the U.K., prove that changing these policies is entirely feasible.

The excessive use of gloves for administering the flu vaccine is not, of course, the only form of waste in health care. There are inappropriate procedures and tests, inefficient scheduling, and unused or wasted supplies, to name a few. We support sustainability efforts in our home health systems. All of this waste adds up. It can feel overwhelming to try to change this large, bureaucratic system, and starting small is better than not starting at all.

This year, everyone going in for their flu vaccine, or stepping into their clinic, office, or operating room, should give some thought to the process in front of them. Start to ask questions. Why are we practicing this way? Is there a better, more efficient way? What can we do to eliminate needless waste? Health system administrators or chief sustainability officers should explicitly demand in your third-party vaccination contracts for the fall that “no gloves are required unless clinically indicated.”

Whether a hospital contracts with a third party to vaccinate employees, or they do it in-house, now is the time to assess PPE policies to be sure they align with best practices. Every health system should likewise assess other policies that might create excessive or unnecessary glove use. The road to a more sustainable health care system starts one step at a time.

Cassandra Thiel, Ph.D., is an assistant professor of population health at NYU Langone Health and the president and CEO of Clinically Sustainable Consulting, where she tackles data and strategies for environmental sustainability in health care. Preeti Jaggi, M.D., is a professor of pediatrics at Emory University School of Medicine, director of antimicrobial stewardship at Children’s Healthcare of Atlanta, and co-founder of the Sustainabil-ID initiative, a global community of health care professionals driving sustainable practices in infection prevention and antimicrobial stewardship.