Mandatory Influenza Vaccination of Healthcare Workers: A 5-Year Study

2010 ◽  
Vol 31 (9) ◽  
pp. 881-888 ◽  
Author(s):  
Robert M. Rakita ◽  
Beverly A. Hagar ◽  
Patricia Crome ◽  
Joyce K. Lammert

Background.The rate of influenza vaccination among healthcare workers (HCWs) is low, despite a good rationale and strong recommendations for vaccination from many health organizations.Objective.To increase influenza vaccination rates by instituting the first mandatory influenza vaccination program for HCWs.Design and Setting.A 5-year study (from 2005 to 2010) at Virginia Mason Medical Center, a tertiary care, multispecialty medical center in Seattle, Washington, with approximately 5,000 employees.Methods.All HCWs of the medical center were required to receive influenza vaccination. HCWs who were granted an accommodation for medical or religious reasons were required to wear a mask at work during influenza season. The main outcome measure was rate of influenza vaccination among HCWs.Results.In the first year of the program, there were a total of 4,703 HCWs, of whom 4,588 (97.6%) were vaccinated, and influenza vaccination rates of more than 98% were sustained over the subsequent 4 years of our study. Less than 0.7% of HCWs were granted an accommodation for medical or religious reasons and were required to wear a mask at work during influenza season, and less than 0.2% of HCWs refused vaccination and left Virginia Mason Medical Center.Conclusion.A mandatory influenza vaccination program for HCWs is feasible, results in extremely high vaccination rates, and can be sustained over the course of several years.

2008 ◽  
Vol 29 (2) ◽  
pp. 99-106 ◽  
Author(s):  
Cori L. Ofstead ◽  
Sharon J. Tucker ◽  
Timothy J. Beebe ◽  
Gregory A. Poland

Objective.To evaluate the receipt of information and knowledge about influenza and vaccination, as well as influenza vaccination status and reasons for declining vaccination, among registered nurses.Design.Cross-sectional survey of registered nurses (RNs).Setting.A large tertiary medical center with a long-standing, multifaceted influenza vaccination program and relatively high vaccination rates among employees overall (76.5%).Participants.Randomly selected group of 990 RNs employed as inpatient staff nurses at the institution.Results.The survey was completed by 513 (51.8%) of 990 RNs. Most RNs (86.7%) had received an influenza vaccination in the past, and 331 (64.5%) intended to receive vaccination during the 2005-2006 influenza season. More than 90% of RNs acknowledged exposure to educational bulletins, and most had received information about influenza severity (383 [74.7%]), transmission (398 [77.6%]), vaccine safety (416 [81.1%]), and the time and location of free vaccination (460 [89.7%]). A majority (436 [85.0%]) felt they had received all the information they needed to make good decisions about vaccination. However, only 49 RNs (9.6%) gave correct answers to more than 85% of the knowledge questions on the survey. The reasons most frequently reported for declining vaccination were doubts about the risk of influenza and the need for vaccination, concerns about vaccine effectiveness and side effects, and dislike of injections.Conclusions.RNs exposed to a longstanding, multifaceted educational program had received information about influenza vaccination, but misconceptions were common and only 331 (64.5%) intended to receive vaccination. Strategies other than educational interventions are needed to increase influenza vaccination rates and thereby to ensure healthcare worker and patient safety.


2007 ◽  
Vol 28 (11) ◽  
pp. 1284-1289 ◽  
Author(s):  
William P. Goins ◽  
William Schaffner ◽  
Kathryn M. Edwards ◽  
Thomas R. Talbot

Objective.To determine knowledge and attitudes about pertussis and pertussis vaccination among healthcare workers (HCWs).Design.Self-administered, Web-based survey.Setting.Tertiary-care academic medical center.Participants.Medical center employees who participated in direct patient care were recruited to complete the survey through institutional e-mail.Results.Of 14,893 potentially eligible employees, 1,819 (12%) completed the survey. Most respondents (87%) did not plan to receive the pertussis vaccine. Intent to receive vaccination (which included recent history of vaccination) was associated with the following 4 factors: receipt of a physician recommendation for vaccination (odds ratio [OR], 9.01), awareness of Centers for Disease Control and Prevention recommendations for pertussis vaccination for HCWs (OR, 6.89), receipt of encouragement to be vaccinated from a coworker (OR, 4.72), the belief that HCWs may spread pertussis to patients and family (OR, 1.80). Two factors were negatively associated with intent to receive vaccination: the presence of children in the HCW's home (OR, 0.69) and employment as a nurse (OR, 0.59). Reasons cited by those who did not intend to receive vaccination included lack of a personal recommendation for vaccination (78%), receipt of vaccination as a child (51%), and perception that there was no significant risk for contracting pertussis (38%).Conclusions.Of the HCWs surveyed, only 13% intended to receive the pertussis vaccine. A perceived lack of recommendation for vaccination and inaccurate conceptions about pertussis and pertussis vaccination were cited as reasons HCWs did not intend to be vaccinated. Institutional pertussis vaccination campaigns should focus on the risks of healthcare-associated pertussis and new recommendations for pertussis vaccination.


2011 ◽  
Vol 32 (4) ◽  
pp. 375-379 ◽  
Author(s):  
Lynne V. Karanfil ◽  
Jan Bahner ◽  
Joan Hovatter ◽  
William L. Thomas

Objective.To determine whether a mandatory seasonal influenza vaccination program will increase vaccination rates among healthcare personnel (HCP) and affiliated physicians.Setting.MedStar Health is a not-for-profit regional healthcare organization that includes 9 hospitals with approximately 25,000 HCP and approximately 4,000 affiliated physicians. HCP describes any person employed by MedStar Health.Methods.With previous vaccination rates parallel to reported national rates of 54% among HCP, MedStar Health introduced a mandatory seasonal influenza vaccination program promulgated during the 2009–2010 influenza season. HCP and affiliated physicians were given an opportunity to apply for medical or religious exemptions. Noncompliant HCP were terminated. Noncompliant physicians had their privileges administratively suspended for the influenza season.Results.HCP compliance (vaccinated and exempt) was 99.9%. The influenza vaccination rate among HCP was 98.5%. There were 338 approved medical exemptions and 18 approved religious exemptions. Only 0.01% of HCP (9 full-time, 2 part-time, and 17 per diem employees) were terminated. Overall, 93% of the affiliated physicians were vaccinated; 7 religious and 99 medical exemptions were granted. In total, 149 physicians (4%) had their admitting privileges suspended during the influenza season.Conclusion.A mandatory influenza vaccination program achieves high rates of vaccination among HCP and affiliated physicians.


2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Saima Cheema ◽  
Christopher Vinnard ◽  
Sarah Foster-Chang ◽  
Darren R. Linkin

Objectives. The national influenza vaccination rate among healthcare workers (HCWs) remains low despite clear benefits to patients, coworkers, and families. We sought to evaluate formally the effect of a one-hour time off incentive on attitudes towards influenza vaccination during the 2011-2012 influenza season. Methods. All HCWs at the Philadelphia Veterans Affairs (VA) Medical Center were invited to complete an anonymous web-based survey. We described respondents’ characteristics and attitudes toward influenza vaccination and determined the relationship of specific attitudes with respondents’ acceptance of influenza vaccination, using a 5-point Likert scale. Results. We analyzed survey responses from 154 HCWs employed at the Philadelphia VA Medical Center, with a response rate of 8%. Among 121 respondents who reported receiving influenza vaccination, 34 (28%, 95% CI 20–37%) reported agreement with the statement that the time off incentive made a difference in their decision to accept influenza vaccination. Conclusions. Our study provides evidence that modest incentives such as one-hour paid time off will be unlikely to promote influenza vaccination rates within medical facilities. More potent interventions that include mandatory vaccination combined with penalties for noncompliance will likely provide the only means to achieve near-universal influenza vaccination among HCWs.


Author(s):  
Mayan Gilboa ◽  
Ilana Tal ◽  
Einav G. Levin ◽  
Shoshi Segal ◽  
Ana Belkin ◽  
...  

Abstract Objective: To assess reasons for noncompliance with COVID-19 vaccination among healthcare workers (HCWs). Design: Cohort observational and surveillance study. Setting: Sheba Medical Center, a 1,600-bed tertiary-care medical center in Israel. Participants: The study included 10,888 HCWs including all employees, students, and volunteers. Intervention: The BNT162b2 mRNA COVID-19 vaccine was offered to all HCWs of the hospital. Noncompliance was assessed, and pre-rollout and post-rollout surveys were conducted. Data regarding uptake of the vaccine as well as demographic data and compliance with prior influenza vaccination were collected, and 2 surveys were distributed. The survey before the rollout pertained to the intention to receive the vaccine, and the survey after the rollout pertained to all unvaccinated HCWs regarding causes of hesitancy. Results: In the pre-rollout survey, 1,673 (47%) of 3,563 HCWs declared their intent to receive the vaccine. Overall, 8,108 (79%) HCWs received the COVID-19 vaccine within 40 days of rollout. In a multivariate logistic regression model, the factors that were significant predictors of vaccine uptake were male sex, age 40–59 years, occupation (paramedical professionals and doctors), high socioeconomic level, and compliance with flu vaccine. Among 425 unvaccinated HCWs who answered the second survey, the most common cause for hesitancy was the risk during pregnancy (31%). Conclusions: Although vaccine uptake among HCWs was higher than expected, relatively low uptake was observed among young women and those from lower socioeconomic levels and educational backgrounds. Concerns regarding vaccine safety during pregnancy were common and more data about vaccine safety, especially during pregnancy, might improve compliance.


2019 ◽  
Vol 26 (3) ◽  
pp. 170
Author(s):  
Ji-Man Kang ◽  
Jinhong Lee ◽  
Yoon Soo Park ◽  
Yoonseon Park ◽  
Yee Gyung Kwak ◽  
...  

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Qalla-Widmer ◽  
C Petignat

Abstract Influenza is a significant cause of morbidity and mortality in elderly. They are at high risk of complications after influenza virus infection. Data on the epidemiology of influenza within nursing homes (NH) are limited. The purpose of this prospective study was to better describe the burden of influenza among residents of NH of canton of Vaud, Switzerland, with influenza-like illness during 2016-2017 and 2017-2018 influenza seasons. First, we determined the proportion of influenza-like illness due to influenza in NH residents. We specifically assessed the impact of a positive influenza PCR on clinical features, morbidity and mortality, 30 and 90 days after diagnosis, as compared to a negative influenza PCR. Moreover, influenza vaccination rates of the residents and the healthcare workers within each nursing home were assessed at the end of each influenza season. A PCR test was performed on 509 residents from 61 NH. 227 influenza virus infections were diagnosed; 181 influenza A and 46 influenza B. Compared to residents without influenza virus infection (IVI), residents with IVI were more often feverish with a high fever (69.1% and 88.5% respectively, p < 0.0001) are significantly more frequently hospitalized within 30 days after diagnosis (17.6% vs 7.1%, p = 0.0003). Any cause mortality at 30 days was similar in both groups (12.8% vs 10.6%, p = 0.48). Only 18.1% of IVI residents were treated with an antiviral and 60.4% of them received antibiotics. Influenza vaccination rates of the healthcare workers and residents were respectively 50% and 82%. During influenza season, the feverish residents should be suspected to have influenza virus infection. Residents should be diagnosed (PCR) and treated with an antiviral where appropriate to limit the risk of hospitalization. Healthcare workers should be encouraged to be vaccinated against influenza in order to acquire a better herd immunity within the NH which will limit the spread of influenza. Key messages Influenza virus in nursing homes is not treated enough. Influenza virus infection in nursing homes causes a high number of hospitalizations.


2005 ◽  
Vol 26 (11) ◽  
pp. 874-881 ◽  
Author(s):  
Donald B. Middleton ◽  
Dwight E. Fox ◽  
Mary Patricia Nowalk ◽  
Susan J. Skledar ◽  
Denise R. Sokos ◽  
...  

AbstractObjectives:To identify and classify barriers to establishing a standing orders program (SOP) for adult pneumococcal vaccination in acute care inpatient facilities and to provide recommendations for overcoming these roadblocks. Vaccination rates in hospitals with SOPs are generally higher than those in hospitals that require individual physician orders. The array of solutions drawn from our experience in different hospital settings should permit many types of facilities to anticipate and overcome barriers, allowing a smoother transition from initiation to successful implementation of an inpatient pneumococcal vaccination SOP.Design:Descriptive study of barriers and solutions encountered during implementation of a pneumococcal vaccination SOP in three hospitals of the University of Pittsburgh Medical Center Health System (UPMC) and in the scientific literature.Setting:As of 2004, two UPMC tertiary-care hospitals and one UPMC community hospital had incorporated SOPs into existing physician order-driven programs for inpatient vaccination with pneumococcal polysaccharide vaccine.Results:Barriers were identified at each step of implementation and categorized as patient related, provider related, or institutional. Based on a process of continual review and revision of our programs in response to encountered barriers, steps were taken to overcome these impediments.Conclusions:A strong commitment by key individuals in the facility's administration including a physician champion; ongoing, persistent efforts to educate and train staff; and close monitoring of the vaccination rate were essential for successful implementation of a SOP for pneumococcal vaccination of eligible inpatients. Legal statutes and evaluations of external hospital-rating associations regarding the effectiveness of the vaccination program were major motivating factors in its success.


2008 ◽  
Vol 29 (2) ◽  
pp. 111-115 ◽  
Author(s):  
Jennifer L. Kuntz ◽  
Stephanie Holley ◽  
Charles M. Helms ◽  
Joseph E. Cavanaugh ◽  
Jeff Vande Berg ◽  
...  

Objective.To determine the effect of a pandemic influenza preparedness drill on the rate of influenza vaccination among healthcare workers (HCWs).Design.Before-after intervention trial.Setting.The University of Iowa Hospitals and Clinics (UIHC), a large, academic medical center, during 2005.Subjects.Staff members at UIHC.Methods.UIHC conducted a pandemic influenza preparedness drill that included a goal of vaccinating a large number of HCWs in 6 days without disrupting patient care. Peer vaccination and mobile vaccination teams were used to vaccinate HCWs, educational tools were distributed to encourage HCWs to be vaccinated, and resources were allocated on the basis of daily vaccination reports. Logit models were used to compare vaccination rates achieved during the 2005 vaccination drill with the vaccination rates achieved during the 2003 vaccination campaign.Results.UIHC vaccinated 54% of HCWs (2,934 of 5,467) who provided direct patient care in 6 days. In 2 additional weeks, this rate increased to 66% (3,625 of 5,467). Overall, 66% of resident physicians (311 of 470) and 63% of nursing staff (1,429 of 2,255) were vaccinated. Vaccination rates in 2005 were significantly higher than the hospitalwide rate of 41% (5,741 of 14, 086) in 2003.Conclusions.UIHC dramatically increased the influenza vaccination rate among HCWs by conducting a pandemic influenza preparedness drill. Additionally, the drill allowed us to conduct a bioemergency drill in a realistic scenario, use innovative methods for vaccine delivery, and secure administrative support for future influenza vaccination campaigns. Our study demonstrates how a drill can be used to improve vaccination rates significantly.


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