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Flu vaccine requirements suboptimal among US HCWs
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BOSTON — Although influenza vaccination requirements were prevalent among hospitals throughout the US, few policies were as stringent or as comprehensive as those endorsed by professional health organizations, according to researchers led by Brady L. Miller, MPH.
Miller presented the results during a presentation here from the first ever study that estimated the prevalence of institutional requirements for influenza vaccination of health care workers (HCWs).
During the 2010-2011 influenza season, nationwide surveys were mailed to 998 acute care hospitals that inquired about institutional requirements, defined as a policy that requires HCWs to receive or decline influenza vaccination, with or without consequences for vaccine refusal.
Eighty-one percent of hospitals responded, of which 55.6% reported institutional requirements for influenza vaccination. Although most HCWs expressed concerns of these requirements, non-employees (53.3%), volunteers (60.4%) and students (48.9%) did not.
Hospitals with requirements were significantly more likely to be located in a state requiring HCWs to receive or decline the influenza vaccine (OR=3.7), care for inpatients who may be immunocompromised or too young to receive the vaccine (OR=1.7), to utilize 9 or more evidence-based influenza vaccination campaign strategies (OR=1.9) and to have for-profit ownership (OR=2).
Of 44.4% of hospitals that reported requirements with consequences for vaccine refusal, nonmedical exemptions were granted in 69.3% of hospitals once consequences were imposed. Approximately 14.4% of hospitals terminated unvaccinated HCWs, however, the most common consequence was to wear a mask among 74.2% of hospitals.
For more information:
- Miller BL. #519. Presented at: The IDSA 49th Annual Meeting; Oct. 20-23, 2011; Boston.
Disclosure: The researchers report no relevant financial disclosures.
Annual influenza immunization is both a professional and ethical responsibility for all HCWs. The principal rationale is patient safety; none of us wish to transmit influenza to our patients. Another reason is that the health care workforce needs to be healthy and able to provide care when influenza strikes. These concepts now are widely acknowledged and virtually all health care facilities freely provide annual influenza vaccine to their workers. As is ruefully acknowledged, however, HCWs have been far from universal in their acceptance of influenza vaccine. Given the professional and ethical imperative, a growing number of facilities have instituted influenza vaccination requirements. This is the first nationally-representative survey of the frequency and characteristics of such requirements. The results indicate that a substantial proportion of responding hospitals (56%) had some sort of ‘requirement’, but that the requirements come in many variations, some with substantial gaps of coverage (often not including students or volunteers) or too readily-given, non-medical exemptions. The goal remains: a 90% annual influenza vaccination rate among HCWs. There may be many roads to that Rome, but requirements that do not require is not one of them. Colleagues, we have more work to do!
– William Schaffner, MD
Infectious Disease News Editorial Board member
President of NFID
Disclosure: Dr. Schaffner reports no relevant financial disclosures.
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