Few health care workers have medical contraindication to flu vaccine in single-center study
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Few health care personnel in a large academic health system who requested a medical waiver for the influenza vaccine had a true medical contraindication, according to findings in Infection Control and Hospital Epidemiology.
About two-thirds of individuals with invalid medical waivers submitted personal conviction waivers to avoid receiving the influenza vaccine.
“During the 2018-2019 influenza season, we changed the personal waiver policy,” Mary S. Hayney, PharmD, MPH, professor of pharmacy at the University of Wisconsin School of Pharmacy, told Healio. “We realized that as recommendations for influenza vaccine have evolved over the years, we should reexamine the medical waiver policy and ask for waiver resubmission, get the vaccine or submit a personal waiver from those whose previously submitted medical waivers were no longer in compliance with current influenza vaccine recommendations.”
To determine the influenza vaccine compliance rate for employees at University of Wisconsin Hospitals and Clinics, as well as the change in vaccination rate, researchers classified medical waivers for the vaccine according to the reason for requesting a medical exemption after the 2018–2019 and 2019–2020 influenza seasons. Employees with prior exemption who were no longer in compliance with Advisory Committee on Immunization Practices recommendations were told to either submit a revised medical waiver, receive the influenza vaccine or fill out a personal conviction waiver for the 2019–2020 influenza season.
According to Hayney, the study showed that updating criteria for health care worker influenza vaccine medical waivers is one strategy that increases vaccine uptake. Among the 131 employees with a prior medical waiver on file, Employee Health Services approved 35 medical exemptions (27%) based on the updated ACIP guidelines. Of the remaining 96 employees, 14 were no longer employed by University of Wisconsin Hospitals and Clinics and 82 were required to act to stay in compliance with the seasonal influenza vaccination requirement.
The researchers found that only 19 of those 82 employees (23.1%) received the 2019–2020 influenza vaccine. A greater proportion of employees with previous severe allergic reactions to egg products submitted personal waivers in 2019–2020 compared with both those with common side effects from the influenza vaccine, such as influenza-like symptoms, injection site reaction or shoulder injury related to vaccine administration (OR = 1.14; 95% CI, 0.34–3.87), in addition to employees with reactions not commonly associated with the vaccine, including Guillain-Barré syndrome and exacerbation of an inflammatory condition (OR = 1.62; 95% CI, 0.51–5.12).
“Although it is important to keep health care system medical waiver policies current, a multipronged approach is needed to keep health care worker influenza immunization rates very high,” Hayney said.
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