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Influenza Vaccination among Healthcare Workers: Ten-Year Experience of a Large Healthcare Organization

Published online by Cambridge University Press:  02 January 2015

M. Cristina Ajenjo ,
Keith F. Woeltje ,
Hilary M. Babcock ,
Nancy Gemeinhart ,
Marilyn Jones  and
Victoria J. Fraser
M. Cristina Ajenjo
Affiliation:
Infectious Disease Division, Washington University in St. Louis School of Medicine, St Louis, Missouri Department of Internal Medicine, Infectious Diseases Program, Pontificia Universidad Católica de Chile, Santiago, Chile
Keith F. Woeltje
Affiliation:
Infectious Disease Division, Washington University in St. Louis School of Medicine, St Louis, Missouri
Hilary M. Babcock
Affiliation:
Infectious Disease Division, Washington University in St. Louis School of Medicine, St Louis, Missouri
Nancy Gemeinhart
Affiliation:
Occupational Health Services and Infection Prevention and Epidemiology Consortium, BJC HealthCare, St Louis, Missouri
Marilyn Jones
Affiliation:
Occupational Health Services and Infection Prevention and Epidemiology Consortium, BJC HealthCare, St Louis, Missouri
Victoria J. Fraser*
Affiliation:
Infectious Disease Division, Washington University in St. Louis School of Medicine, St Louis, Missouri
*
Infectious Diseases Division, Washington University in St. Louis School of Medicine, Campus Box 8051, 660 South Euclid Avenue, St Louis, MO 63110 (vfraser@wustl.edu)
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Extract

Objective.

To describe the results of different measures implemented to improve adherence to the healthcare worker (HCW) influenza immunization program at BJC HealthCare during the period from 1997 through 2007.

Design.

Descriptive retrospective study.

Setting.

BJC HealthCare, a 13-hospital nonprofit healthcare organization in the Midwest.

Methods.

We reviewed and analyzed HCW influenza vaccination data from all BJC HealthCare Occupational Health Services and hospitals during the period from 1997 through 2007. Occupational health staff, infection prevention personnel, and key influenza vaccination campaign leaders were also interviewed regarding implementation measures during the study years.

Results.

At the end of 2007, BJC HealthCare had approximately 26,000 employees. With the use of multiple progressive interventions, influenza vaccination rates among BJC employees increased from 45% in 1997 to 72% in 2007 (P<.001). The influenza vaccination rate in 2007 was significantly higher than in 2006: 72%, compared with 54% (P<.001). Five hospitals had influenza vaccination rates that exceeded the target goal of 80% in 2007. The most successful interventions were adding influenza vaccination rates to the quality scorecard incentive program and the use of declination statements, both of which were implemented in 2007. The most important barriers to success identified by interview respondents were HCWs' misconceptions about influenza vaccination and a perceived lack of leadership support.

Conclusions.

Influenza vaccination rates among HCWs significantly improved with multiple interventions over the years. However, the BJC HealthCare influenza vaccination target of 80% was not attained at all hospitals with these measures. More aggressive interventions, such as implementing mandatory influenza vaccination policies, are needed to achieve higher vaccination rates.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 31 , Issue 3 , March 2010 , pp. 233 - 240
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2010

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References

1.Thompson, WW, Shay, DK, Weintraub, E, et al.Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA 2003;289:179–186.CrossRefGoogle ScholarPubMed
2.Thompson, WW, Shay, DK, Weintraub, E, et al.Influenza-associated hospitalizations in the United States. JAMA 2004;292:1333–1340.CrossRefGoogle ScholarPubMed
3.Molinari, NA, Ortega-Sanchez, IR, Messonnier, ML, et al.The annual impact of seasonal influenza in the US: measuring disease burden and costs. Vaccine 2007;25:5086–5096.Google Scholar
4.Doebbeling, BN, Edmond, MB, Davis, CS, Woodin, JR, Zeitler, RR. Influenza vaccination of health care workers: evaluation of factors that are important in acceptance. Prev Med 1997;26:68–77.CrossRefGoogle ScholarPubMed
5.Salgado, CD, Farr, BM, Hall, KK, Hayden, FG. Influenza in the acute hospital setting. Lancet Infect Dis 2002;2:145–155.CrossRefGoogle ScholarPubMed
6.Rabagliati, R, Benitez, R, Fernandez, A, et al.Influenza-A as etiology of fever and respiratory insufficiency in adults hospitalized during an outbreak in Chile [in Spanish]. Rev Med Chil 2004;132:317–324.Google ScholarPubMed
7.Pearson, ML, Bridges, CB, Harper, SA. Influenza vaccination of healthcare personnel: recommendations of the Healthcare Infection Control Practices Advisory Committee (HICPAC) and the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2006;55:1–16.Google Scholar
8.Maltezou, HC, Drancourt, M. Nosocomial influenza in children. J Hosp Infect 2003;55:83–91.CrossRefGoogle ScholarPubMed
9.Sartor, C, Zandotti, C, Romain, F, et al.Disruption of services in an internal medicine unit due to a nosocomial influenza outbreak. Infect Control Hosp Epidemiol 2002;23:615–619.Google Scholar
10.Dash, GP, Fauerbach, L, Pfeiffer, J, et al.APIC position paper: improving health care worker influenza immunization rates. Am J Infect Control 2004;32:123–125.Google Scholar
11.Stott, DJ, Kerr, G, Carman, WF. Nosocomial transmission of influenza. Occup Med (Lond) 2002;52:249–253.Google Scholar
12.Carman, WF, Elder, AG, Wallace, LA, et al.Effects of influenza vaccination of health-care workers on mortality of elderly people in long-term care: a randomised controlled trial. Lancet 2000;355:93–97.Google Scholar
13.Potter, J, Stott, DJ, Roberts, MA, et al.Influenza vaccination of health care workers in long-term-care hospitals reduces the mortality of elderly patients. J Infect Dis 1997;175:1–6.CrossRefGoogle ScholarPubMed
14.Saxen, H, Virtanen, M. Randomized, placebo-controlled double blind study on the efficacy of influenza immunization on absenteeism of health care workers. Pediatr Infect Dis J 1999;18:779–783.CrossRefGoogle ScholarPubMed
15.Wilde, JA, McMillan, JA, Serwint, J, Butta, J, O'Riordan, MA, Steinhoff, MC. Effectiveness of influenza vaccine in health care professionals: a randomized trial. JAMA 1999;281:908–913.Google Scholar
16.Bridges, CB, Thompson, WW, Meltzer, MI, et al.Effectiveness and cost-benefit of influenza vaccination of healthy working adults: a randomized controlled trial. JAMA 2000;284:1655–1663.Google Scholar
17.Salgado, CD, Giannetta, ET, Hayden, FG, Farr, BM. Preventing nosocomial influenza by improving the vaccine acceptance rate of clinicians. Infect Control Hosp Epidemiol 2004;25:923–928.CrossRefGoogle ScholarPubMed
18.Hayward, AC, Harling, R, Wetten, S, et al.Effectiveness of an influenza vaccine programme for care home staff to prevent death, morbidity, and health service use among residents: cluster randomised controlled trial. BMJ 2006;333:1241.CrossRefGoogle ScholarPubMed
19.Fiore, AE, Shay, DK, Haber, P, et al.Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2007. MMWR Recomm Rep 2007;56:1–54.Google Scholar
20.Talbot, TR, Bradley, SE, Cosgrove, SE, Ruef, C, Siegel, JD, Weber, DJ. Influenza vaccination of healthcare workers and vaccine allocation for healthcare workers during vaccine shortages. Infect Control Hosp Epidemiol 2005;26:882–890.CrossRefGoogle ScholarPubMed
21.Harper, SA, Fukuda, K, Uyeki, TM, Cox, NJ, Bridges, CB. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2005;54:1–40.Google Scholar
22.Lugo, NR. Will carrots or sticks raise influenza immunization rates of health care personnel? Am J Infect Control 2007;35:1–6.CrossRefGoogle ScholarPubMed
23.Poland, GA, Tosh, P, Jacobson, RM. Requiring influenza vaccination for health care workers: seven truths we must accept. Vaccine 2005;23:2251–2255.CrossRefGoogle ScholarPubMed
24.McArthur, MA, Simor, AE, Campbell, B, McGeer, A. Influenza vaccination in long-term-care facilities: structuring programs for success. Infect Control Hosp Epidemiol 1999;20:499–503.CrossRefGoogle ScholarPubMed
25.Saito, R, Suzuki, H, Oshitani, H, Sakai, T, Seki, N, Tanabe, N. The effectiveness of influenza vaccine against influenza A (H3N2) virus infections in nursing homes in Niigata, Japan, during the 1998–1999 and 1999–2000 seasons. Infect Control Hosp Epidemiol 2002;23:82–86.Google Scholar
26.Bryant, KA, Stover, B, Cain, L, Levine, GL, Siegel, J, Jarvis, WR. Improving influenza immunization rates among healthcare workers caring for high-risk pediatric patients. Infect Control Hosp Epidemiol 2004;25:912–917.Google Scholar
27.Lester, RT, McGeer, A, Tomlinson, G, Detsky, AS. Use of, effectiveness of, and attitudes regarding influenza vaccine among house staff. Infect Control Hosp Epidemiol 2003;24:839–844.CrossRefGoogle ScholarPubMed
28.Harbarth, S, Siegrist, CA, Schira, JC, Wunderli, W, Pittet, D. Influenza immunization: improving compliance of healthcare workers. Infect Control Hosp Epidemiol 1998;19:337–342.CrossRefGoogle ScholarPubMed
29.Sartor, C, Tissot-Dupont, H, Zandotti, C, et al.Use of mobile cart influenza program for vaccination of hospital employees. Infect Control Hosp Epidemiol 2004;25:918–922.Google Scholar
30.Polgreen, PM, Septimus, EJ, Parry, MF, et al.Relationship of influenza vaccination declination statements and influenza vaccination rates for healthcare workers in 22 US hospitals. Infect Control Hosp Epidemiol 2008;29:675–677.CrossRefGoogle ScholarPubMed
31. Self-reported influenza vaccination coverage trends 1989-2006 among adults by age group, risk group, race/ethnicity, health-care worker status, and pregnancy status, United States, National Health Interview Survey (NHIS). Available at: http://www.cdc.gov/flu/professionals/vaccination/pdf/vaccinetrend.pdf. Accessed May 14, 2009.Google Scholar
32.Van den Dool, C, Van Strien, AM, den Akker, IL, Bonten, MJ, Sanders, EA, Hak, E. Attitude of Dutch hospital personnel towards influenza vaccination. Vaccine 2008;26:1297–1302.CrossRefGoogle ScholarPubMed
33.Shah, SI, Caprio, M. Availability of trivalent inactivated influenza vaccine to parents of neonatal intensive care unit patients and its effect on the healthcare worker vaccination rate. Infect Control Hosp Epidemiol 2008;29:309–313.CrossRefGoogle ScholarPubMed
34.Watanakunakorn, C, Ellis, G, Gemmel, D. Attitude of healthcare personnel regarding influenza immunization. Infect Control Hosp Epidemiol 1993;14:17–20.CrossRefGoogle ScholarPubMed
35.Talbot, TR. Improving rates of influenza vaccination among healthcare workers: educate; motivate; mandate? Infect Control Hosp Epidemiol 2008;29:107–110.Google Scholar
36.Sartor, C, Tissot-Dupont, H, Zandotti, C, Martin, F, Roques, P, Drancourt, M. Use of a mobile cart influenza program for vaccination of hospital employees. Infect Control Hosp Epidemiol 2004;25:918–922.Google Scholar
37.Nafziger, DA, Herwaldt, LA. Attitudes of internal medicine residents regarding influenza vaccination. Infect Control Hosp Epidemiol 1994;15:32–35.CrossRefGoogle ScholarPubMed
38.Ohrt, CK, McKinney, WP. Achieving compliance with influenza immunization of medical house staff and students: a randomized controlled trial. JAMA 1992;267:1377–1380.Google Scholar
39.Poland, GA, Ofstead, CL, Tucker, SJ, Beebe, TJ. Receptivity to mandatory influenza vaccination policies for healthcare workers among registered nurses working on inpatient units. Infect Control Hosp Epidemiol 2008;29:170–173.Google Scholar
40.Babcock, HM, Gemeinhart, N, Jones, M, Dunagan, WC, Woeltje, KF. Mandatory influenza vaccination: translating policy to practice. In: Society for Healthcare Epidemiology of America (SHEA) 19th Annual Scientific Meeting, San Diego, California, March 19–22, 2009. Abstract 517.Google Scholar