Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-28T02:15:59.917Z Has data issue: false hasContentIssue false
  • English
  • Français

Voluntary to Mandatory: Evolution of Strategies and Attitudes toward Influenza Vaccination of Healthcare Personnel

Published online by Cambridge University Press:  02 January 2015

Kathleen Quan ,
David M. Tehrani ,
Linda Dickey ,
Eugene Spiritus ,
Denise Hizon ,
Kristie Heck ,
Pamela Samuelson ,
Elliott Kornhauser ,
Raja Zeitany  and
Susan Mancia
...Show all authors
Kathleen Quan
Affiliation:
Department of Epidemiology and Infection Prevention, University of California Irvine Medical Center, Orange, California
David M. Tehrani
Affiliation:
Division of Infectious Disease and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, California
Linda Dickey
Affiliation:
Department of Epidemiology and Infection Prevention, University of California Irvine Medical Center, Orange, California
Eugene Spiritus
Affiliation:
University of California, Irvine Health, Irvine, California
Denise Hizon
Affiliation:
University of California, Irvine Health, Irvine, California
Kristie Heck
Affiliation:
University of California, Irvine Health, Irvine, California
Pamela Samuelson
Affiliation:
University of California, Irvine Health, Irvine, California
Elliott Kornhauser
Affiliation:
University of California, Irvine Health, Irvine, California
Raja Zeitany
Affiliation:
University of California, Irvine Health, Irvine, California
Susan Mancia
Affiliation:
University of California, Irvine Health, Irvine, California
Lauri Thrupp
Affiliation:
Department of Epidemiology and Infection Prevention, University of California Irvine Medical Center, Orange, California
Susan M. Tiso
Affiliation:
University of California, Irvine Health, Irvine, California
Susan S. Huang*
Affiliation:
Department of Epidemiology and Infection Prevention, University of California Irvine Medical Center, Orange, California Division of Infectious Disease and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, California
*
University of California Irvine School of Medicine, Division of Infectious Diseases and Health Policy Research Institute, 101 The City Drive, City Tower, Suite 400, ZC 4081, Orange, CA 92868 (sshuang@uci.edu)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background.

Assessing the relative success of serial strategies for increasing healthcare personnel (HCP) influenza vaccination rates is important to guide hospital policies to increase vaccine uptake.

Objective.

To evaluate serial campaigns that include a mandatory HCP vaccination policy and to describe HCP attitudes toward vaccination and reasons for declination.

Design.

Retrospective cohort study.

Methods.

We assessed the impact of serial vaccination campaigns on the proportions of HCP who received influenza vaccination during die 2006–2011 influenza seasons. In addition, declination data over these 5 seasons and a 2007 survey of HCP attitudes toward vaccination were collected.

Results.

HCP influenza vaccination rates increased from 44.0% (2,863 of 6,510 HCP) to 62.9% (4,037 of 6,414 HCP) after institution of mobile carts, mandatory declination, and peer-to-peer vaccination efforts. Despite maximal attempts to improve accessibility and convenience, 27.2% (66 of 243) of die surveyed HCP were unwilling to wait more than 10 minutes for a free influenza vaccination, and 23.3% (55 of 236) would be indifferent if they were unable to be vaccinated. In this context, institution of a mandatory vaccination campaign requiring unvaccinated HCP to mask during the influenza season increased rates of compliance to over 90% and markedly reduced the proportion of HCP who declined vaccination as a result of preference.

Conclusions.

A mandatory influenza vaccination program for HCP was essential to achieving high vaccination rates, despite years of intensive vaccination campaigns focused on increasing accessibility and convenience. Mandatory vaccination policies appear to successfully capture a large portion of HCP who are not opposed to receipt of die vaccine but who have not made vaccination a priority.

Infect Control Hosp Epidemiol 2012;33(1):63-70

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 33 , Issue 1 , January 2012 , pp. 63 - 70
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Fiore, AE, Uyeki, TM, Broder, K, et al. Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010. MMWR Recomm Rep 2010;59(RR-8):1–62.Google ScholarPubMed
2. Walker, FJ, Singleton, JA, Lu, P, Wooten, KG, Strikas, RA. Influenza vaccination of healthcare workers in the United States, 1989–2002. Infect Control Hosp Epidemiol 2006;27(3):257–265.Google Scholar
3. Caban-Martinez, AJ, Lee, DJ, Davila, EP, et al. Sustained low influenza vaccination rates in US healthcare workers. Prev Med 2010;50(4):210–212.Google Scholar
4. Interim results: influenza A (H1N1) 2009 monovalent and seasonal influenza vaccination coverage among health-care personnel—United States, August 2009-January 2010. MMWR Morb Mortal Wkly Rep 2010;59(12):357–362.Google Scholar
5. Influenza vaccination coverage among health-care personnel—United States, 2010–11 influenza season. MMWR Morb Mortal Wkly Rep 2011;60:1073–1077.Google Scholar
6. 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(7581):1241.Google Scholar
7. Lemaitre, M, Meret, T, Rothan-Tondeur, M, et al. Effect of influenza vaccination of nursing home staff on mortality of residents: a cluster-randomized trial. J Am Geriatr Soc 2009;57(9):1580–1586.Google Scholar
8. Thompson, WW, Shay, DK, Weintraub, E, et al. Influenza-associated hospitalizations in the United States. JAMA 2004;292(11):1333–1340.Google Scholar
9. Thompson, WW, Shay, DK, Weintraub, E, et al. Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA 2003;289(2):179–186.CrossRefGoogle ScholarPubMed
10. Mereckiene, J, Cotter, S, D'Ancona, F, et al. Differences in national influenza vaccination policies across the European Union, Norway and Iceland 2008–2009. Euro Surveill 2010;15(44):1–4.CrossRefGoogle ScholarPubMed
11. 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(13):1655–1663.Google Scholar
12. Orenstein, WA, Papania, MJ, Wharton, ME. Measles elimination in the United States. J Infect Dis 2004;189(suppl 1):S1–S3.Google Scholar
13. Nguyen, HQ, Jumaan, AO, Seward, JF. Decline in mortality due to varicella after implementation of varicella vaccination in the United States. N Engl J Med 2005;352(5):450–458.Google Scholar
14. Reef, SE, Frey, TK, Theall, K, et al. The changing epidemiology of rubella in the 1990s: on the verge of elimination and new challenges for control and prevention. JAMA 2002;287(4):464–472.CrossRefGoogle ScholarPubMed
15. Vogt, T, Wise, M, Shih, H, Williams, I. Hepatitis B mortality in the United States. In: 45th Annual Meeting of Infectious Diseases Society of America; 2007; San Diego, CA.Google Scholar
16. HealthyPeople.gov. http://www.healthypeople.gov. Accessed March 1, 2010.Google Scholar
17. Shefer, A. Healthy people 2020 update. In: National Influenza Summit; 2011; San Diego, CA.Google Scholar
18. 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(11):918–922.CrossRefGoogle ScholarPubMed
19. Trape-Cardoso, M, Divinere, M, Barnosky, S. Improving compliance with influenza vaccination for hospital healthcare workers from high-risk areas: a 6-year analysis. Am J Infect Control 2005;33(5):e89.Google Scholar
20. Interventions to increase influenza vaccination of health-care workers-California and Minnesota. MMWR Morb Mortal Wkly Rep 2005;54(8):196–199.Google Scholar
21. Talbot, TR. Do declination statements increase health care worker influenza vaccination rates? Clin Infect Dis 2009;49(5):773–779.CrossRefGoogle ScholarPubMed
22. Pearson, ML, Bridges, CB, Harper, SA. Influenza vaccination of health-care personnel: recommendations of the Healthcare Infection Control Practices Advisory Committee (HICPAC) and the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2006;55(RR-2):1–16.Google ScholarPubMed
23. California hospital influenza law. In: California Health and Safety Code, Division 2. Sacramento, CA: Legislative Counsel, 2006.Google Scholar
24. 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(7):675–677.Google Scholar
25. Bertin, M, Scarpelli, M, Proctor, AW, et al. Novel use of the intranet to document health care personnel participation in a mandatory influenza vaccination reporting program. Am J Infect Control 2007;35(1):33–37.CrossRefGoogle Scholar
26. Ribner, BS, Hall, C, Steinberg, JP, et al. Use of a mandatory declination form in a program for influenza vaccination of healthcare workers. Infect Control Hosp Epidemiol 2008;29(4):302–308.Google Scholar
27. IDSA Policy on Mandatory Immunization of Health Care Workers Against Seasonal and Pandemic Influenza. Arlington, VA: Infectious Diseases Society of America, 2011.Google Scholar
28. Talbot, TR, Babcock, H, Caplan, AL, et al. Revised SHEA position paper: influenza vaccination of healthcare personnel. Infect Control Hosp Epidemiol 2010;31(10):987–995.Google Scholar
29. Greene, LR, Cox, T, Dolan, S, et al. APIC Position Paper: Influenza Vaccination Should Be a Condition of Employment for Healthcare Personnel, Unless Medically Contraindicated. Washington, DC: APIC, 2011.Google Scholar
30. Rakita, RM, Hagar, BA, Crome, P, Lammert, JK. Mandatory influenza vaccination of healthcare workers: a 5-year study. Infect Control Hosp Epidemiol 2010;31(9):881–888.Google Scholar
31. Babcock, HM, Gemeinhart, N, Jones, M, Dunagan, WC, Woeltje, KF. Mandatory influenza vaccination of health care workers: translating policy to practice. Clinlnfect Dis 2010;50(4):459–464.Google Scholar
32. Septimus, EJ, Perlin, JB, Cormier, SB, Moody, JA, Hickok, JD. A multifaceted mandatory patient safety program and seasonal influenza vaccination of health care workers in community hospitals. JAMA 2011;305(10):999–1000.Google Scholar
33. van Delden, JJ, Ashcroft, R, Dawson, A, Marckmann, G, Upshur, R, Verweij, MF. The ethics of mandatory vaccination against influenza for health care workers. Vaccine 2008;26(44):5562–5566.CrossRefGoogle ScholarPubMed
34. Ottenberg, AL, Wu, JT, Poland, GA, Jacobson, RM, Koenig, BA, Tilburt, JC. Vaccinating health care workers against influenza: the ethical and legal rationale for a mandate. Am J Public Health 2011;101(2):212–216.Google Scholar
35. Talbot, TR. Improving rates of influenza vaccination among healthcare workers: educate; motivate; mandate? Infect Control Hosp Epidemiol 2008;29(2):107–110.CrossRefGoogle ScholarPubMed
36. Helms, CM, Polgreen, PM. Should influenza immunisation be mandatory for healthcare workers? yes. BMJ 2008;337:a2142.Google Scholar
37. Isaacs, D, Leask, J. Should influenza immunisation be mandatory for healthcare workers? no. BMJ 2008;337:a2140.Google Scholar
38. Nichol, KL, Margolis, KL, Lind, A, et al. Side effects associated with influenza vaccination in healthy working adults: a randomized, placebo-controlled trial. Arch Intern Med 1996;156(14):1546–1550.Google Scholar