Implementation of a Successful Seasonal Influenza Vaccine Strategy in a Large Healthcare System

Background: As part of a comprehensive seasonal influenza prevention strategy, the Hospital Corporation of America (HCA) implemented a program that required employees who could infect or become infected by a patient to receive the seasonal influenza vaccine or wear a surgical mask in patient care areas.  HCA is the nation's largest provider of healthcare services, composed of locally managed facilities that include 163 hospitals, 112 outpatient centers and 368 physician practices in 20 states.  The strategy was announced by the corporate CEO and Chief Medical Officer.  A core group representing emergency preparedness, infection prevention, human resources, legal, pharmacy, communications, and supply was formed.  This core group recommended strategy, provided tools, resources, and regular flu updates for the program.  The reason for the program, as well as implementation strategies were relayed in a webcast to all facilities.  Non vaccine strategies, such as cough and sneeze etiquette, proper hand hygiene, proper cleaning techniques, and hazards of Presenteeism were also introduced.  Human resources policies were changed to accommodate time off needed by employees ill with the flu.   Prior to the program, seasonal influenza vaccine rates for the 2008-2009 influenza season varied from a low of 20% to a high of 74% (Mean 58%).

Objective: To review the strategies and outcomes of a comprehensive seasonal influenza prevention program to include vaccination and declination rates.

Methods: Concurrent analysis.   Consents and declinations were documented in a corporate wide electronic database.

Results: As of November 1, 2009, 140,599 employees were offered the seasonal influenza vaccination, with 135,584 accepting, or 96%.  This correlates to clinical employees (98,067 total with 94,530 accepting.)  A total of 5,015 employees declined the seasonal influenza vaccine.  Reasons for declination were allergy (12%), contraindicated (7%), Fear (4%), pregnant (1%), religion (3%), and no reason given (73%).

Conclusions: The program resulted in a 65% increase in employee vaccine rates.   Vaccine rates at unionized facilities were 95%; in non-unionized facilities they were 97%.  A comprehensive vaccine strategy which includes vaccine or surgical mask use is successful in increasing vaccination rates.