Mandatory Influenza Vaccination during the 2009-2010 Pandemic at Wake Forest University Baptist Medical Center (WFUBMC)

Background: During the previous influenza season, when the H1N1 Pandemic was in process, our medical center decided to make influenza vaccine mandatory for all medical center personnel, with or without patient contact. 

Objective: To demonstrate the effectiveness of a mandatory vaccination policy on vaccination rates of healthcare workers in a major academic medical center during the recent influenza during pandemic, for both H1N1 and Seasonal Influenzas.

Methods: The primary responsibility for implementing the mandatory influenza vaccination was held by the Influenza Task Force which was chaired by the Director of the Medical Center Employee and Occupational Health Services (EHS). This was a multidisciplinary group that included EHS personnel, Nursing, Infectious Diseases faculty, Pharmacy, PR &Marketing, HR, and Information Services. In addition, there was an Influenza Steering Committee chaired by our CMO, which met weekly and made institutional level decisions of an HR, financial, and logistical nature. Vaccination was begun with the seasonal influenza vaccine on September 24, 2009 due to its availability prior to the H1N1 vaccine. The first doses of H1N1 vaccine were administered beginning October 9, 2009 to the highest risk groups (employees first, then patients). Employees could be exempted from receiving the vaccine based on medical or religious reasons. Medical exemptions were handled by the Director of EHS in collaboration with an Infectious Diseases physician. Religious exemptions were handled by HR.

Results: WFUBMC has approximately 14,000 personnel who were required to receive the vaccine; 99.8% were vaccinated for H1N1; approximately 85% for seasonal in spite of significant shortages of the seasonal vaccine.  No severe adverse reactions, such as anaphylaxis or Guillain Barre occurred. 258 personnel applied for exemption; 171 based on medical reasons, 87 based on religious reasons. 206 exemptions were granted. Ten volunteers and nine employees elected to leave the institution rather than be vaccinated. No lawsuits have been filed to date. 

Conclusions: A mandatory influenza vaccination was implemented during the H1N1 pandemic flu season with great success. We will continue with a mandatory vaccination program from this point forward.