Healthcare Worker Influenza Vaccine Uptake at a Midwestern Children's Hospital Using a Mandatory Vaccination/Declinaton/Masking Policy

Background: The CDC has recommended seasonal influenza vaccine for healthcare workers (HCW's) since 1984. Despite this recommendation, annual influenza vaccination rates of HCW's remain low, typically around 40% nationally. The Society for Healthcare Epidemiology of America, Infectious Diseases Society of America, and Association for Professionals in Infection Control have released statements supporting mandatory influenza vaccination of HCW's, with medical exemptions supported by all three organizations.

Objective: To further increase HCW influenza vaccination rates by using a mandatory vaccination/declination/masking policy in lieu of a full mandatory vaccination policy

Methods: During this year's influenza vaccination campaign a mandatory vaccination/declination/masking policy was implemented with an established deadline for compliance. HCW's were required to receive influenza vaccine or sign a declination by November 15, 2010 or become ineligible to work until compliance was achieved. HCW's who declined influenza vaccine were required to wear a surgical mask during influenza season, as determined by Infection Prevention & Control.

Results: Between 2004-2009 HCW influenza vaccination rates increased from 63% to 90.5% with the adoption of a mandatory vaccination/declination policy during the last two influenza seasons. This influenza season, we adopted a mandatory vaccination/declination/masking policy with 96% of employees receiving influenza vaccine.  180/6000 (3%) of HCW's declined vaccine. 1% of employees were on leave of absence at the time of the campaign.  13/180 (7.2%) of HCW's who initially declined influenza vaccine were vaccinated after the masking requirement was initiated on January 14, 2011.  Eleven of these individuals (84.6%) were involved in direct patient care.

Conclusions:    HCW influenza vaccine coverage rates increased from 90.5% for the 2009-2010 influenza season to 96% this season with the introduction of a mandatory vaccination/declination/masking policy. Mandatory vaccination policies, +/- a masking component, without declinations are a means to further increase HCW influenza vaccine coverage rates.