A mandatory influenza vaccination policy improves immunization rates
among health care workers, according to a recent study of a large
health care organization. The finding comes from a study, now available online, published in the February 15 issue of Clinical Infectious Diseases.
Health Care, a multi-hospital health care system in the Midwest,
implemented a mandatory influenza vaccination policy for its
approximately 26,000 employees in 2008 after several years of free
vaccinations, extensive educational efforts, and incentives failed to
increase the employee vaccination rate to the system’s goal of 80
percent. The new policy improved the vaccination rate to 98 percent
compared with rates of 71 percent in 2007 and 54 percent in 2006.
and religious exemptions were granted to 411 employees under the
mandatory policy in 2008. Eight workers who were not vaccinated or
granted exemptions were terminated for not complying with the policy.
programs work and can be implemented at large health care facilities or
systems successfully,” said study author Hilary Babcock, MD, of the
Washington University School of Medicine in St. Louis. “Staff influenza
vaccination rates are being discussed as a possible patient safety
indicator that could be used for accreditation or public reporting,
which would increase the likelihood of more programs developing
The study’s findings reveal that such
policies result in extremely high vaccination coverage rates among
health care workers, said the author of an accompanying editorial,
Andrew Pavia, MD, FIDSA, of the University of Utah in Salt Lake City.
“Health care organizations should be expected to achieve influenza
vaccine coverage that optimizes patient safety,” wrote Dr. Pavia, who
proposed an employee vaccination rate of 90 percent as an appropriate
target. “Organizations can then choose to achieve the target with less
coercive methods if they can, or if necessary, choose to mandate
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