December 06, 2015
2 min read
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Less than half of non-VA hospitals require flu vaccination in HCWs

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In a 2013 survey of hospitals, less than half reported that they require all health care workers who provide patient care to receive annual influenza vaccination, according to findings published in Infection Control and Hospital Epidemiology.

Of the 386 hospitals and 77 Veterans Affairs facilities that responded to the survey, 42.7% of non-VA hospitals mandated the vaccine in HCWs, according to Sanjay Saint, MD, MPH, George Dock Collegiate Professor of Internal Medicine at the University of Michigan Medical School, and colleagues. For VA hospitals, the rate was 1.3%.

Sanjay Saint

Sanjay Saint

According to the research, either the administrations or human resources departments of 22.3% of non-VA facilities did not require vaccination. Other common reasons for not mandating vaccination included policies strongly encouraging vaccines but not requiring them (21.9%), and the use of declination policies, with a signed form and/or mask required (21.4%). Among VA hospitals, 56.6% cited the lack of a federal VA mandate, while 27.6% reported union resistance to mandatory influenza vaccination.

“Recent estimates indicate that settings with mandatory vaccination for [HCW] may yield nearly 98% coverage, followed by approximately 72% coverage in settings where vaccinations are not required but are promoted and only 48% coverage in settings lacking both vaccination requirements and promotion,” the researchers wrote. “Prior studies have shown significant increases in vaccination coverage following the implementation of institutional requirements, with the greatest increases in coverage found among institutions with strict consequences (including termination of employment) for unvaccinated [HCWs].”

The survey was distributed to 697 hospitals, yielding an overall response rate of 69%. The non-VA hospital response rate was 71%, while the VA center response rate was 63%. Of those who responded, 96% of both VA and non-VA hospitals answered the question regarding HCW vaccination.

Sanjay and colleagues acknowledged that the survey’s question did not specify a definition for “required.” In addition, 9.8% of non-VA hospitals that did not mandate vaccination at the time of the survey planned to begin requiring them in the 2013-2014 influenza season. The researchers also were unable to record the influenza vaccination and infection rates at the hospitals that chose to respond.

“Limitations notwithstanding, our findings suggest that opportunities remain for many health care organizations to consider the use of compulsory vaccination policies to increase coverage rates, while appropriately weighing and managing the moral, ethical and legal implications associated with implementing them,” the researchers said. “We acknowledge that mandated vaccinations are not a simple panacea and will continue to be met with challenges and opposition. Nevertheless, mandatory vaccinations and other proven strategies to increase vaccination rates will be key as U.S. hospitals strive to reach the Healthy People 2020 goal of 90% vaccination coverage among [HCW].” – by Jason Laday

Disclosure: The researchers report no relevant financial disclosures.