Hospitals can improve flu vaccination rate among health care workers by using mandatory policy

Hospitals can greatly improve their flu vaccination rate among health care workers by using a mandatory employee vaccination policy, according to a Henry Ford Health System study.

Citing its own data, Henry Ford researchers say the health system achieved employee vaccination rates of 99 percent in the first two years of its mandatory policy, in which annual vaccination compliance is a condition of employment.

Nationally, 63 percent of health care workers were immunized against the flu in the past two years, according to the Centers for Disease Control and Prevention.

Allison Weinmann, M.D., a Henry Ford Hospital Infectious Diseases physician and study co-author, says it was only after the health system went to the mandatory policy for the 2012-13 flu season did the vaccination rate substantial improve. Ongoing employee communication and having available vaccine were also key factors,
Dr. Weinmann says.

The study is being presented Saturday at the 54th Interscience Conference on Antimicrobial Agents and Chemotherapy in Washington D.C.

"As expected we got push-back from employees. But we always believed it was the right thing to do for patient and employee safety," says Dr. Weinmann, who leads the health system's immunization task force and was an early champion of the mandatory policy.

"The health and safety of our patients and employees is paramount, and requiring employees to receive vaccination every flu season will help reduce the spread of infection to our patients. We also were proactive in vaccinating hospitalized patients."

More than 9,600 people were hospitalized for the flu during the 2013-14 flu season, and 60 percent of them were between the ages 18-64, the CDC says. The CDC recommends vaccination for anyone six months and older.

For years, Henry Ford was like many health systems and hospitals requiring voluntary vaccination among employees. Between 2005 and 2010, its vaccination rate hovered between 41 percent and 55 percent, though the health system's goal was always 100 percent immunization.

For the 2010-11 flu season, Henry Ford made a shift in policy, requiring:

•Annual vaccination for employees in patient care areas.
•An opt-out measure allowed employees in patient care areas to forgo vaccination for wearing a mask.
•Vaccination was highly recommended, though not required, for employees in non-patient care areas.

Vaccination rates jumped to 84 percent and 87 percent between 2010-2012.

For the 2012-13 flu season, Henry Ford revised its policy once more, this time requiring annual vaccination for all employees. The result was a 99 percent vaccination rate. The Detroit-based Henry Ford has more than 23,000 employees.

An opt-out measure allows employees to decline vaccination for a medical or religious reason. These employees must complete a declination form, which requires their physician or religious leader to state the reason for forgoing vaccination and to sign their name.

Dr. Weinmann says the number of medical and religious declinations, coupled with employees who chose to leave their job in lieu of vaccination, accounted for less than 1 percent of its workforce.

"Our success is attributed to three factors: Our commitment to patient and employee safety, aggressive employee communication and education and making sure we have enough vaccine to accommodate everyone," Dr. Weinmann says. "We couldn't have made the strides we did without all three working together.

"A big hurdle was addressing the myths associated with the vaccine itself and reassuring employees this was all safety driven."