BACKGROUND: The Centers for Disease Control and Prevention (CDC), the Advisory Committee on Immunization Practices, and the Healthcare Infection Control Practices Advisory Committee recommend that all U.S. healthcare personnel get vaccinated annually against influenza. Influenza (flu) is a common and serious disease that can lead to hospitalization and death. Healthcare worker vaccination is especially important because it has been shown to reduce nosocomial transmission of influenza to hospitalized patients at highest risk of adverse outcomes. The Arkansas Department of Health (ADH) has data from approximately 53 acute care healthcare facilities on employee flu vaccination coverage as well as policies and strategies since the 2012-13 flu season. Policy makers could benefit from learning what facility/employee characteristics and policies are associated with higher vaccination coverage.
METHODS: All data were obtained from survey and summary information collected in the CDC’s National Healthcare Safety Network (NHSN). SAS (Version 9.3, Cary, NC, USA) was used to determine the mean percentage vaccinated among employees and all healthcare personnel (employees, licensed independent practitioners, and student volunteers) stratified by flu season, facility bed size, region of the state, and strategies implemented. Additionally, Pearson correlation coefficients were used to determine which variables were significantly associated with higher vaccination coverage.
RESULTS: Averaging the three flu seasons (2012-13, 2013-14, and 2014-15), facilities with a bed capacity of 201-800 had the highest mean percentage of all healthcare personnel vaccinated for the flu (79%). Conversely, facilities with a capacity of ≤25 beds had the highest mean percentage of employees vaccinated (87%). Facilities in the Central Region of Arkansas had the highest mean percentage of employees (86%) and all personnel (79%) vaccinated. Higher vaccination coverage for employees was associated with requiring receipt of vaccination for credentialing and condition of employment, tracking vaccination on a regular basis for targeting purposes, and providing vaccination at any meetings. Requiring receipt of vaccination as a condition of employment was associated with higher vaccination coverage among all healthcare personnel. In contrast, sending vaccination reminders by mail, email, and/or pager was correlated with lower coverage for employees and all personnel.
CONCLUSIONS: Certain strategies and policies implemented by healthcare facilities were shown to influence the number of healthcare personnel receiving flu vaccination. The counter intuitive response observed with reminder recall systems needs to be further explored. These results will assist ADH in writing a brief publication encouraging all healthcare personnel around the state to get vaccinated for the flu each year.