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Less Than Half of U.S. Hospitals Require Flu Shots for Staff––Despite Risk to Patients

Survey of infection-prevention specialists shows room for improvement

Within weeks, influenza infections will start spreading across North America. Multiple national recommendations urge all health care workers to get a flu vaccination to reduce the chances they will pass the virus on to their patients. But a new study finds that more than half of hospitals still don’t require their doctors, nurses, and other health care providers to get vaccinated against the flu –– despite the fact that they are in contact with the people who are most vulnerable to flu every day.

In a paper published in Infection Control and Hospital Epidemiology, researchers at the University of Michigan Medical School and the Veterans Administration (VA) Ann Arbor Healthcare System report the results of a survey that they conducted in 2013.

They asked infection-prevention specialists what their hospitals’ flu vaccine policies were and why.

Only 43% of those who responded from 386 hospitals said their hospital required flu vaccination of all health care providers. About 10% more said their hospital would require vaccinations for the following flu season.

The rate of flu vaccinations at VA hospitals was very low: 1.3%. Since the time of the survey, the VA system has encouraged its hospitals to work toward near-universal vaccination by the year 2020. That’s in line with recommendations issued for all health care workers by the Department of Health and Human Services.

About 15% of the non-VA infection-prevention specialists surveyed said that opposition from health care workers’ unions or concerns about staff opposition was keeping their hospitals from requiring vaccinations. The concern about union opposition was higher at the VA hospitals, where 28% of infection-control staff surveyed said this was a factor in the lack of a flu vaccine requirement.

Another factor appeared to be variations in the willingness of hospital administrators to implement a vaccination requirement. About 22% of those surveyed said that their hospital administration would not mandate the vaccine.

Another 22% of the non-VA hospitals said their providers were “strongly encouraged” to get vaccinated against the flu. For more than half of the 77 VA hospitals that returned surveys, infection-prevention staff said that they could not mandate the vaccine because they were part of a federal system.

Just over 21% of those surveyed said that vaccinations weren’t mandated at their hospitals, but that unvaccinated staff had to sign a form saying they had declined to get vaccinated, or they had to wear a mask while seeing patients during flu season.

A survey conducted by the Centers for Disease Control & Prevention (CDC) in 2015 showed that health care settings with mandatory vaccination for health care personnel achieved 96% vaccination coverage of their workers, compared with only 44% coverage in settings that didn’t require or promote vaccination. Because of this, the CDC recommends annual influenza vaccination for all health care personnel who provide direct patient care.

Source: University of Michigan Health System; December 8, 2015.

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