520. Institutional requirements for influenza vaccination of healthcare personnel: results from a nationally representative survey of acute care hospitals—United States, 2011
Session: Poster Abstract Session: Influenza Vaccines
Friday, October 21, 2011
Room: Poster Hall B1

Although annual influenza vaccination has long been recommended for healthcare personnel (HCP), vaccination coverage remains suboptimal.  Many health professional organizations now endorse influenza vaccination as a condition of employment.  Our objective was to describe institutional requirements for influenza vaccination of HCP among US hospitals during the 2010-2011 influenza season. 


Survey mailed in 2011 to a nationally representative sample of 998 acute care hospitals.  An institutional requirement was defined as “a policy that requires HCP to receive or decline influenza vaccination, with or without consequences for vaccine refusal.”  A weighted analysis included univariate analyses and logistic regression.


Of responding hospitals (n=808, 81.0%), 440 (55.6%) reported institutional requirements for influenza vaccination.  While employees were uniformly subject to requirements, non-employees (53.3%), volunteers (60.4%) and students (48.9%) often were not.  The proportion of requirements with consequences for vaccine refusal was 44.4% (n=194); where consequences were imposed, nonmedical exemptions were often granted (69.3%). Wearing a mask was the most common consequence (74.2% of 194); by contrast, 29 (14.4%) terminated unvaccinated HCP.  After adjusting for region, bed size, urban location and Joint Commission accreditation, the following characteristics remained significantly associated with requirements: location in a state requiring HCP to receive or decline influenza vaccine (n=6 states) (OR=3.7), caring for inpatients who may be immunocompromised (e.g., transplant, chemotherapy) or too young to receive influenza vaccine (e.g., obstetrical, neonatal intensive care) (OR=1.7), utilization of ≥9 evidence-based influenza vaccination campaign strategies (OR=1.9) and for-profit ownership (OR=2.0).


This is the first study to estimate prevalence of institutional requirements for influenza vaccination using a nationally representative sample of US hospitals.  Although influenza vaccination requirements were prevalent among hospitals of varying size and location, few policies were as stringent or as comprehensive as those endorsed by health professional organizations. 

Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

Brady L. Miller, MPH, Faruque Ahmed, PhD, Megan C. Lindley, MPH and Pascale M. Wortley, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA


B. L. Miller, None

F. Ahmed, None

M. C. Lindley, None

P. M. Wortley, None

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