768. Institutional requirements for pertussis vaccination of healthcare personnel: results from a nationally representative survey of acute care hospitals—United States, 2011
Session: Oral Abstract Session: Pertussis Vaccines and Challenges
Friday, October 21, 2011: 4:00 PM
Room: 156ABC

In 2005, tetanus, diphtheria, and acellular pertussis vaccine (Tdap) was recommended for adults, including healthcare personnel (HCP).  Tdap vaccination coverage among US HCP was 17.0% in 2009.  Institutional Tdap requirements may improve vaccine uptake.  Our objective was to describe institutional requirements for Tdap vaccination of HCP, among US hospitals.          


Survey mailed in 2011 to a nationally representative sample of 998 acute care hospitals.  An institutional requirement was defined as “a policy that requires receipt or declination of Tdap vaccination, with or without consequences for vaccine refusal.” Weighted univariate analyses and logistic regression accounted for sample design and non-response. 


Of 808 responding hospitals (81.0%), 239 (30.9%) had institutional requirements for Tdap vaccination. Requirements often applied only to HCP with direct patient contact (43.2%); few applied to all HCP at an institution (10.8%).  Institutional Tdap requirements at hospitals providing infant care almost always included HCP working in neonatal intensive care units (NICU) (64/70, 91.7%), as well as labor/delivery (167/180, 93.1%) and postpartum (166/180, 92.6%) units.  Most requirements did not impose consequences for vaccine refusal (178/239, 74.4%).  After adjusting for demographic factors, the following hospital characteristics remained associated with having Tdap requirements: location in states with a legislative requirement for HCP to receive or decline Tdap (CA, RI; n=52) (OR=14.1, P<0.001), having an institutional requirement for influenza vaccination (OR=3.5, P<0.001) and having NICUs or obstetrical units (OR=1.7, P=0.02).  Accounting for location in states with comparatively high pertussis activity (e.g., reported cases, incidence) during 2006-2010 had no effect on parameter estimates.


Despite the absence of any known reports of such policies in the peer-reviewed literature, nearly one-third of sampled US hospitals have institutional Tdap requirements.  The higher-than-expected prevalence of Tdap requirements may be explained by increasing experience with influenza vaccination requirements and a desire to protect patients vulnerable to pertussis, such as infants.

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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