522. Increases in vaccination coverage of healthcare personnel following institutional requirements for influenza vaccination: a national survey of US hospitals
Session: Poster Abstract Session: Influenza Vaccines
Friday, October 21, 2011
Room: Poster Hall B1
Background: 

Institutional requirements for influenza vaccination, ranging from policies that mandate declinations to those terminating unvaccinated healthcare personnel (HCP), are increasingly common in the US.  Our objective was to determine HCP vaccine uptake following institutional requirements for influenza vaccination, among US hospitals.   

Methods: 

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 influenza vaccination, with or without consequences for vaccine refusal.”  Respondents reported institutional-level, seasonal influenza vaccination coverage, if known, during two consecutive influenza seasons (season prior to [ie, pre-requirement], and first season of requirement [ie, post-requirement]).  Weighted univariate analyses accounted for sampling design and non-response. 

Results: 

808 (81.0%) hospitals responded.  Of 440 institutions reporting requirements for influenza vaccination, 244 (55.5%) reported identically-calculated, pre- and post-requirement vaccination rates, comprising the analytic sample. The analytic sample and excluded hospitals (n=196) were distributed similarly on demographic factors such as bed size, ownership, urban location, and teaching status; however, hospitals in the South were less likely to be excluded (P=0.04).  Median reported influenza vaccination coverage during pre- and post-requirement influenza seasons was 61.3% and 76.0%, respectively.  Overall, the median percentage point increase in coverage following an influenza vaccination requirement was 11.4 (95% CI: 9.6,13.2), and was significantly greater among hospitals 1) with consequences for vaccine refusal (15.8 vs. 7.0, P<0.001) and 2) reporting lower pre-requirement influenza vaccination coverage.  Aside from location in urban settings (13.4 vs. 9.6, P=0.01), increases in vaccine uptake did not significantly differ by demographic factors.              

Conclusion: 

Measurable increases in influenza vaccination uptake among HCP are likely to follow institutional requirements. Hospitals with low vaccination coverage and those implementing consequences for vaccine refusal may see the greatest gains.      


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

Disclosures:

B. L. Miller, None

F. Ahmed, None

M. C. Lindley, None

P. M. Wortley, None

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