135. The Impact of Mandatory vs. Non-Mandatory Vaccination Programs on Employee Sick Leave During Acute Respiratory Virus Season: Observations from the ResPECT Study
Session: Oral Abstract Session: Protecting Healthcare Personnel from Viral Respiratory Infections
Thursday, October 3, 2013: 11:42 AM
Room: The Moscone Center: 200-212

Background:

The Respiratory Protection Effectiveness Clinical Trial (ResPECT) evaluates the effectiveness of influenza vaccination, facial protective equipment (FPE), and hand hygiene (HH) for prevention of acute respiratory illness (ARI) in outpatient health-care personnel (HCP) during a 12 week peak period of ARI season. 

Private sites (PS) include Johns Hopkins University (JHU) in Baltimore, MD; Denver Health Medical Center (DH), and Children's Hospital Colorado (CHCO) in Denver, CO. Veterans Administration (VA) sites include New York, NY; Washington, DC; Denver, CO, and Houston, TX.  PS have a mandatory influenza vaccination policy; VA sites do not. As the impact of influenza vaccination on ARI absenteeism is not well defined, we focused on its effect.

 

Methods:

1077 HCP completed the study (64% PS, 36% VA).  Participants reported influenza vaccination and symptomatic absenteeism (sick days due to flu-like symptoms) weekly. Sick day ratio (SDR) was defined as symptomatic absenteeism / # of participants.  Trained observers recorded participant and non-participant HCP FPE and HH compliance during patient interaction.

 

Results:

PS had a higher mean influenza vaccination rate among HCP than VA sites (89% vs. 59%, p = <0.0001) and a lower mean SDR (0.53 vs. 0.95, p = 0.02, Figure 1).

HH compliance rates did not differ between VA and PS (33.1 % vs. 33.8 % respectively, p= 0.57).  VA HCP experienced more exposure to patients with ARI than PS HCP (11.1% vs. 6.7%, p = <0.0001). FPE compliance differed marginally between VA and PS during these respiratory illness exposures (23.7% vs. 19.8%, p= 0.09).

 

Conclusion:

It appears that higher influenza vaccination rates correlated with lower HCP SDRs. The difference in SDRs for VA and PS may also stem from other variables such as sick leave policy, geographical region, patient population, and burden of disease. For example, observed ARI exposure was higher for VA HCPs, potentially explaining their higher SDR. However, both HH and FPE compliance did not differ significantly between VA and PS, suggesting that vaccination rates may be a driving force behind reducing absenteeism. Given the ongoing debate over mandatory influenza vaccination policies, these findings warrant further investigation of their role.

Figure 1: Self-reported vaccination rate vs. SDR.

John Frederick, BA, Research, VA New York Harbor Healthcare System, New York, NY, Cynthia Akagbosu, MA, Research, New York Harbor Healthcare System-Manhattan VA, New York, NY, Mary Bessesen, MD, Infectious Diseases, University of Colorado Denver, Aurora, CO, Cynthia Gibert, MD, MSc, Washington, DC, VAMC, Washington, DC, Ann-Christine Nyquist, MD, MSPH, University of Colorado, Denver, CO, Trish M. Perl, MD, MSc, FIDSA, FSHEA, Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, Connie Price, MD, Denver Health Medical Center, Denver, CO, Lewis Radonovich, MD, University of Florida College of Medicine, Gainesville, FL, Nicholas G Reich, PhD, Biostatistics, Johns Hopkins University, Baltimore, MD, Maria Rodriguez-Barradas, MD, Medicine- Infectious Disease, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, TX, Michael Simberkoff, MD, VA NY Harbor Healthcare System, New York, NY and The ResPECT Study Team

Disclosures:

J. Frederick, None

C. Akagbosu, None

M. Bessesen, None

C. Gibert, None

A. C. Nyquist, None

T. M. Perl, None

C. Price, None

L. Radonovich, None

N. G. Reich, None

M. Rodriguez-Barradas, None

M. Simberkoff, None

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