1870. The Impact of Mandatory vs. Non-Mandatory Vaccination Programs on Employee Sick Days During Three Consecutive Acute Respiratory Illness Seasons: Observations from the ResPECT Study
Session: Poster Abstract Session: Vaccines: Improving Immunization Uptake
Saturday, October 10, 2015
Room: Poster Hall
  • 2015 ID week poster v3.pdf (407.7 kB)
  • The impact of mandatory vs. non-mandatory vaccination programs on employee sick days during three consecutive acute respiratory illness seasons: observations from the ResPECT Study


    The Respiratory Protection Effectiveness Clinical Trial (ResPECT) evaluated the effectiveness of infection control measures for prevention of acute respiratory illness (ARI) in outpatient health-care personnel (HCP) during three ARI seasons from 2012-2015. 

    Mandatory vaccination policy (MVP) sites include Johns Hopkins University (JHU) in Baltimore, and Denver Health Medical Center (DH) and Children's Hospital Colorado (CHCO) in Denver. Veterans Administration (VA) sites include New York, Washington, Denver, and Houston. MVP sites require HCP influenza vaccination; VA sites encourage it but do not mandate it. As the impact of influenza vaccine mandates on ARI-related absenteeism in HCP is not well defined, we focused on its effect.


    A total of 4283 HCP enrolled in the study (56.6% MVP, 43.4% VA) over three ARI seasons.  Participants reported influenza vaccination status and symptomatic absenteeism (sick days due to ARI symptoms) weekly. Sick day ratio (SDR) was defined as symptomatic absenteeism days/# of participants. 


    Over three ARI seasons, MVP sites had significantly increased rates of influenza vaccination compared to VA sites (94.7% vs. 65.0%, t4.3 = 4.81, p < 0.007). MVP sites also had significantly lower mean SDR (0.50 vs. 1.33 sick days per HCP, t4.01 = -8.74, p < 0.0009) (Table 1). There was a statistically significant relationship between site type (MVP vs. VA) and SDR (p = .00002) (Figure 1). There was no effect of study year on the relationship between site type and SDR.


    Higher influenza vaccination rates at MVP sites were associated with lower HCP SDRs (Figure 1). The difference in SDRs for VA and MVP sites may also stem from other variables such as geographical region, patient/HCP population, and burden of disease. These findings warrant further investigation of the role of vaccine mandates and clinical outcomes in healthcare settings.

    Table 1: Self-reported vaccination rate vs. SDR



    MVP 1



    MVP 2



    MVP 3



    VA 1



    VA 2



    VA 3



    VA 4



    Avg. MVP



    Avg. VA



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

    John Frederick, BA1, Madeline Dansky, BA1, Alexandria C Brown, PhD2, Mary Bessesen, MD3, Derek Cummings, PhD4, Cynthia Gibert, MD, MSc, FIDSA5, Geoffrey Gorse, MD, FIDSA6, Ann-Christine Nyquist, MD, MSPH, FPIDS7, Trish M. Perl, MD, MSc, FIDSA, FSHEA8, Connie Price, MD9, Lewis Radonovich, MD10, Nicholas G. Reich, PhD11, Maria Rodriguez-Barradas, MD, FIDSA12, Michael S. Simberkoff, MD, FIDSA13 and ResPECT Study, (1)Research, VA New York Harbor Healthcare System, New York, NY, (2)University of Massachusets Amherst, Amherst, MA, (3)VA Eastern Colorado Healthcare System, Denver, CO, (4)Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, (5)Washington, DC, VAMC, Washington, DC, (6)VA St. Louis Healthcare System, St. Louis, MO, (7)University of Colorado, Denver, CO, (8)Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, (9)Infectious Diseases, Denver Health Medical Center, Denver, CO, (10)Department of Veterans Affairs Veterans Health Administration Office of Public Health, Gainesville, FL, (11)School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, (12)Section of Infectious Disease, Department of Medicine, Michael E. DeBakey VAMC, Houston, TX, (13)VA New York Harbor Healthcare System, New York, NY


    J. Frederick, None

    M. Dansky, None

    A. C. Brown, None

    M. Bessesen, None

    D. Cummings, None

    C. Gibert, None

    G. Gorse, None

    A. C. Nyquist, None

    T. M. Perl, None

    C. Price, None

    L. Radonovich, None

    N. G. Reich, None

    M. Rodriguez-Barradas, None

    M. S. Simberkoff, None

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