337. Impact of a Public Health Officer Order Mandating Health Care Personnel Vaccination in Los Angeles County
Session: Poster Abstract Session: HAI: Occupational Health
Thursday, October 8, 2015
Room: Poster Hall
  • IDSA Flu Project 2015.pdf (3.1 MB)
  • Background:  Influenza vaccination of healthcare personnel (HCP) decreases influenza-related morbidity and mortality. Higher HCP vaccination rates result from policies that include consequences for non-compliance.  In 2013, the Los Angeles County Department of Public Health (LACDPH) issued a Health Officer Order mandating HCP receive annual influenza vaccination or wear a mask. This study evaluates the impact of the order on HCP vaccination and associated factors, and explores its impact on hospital onset influenza (HOI) cases and HCP absenteeism.

    Methods:   HCP vaccination rates, information on facilities’ vaccine programs, HCP absenteeism, and HOI cases were obtained from the California Department of Public Health (CDPH), surveys of infection preventionists (IP), and facility human resource and lab databases for 2 seasons preceding (2011-12, 2012-13) and 1 season following the order (2013-14). Linear models were used to evaluate predictors of HCP vaccination rates and the impact of the LADPH order on these rates. Variables with p values ≤ 0.05 were included in final models. 

    Results:  Factors associated with HCP vaccination rates prior to the order were number of IPs, and having a policy requiring vaccination in multivariate models; and being a teaching facility in univariate analysis (p ≤0.02).  Rates increased from 69.8% and 73.6% before the order (seasons 1 and 2) to 85.2% (season 3) after. Facilities with the lowest pre-order rates had greater increases in rates following the order. Vaccination rates increased each season but the magnitude of change following the order (season 2 to 3) was significant compared to the change between seasons 1 and 2 (p < 0.0001). Final multivariate model determined the lack of a prior policy mandating vaccination was associated with greater increases in rates following the order (p<0.0001). HCP absenteeism was unchanged (6.3 days/person before and after order) based on data from 23 facilities, and percentage of HOIs (from total positive inpatient influenza tests) increased over 3 seasons (1.4%, 2.6% and 4.4%) based on unadjusted data from 20 facilities. 

    Conclusion: The 2013-2014 LACDPH Health Officer Order Mandating HCP Vaccination was successful in improving rates in LAC.  Initial analysis determined no observed impact on absenteeism or HOIs, but conclusions are limited by data heterogeneity and reporting.

    Allison Bearden, MD/MPH1, Jessica Silvaggio, MPH2, Dawn Terashita, MD, MPH2, Patricia Marquez, MPH2 and Laurene Mascola, MD, MPH2, (1)Pediatrics, Infectious Disease, University of Southern California, Los Angeles, CA, (2)Acute Communicable Disease Control Program, Los Angeles County Department of Public Health, Los Angeles, CA


    A. Bearden, None

    J. Silvaggio, None

    D. Terashita, None

    P. Marquez, None

    L. Mascola, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.