Mandatory Vaccine Program Lowers Provider Sick Days

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SAN FRANCISCO — A mandatory vaccine program could attenuate at least some of the effect of acute respiratory infection (ARI) exposures among providers, according to a report from the Respiratory Protection Effectiveness Clinical Trial (ResPECT).

ResPECT is an ongoing cluster randomized trial being conducted at 99 outpatient departments and emergency departments in seven locations across the United States. The current analyses are based on data collected during 12 weeks of the 2011-12 and 2012-13 respiratory illness seasons.

In a presentation at IDWeek 2013, John Frederick of New York Harbor Healthcare System in New York noted that, of 1,077 healthcare providers included in that analysis, 64% were from private sites with mandatory vaccine policies and 36% were from VA and private sites without mandatory vaccine policies. 1

Private sites include Johns Hopkins University in Baltimore, MD; Denver Health Medical Center and Children’s Hospital Colorado in Denver. VA sites include New York, Washington, Denver and Houston.

Those from sites with mandatory vaccination had significantly higher mean influenza vaccination rates — 88% vs. 59% — and a lower mean sick day ratio, defined as symptomatic absenteeism/number of participants — 0.56 vs. 0.90.

The differences weren’t explained by some other common factors, Frederick pointed out. Hand hygiene compliance rates did not differ significantly between the private site and VA site participants, 33.1% vs. 33.8%, respectively, and only marginal differences were noted in facial protective equipment compliance during respiratory illness exposures, 24.7% vs. 19.8%. VA site subjects had a significantly greater exposure rate that others, 11.1% vs. 6.7%.

“So this would suggest that, even in the face of increased influenza rates — an increased burden of disease — increased vaccination rates can actually provide a protective effect to health care personnel, and vaccination rates may very well be the driving differential force,” Frederick said.

Study authors called for additional studies looking at the influence of other factors, such as sick leave policies.

IDWeek is the combined annual meetings of the Infectious Diseases Society of America, the Society for Healthcare Epidemiology of America, the HIV Medicine Association and the Pediatric Infectious Diseases Society.

1 Frederick J, et al. The Impact of Mandatory vs. Non-Mandatory Vaccination Programs on Employee Sick Leave During Acute Respiratory Virus Season: Observations from the ResPECT Study. IDWeek 2013; Abstract 135

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