Increasing healthcare workers’ vaccination rates significantly above the 77% average achieved in 2009 will take a coordinated effort. “Two actions will make a significant difference in reaching the 85% goal this flu season,” Martinello said. “First, leadership at every facility must recognize that vaccinating healthcare workers is a high priority for the VA and communicate that throughout the organization, so the message rises above the competition.” Facility leaders can demonstrate the importance of vaccination by ensuring that directors, service chiefs, chief residents and other managers get their vaccines and personally encourage their staffs to follow their example.

“Second, facility leadership must devote sufficient resources to make the vaccine easily accessible. That means making as many people available as possible to conduct vaccinations of healthcare workers, ensuring sufficient vaccine is on hand, providing space for vaccinations, and allocating mobile carts to take vaccines to people,” he added. Offering FluMist and intradermal vaccine, when appropriate, may also increase vaccination rates.

Nurses on transitional duty and nursing students can supplement regular employees to extend occupational health clinic hours, increase locations where vaccinations are available, and staff mobile vaccine carts.

Documentation Critical

To avoid underreporting of vaccination rates, the VA’s “Infection: Don’t Pass It On” team strongly encourages facilities to train all employees responsible for documentation on the proper procedures for entering data in the OHRS, as outlined in the VA Influenza Manual 2011-2012. Facilities also might consider distributing postcards to enable identification of workers who received their vaccinations elsewhere. Tracking who has been vaccinated in OHRS allows influenza vaccine campaign coordinators to send reminders to those who still need vaccination. Surveying stragglers also helps campaign planners develop effective materials to allay concerns or address misconceptions healthcare personnel might have about the flu vaccine.

While it might seem late in the season to focus on vaccination rates, Nichol pointed out that 60% of flu seasons do not peak until February. Influenza remains prevalent in many communities through March in most years, and CDC data shows that about 15% of flu seasons have their peak activity in March or later. Most recently, the first wave of the 2009 H1N1 pandemic occurred from mid-April to early May.

In addition to the health concerns, workdays lost by HCWs who contract influenza can be costly. The authors of the Disaster Medicine study estimate that economic burden of sick days taken by VA healthcare workers who contracted influenza during the second wave of the 2009 pandemic exceeded $20 million during a six-week period.

CDC recommends that all healthcare workers receive annual influenza vaccination to prevent transmission and avoid disruption of services. The U.S. Public Health Service’s Healthy People 20220 sets a minimum coverage rate of 90% among healthcare workers. Despite these recommendations, their national vaccination rates remain below 65%.

Influenza Vaccination Compared with National Vaccination Rates

• Not all facilities documented seasonal influenza vaccinations in OHRS.

Chart from 2011-2012 VA Influenza Manual

Sutdy in Disaster Medicine

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