ANN ARBOR, MI—Multiple national recommendations encourage all healthcare workers to get the influenza vaccination, thereby reducing the chance they will pass the virus on to their patients.

Despite a patient population of older and sicker patients more likely to develop influenza complications, many VAMCs have a relatively low rate of employee vaccination, according to a recent report.

The study published in Infection Control and Hospital Epidemiology reports that, three years ago, more than half of hospitals surveyed didn’t require their medical staff to be vaccinated. The data was gathered by researchers from the University of Michigan Medical School and VA Ann Arbor, MI, Healthcare System who asked infection preventionists about their hospitals’ flu vaccine policies.1

Overall, 42.7% of respondents from 386 hospitals said universal flu vaccination was required, and about another 10% said it was being required for the first time during the next flu season.

At that time, the rate of required vaccinations at VAMCs was very low, 1.3%, but the VA has since encouraged its hospitals to work toward near-universal vaccination by the year 2020, which is in line with the recommendations set out for all healthcare workers by the U.S. Department of Health and Human Services.

“Vaccination of healthcare workers has been shown to significantly reduce patients’ risk of influenza and its complications, including pneumonia and death, compared with vaccination of patients alone,” said senior author Sanjay Saint, MD, MPH, chief of medicine at the Ann Arbor VAMC. “To put it bluntly, American hospitals have a lot of work to do.” Saint is the George Dock professor internal medicine at Michigan and chief of medicine at the Ann Arbor VAMC.

As of late December last year, 42% of paid VA employees had been documented as receiving flu vaccination, according to a report from the American Federation of Government Employees VA Council.

The report from the group’s president, Alma L. Lee, noted that the facilities with the largest percent of documented employee influenza vaccination, based on Occupational Health, VA Central Office information, were Sioux Falls 81%, Boise 81%, Albany 73%, Erie 71%, Wilmington 71%, Walla Walla 69%, St Cloud 65%, Fargo 64%, Amarillo 64%, Manchester 63%, Saginaw 63%, Iron Mountain 63%, Madison 63%, Salt Lake City 60%, West Texas 60%. The report stated that VISN 2 data could not be broken into individual facilities– except Albany and Syracuse.

The most recent data from the national Centers for Disease Control and Prevention, from early in the 2014-15 flu season, notes that vaccination coverage among healthcare personnel nationally was 64.3%, adding that flu vaccination coverage tends to increase by 9 to 12 percentage points from early season to the end of the season.

By occupation, early-season flu vaccination coverage was highest among pharmacists (86.7%), nurse practitioners/physician assistants (85.8%), physicians (82.2%), nurses (81.4%) and other clinical professionals (72.0%), according to the CDC.

About 15% of the non-VA infection prevention specialists surveyed said that opposition from healthcare worker unions or concerns about staff opposition was keeping their hospitals from requiring vaccination. At VA hospitals, meanwhile, the concern about union opposition was even higher, with 27.6% of respondents saying that was a factor in the lack of a flu vaccine requirement.

In addition, more than half of the 77 VA hospitals returning surveys said a vaccine could not be mandated because they were part of a federal system.

About a fifth of the hospitals saying the vaccine wasn’t mandated noted that unvaccinated staff had to sign a form saying they had declined, or wear a mask while seeing patients during flu season.

Saint pointed out that a 2015 survey from the national Centers for Disease Control and Prevention found that healthcare settings with mandatory vaccination for healthcare personnel achieved 96% vaccination coverage of their workers, compared to only 44% in settings that didn’t require or promote vaccination.

1 Greene MT, Fowler KE, Krein SL, Gaies E, Ratz D, Bradley SF, Saint S. Influenza Vaccination Requirements for Healthcare Personnel in U.S. Hospitals: Results of a National Survey. Infect Control Hosp Epidemiol. 2016 Apr;37(4):485-7. doi: 10.1017/ice.2015.277. PubMed PMID: 26996061.