Only 4% of VA Hospitals Require Flu Vaccines for Health Care Personnel

The overall rate of health care personnel receiving flu shots has gone up in recent years, but a new study finds that much of the increase is due to policies held at non-VA hospitals.

Influenza vaccination coverage rates among the general public still remain below target, but a new study has found that coverage among health care workers in the United States has gone up since more hospitals have made it a requirement.

Among the general population, flu vaccination rates have continued to lag below coverage goals set by public health officials. Based on early estimates on the 2017-2018 flu season released by the Centers for Disease Control and Prevention (CDC) in November 2017, fewer than 40% of both children and adults in the United States had received the seasonal flu vaccine. In addition, flu vaccination coverage among adults ages 18 to 49 years decreased by 3.7 percentage points compared with the same time the previous season. At the same time, early season flu vaccination coverage among health care personnel (HCP) was 67.6%, the rate rose by 10 to 12 percentage points over the course of each of the previous 2 flu seasons. Coverage was highest overall in hospital workers, followed by pharmacists, physicians, nurses, nurse practitioners, and other clinical personnel.

The CDC notes that HCP are particularly at risk of occupationally acquired flu, and passing the virus along to patients. Influenza infections can cause a serious health threat to adults aged 65 and older, especially those receiving long-term care for chronic medical conditions; preventing influenza among health care personnel can help reduce the spread of influenza in hospitals and care facilities. It’s recommended that caregivers with direct or indirect contact with older adults, individuals with disabilities, and those with chronic medical conditions receiving care receive a seasonal flu shot early in the season. A new study by researchers from the University of Michigan Medical School and Veterans Affairs (VA) Ann Arbor Healthcare System, recently published in JAMA Network Open, has found that while almost 70% of non-VA hospitals now require that caregivers receive the flu vaccine or wear a mask during flu season, only 4% of VA hospitals have the same requirements.

According to national surveys conducted from 2013 to 2017 for the study, the overall percentage of hospitals requiring flu vaccination rose from 37.1% to 61.4% and was driven largely by non-VA hospitals. While flu vaccination requirement policies for non-VA hospitals rose from 44.3% to 69.4% during the study period, VA hospitals only saw the rate increase from 1.3% to 4.1%. Of hospitals with mandatory flu vaccination policies, 96.2% allowed HCP to decline vaccination for medical contraindications, 78% allowed HCP to decline vaccination for religious reasons, and 12.8% did not require a reason. Unvaccinated HCP in hospitals with mandatory flu vaccination policies were required to wear a mask in more than 80% of those while caring for patients during flu season.

“In just four years, the non-VA hospitals have really stepped up on requiring the vaccine, rather than just encouraging it,” said lead author Todd Greene, PhD, MPH, in a recent statement. “Studies have shown that vaccination mandates, coupled with an option of declining vaccination in favor of wearing a mask, are most effective in reaching high percentages of vaccination.” The authors of an editorial comment to the study noted that the surveys conducted in 2013 and 2017 were worded differently and that the hospitals responding in 2017 were not the same as those that responded to the initial survey.

For the 2016-2017 flu season, the CDC notes that 78.6% of HCP responding to a survey reported receiving the flu vaccine. The CDC’s Healthy People 2020 initiative has set a goal of 90% or greater flu vaccination rates among HCP.