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Impact of mandatory vaccination of healthcare personnel on rates of influenza and other viral respiratory pathogens

Published online by Cambridge University Press:  05 August 2021

Michael S. Simberkoff*
Affiliation:
Veterans’ Affairs (VA) New York Harbor Healthcare System and NYU Grossman School of Medicine, New York, New York
Susan M. Rattigan
Affiliation:
University of Florida, Gainesville, Florida
Charlotte A. Gaydos
Affiliation:
Johns Hopkins University School of Medicine, Baltimore, Maryland
Cynthia L. Gibert
Affiliation:
Veterans’ Affairs Medical Center, Washington, DC
Geoffrey J. Gorse
Affiliation:
VA St Louis Health Care SystemSt Louis, Missouri Saint Louis University School of Medicine, St. Louis, Missouri
Ann-Christine Nyquist
Affiliation:
Children’s Hospital Colorado, Aurora, Colorado University of Colorado School of Medicine, Aurora, Colorado
Connie S. Price
Affiliation:
University of Colorado School of Medicine, Aurora, Colorado Denver Health and Hospital, Aurora, Colorado
Nicholas Reich
Affiliation:
University of Massachusetts, Amherst, Massachusetts
Maria C. Rodriguez-Barradas
Affiliation:
Michael E. DeBakey VA Medical Center, Houston, Texas Baylor College of Medicine, Houston, Texas
Mary Bessesen
Affiliation:
University of Colorado School of Medicine, Aurora, Colorado VA-Eastern Colorado Healthcare System, Denver, Colorado
Alexandria Brown
Affiliation:
University of Massachusetts, Amherst, Massachusetts
Derek A.T. Cummings
Affiliation:
University of Florida, Gainesville, Florida
Lewis J. Radonovich Jr.
Affiliation:
Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Pittsburgh, Pennsylvania
Trish M. Perl
Affiliation:
Johns Hopkins University School of Medicine, Baltimore, Maryland University of Texas Southwestern Medical Center, Dallas, Texas
*
Author for correspondence: Michael S. Simberkoff, E-mail: [email protected]

Abstract

Objective:

The implementation of mandatory influenza vaccination policies among healthcare personnel (HCP) is controversial. Thus, we examined the affect of mandatory influenza vaccination policies among HCP working in outpatient settings.

Setting:

Four Veterans’ Affairs (VA) health systems and three non-VA medical centers.

Methods:

We analyzed rates of influenza and other viral causes of respiratory infections among HCP working in outpatient sites at 4 VA health systems without mandatory influenza vaccination policies and 3 non-VA health systems with mandatory influenza vaccination policies.

Results:

Influenza vaccination was associated with a decreased risk of influenza (odds ratio, 0.17; 95% confidence interval [CI], 0.13–0.22) but an increased risk of other respiratory viral infections (incidence rate ratio, 1.26; 95% CI, 1.02–1.57).

Conclusions:

Our fitted regression models suggest that if influenza vaccination rates in clinics where vaccination was not mandated had equalled those where vaccine was mandated, HCP influenza infections would have been reduced by 52.1% (95% CI, 51.3%–53.0%). These observations, their possible causes, and additional strategies to reduce influenza and other viral respiratory illnesses among HCP working in ambulatory clinics warrant further investigation.

Type
Original Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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Footnotes

a

The ResPECT Team: The Johns Hopkins University (Baltimore, MD): Trish Perl, MD, MSc; Justin Getka, BA; Tina Hoang, MS; Rose Kajih, PharmD; Amanda Krosche, BS; Meghan Kubala, MS, MD; Jenna Los, MLA; Liandra Presser, MD; Kathleen Pulice, MS; Margaret Spach, DDS. VA New York Harbor Healthcare System (New York, NY): Michael S. Simberkoff, MD; Cynthia Akagbosu, BA, MA; Madeline Dansky, BA; Benedict J. Frederick, BA; Marilyn Last, RN; Scott Laverie, RN; Courtney Pike, BA; Shefali Rikhi, BS; Nicole Spector, RN; Christine A. Reel-Brander, RN. Denver Health & Hospital Authority (Denver, CO): Connie Price, MD; Katie Gorman, BS; Amy Irwin, DNP, RN; Sean O’Malley; Kevin Silva, BS. UT Southwestern Medical Center (Dallas, TX): Trish M. Perl, MD, MSc; Deepa Raj, MPH. VA Eastern Colorado Healthcare System (Denver, CO): Mary Bessesen, MD; Jill C. Adams, BSN, BA; Shannon Kingery, BS; Stefanie Tuder, BS; Erron Fruchter-Palmer, MPH. Children’s Hospital Colorado (Denver, CO): Ann-Christine Nyquist, MD, MSPH; Megan Brocato, BA. VA Washington DC Medical Center (Washington, DC): Cynthia Gibert, MD, MSc; Laura Chopko, BA; Kathy Haines, MSW, MPH; Caitlin Langhorne, MPH; Dana Silver, BA; Courtney Southard, MPH. VA Michael C. DeBakey Medical Center (Houston, TX): Maria C. Rodriguez-Barradas, MD; Barbara Kertz, MS; Mahwish Mushtaq, MD, MPH; Blanca Vargas, MD. Centers for Disease Control and Prevention, National Institute for Occupational Safety & Health (Pittsburgh, PA): Edward Fisher, MS; Ronald Shaffer, PhD; Lewis J. Radonovich, MD. Veterans’ Health Administration Office of Public Health (Gainesville, FL): Aaron Eagan, MPH, RN. HandyMetrics Corporation (Toronto, Ontario, Canada): Melanie Lipka, BS; Michael Tsang, PhD. Laboratory Core at Johns Hopkins University (Baltimore, MD): Charlotte Gaydos, DrPH, Jeffrey Holden, MA; Alexandra Valsamakis, MD, PhD. Laboratory Core at VA St. Louis Health Care System and St. Louis University School of Medicine (St. Louis, MO): Geoffrey J. Gorse, MD; Michelle Mitchell, BS; Gira B. Patel, MS; Yinyi Yu, BS, Tamara Blevins, MS. REDCap Core at Johns Hopkins University (Baltimore, MD): Andre Hackman, BA, Michael Sherman, BS. Statistical and Epidemiologic Core (University of Florida, Gainesville, FL):

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