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Use of a comprehensive program to review religious and personal seasonal influenza vaccination exemption requests by healthcare personnel

Published online by Cambridge University Press:  29 October 2020

Benjamin C. Boone
Affiliation:
Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
Rochelle T. Johnson
Affiliation:
Department of Human Resources, Vanderbilt University Medical Center, Nashville, Tennessee
Lori A. Rolando
Affiliation:
Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
Thomas R. Talbot*
Affiliation:
Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
*
Author for correspondence: Thomas R. Talbot, E-mail: [email protected]

Abstract

Objective:

Vanderbilt University Medical Center (VUMC) requires that all faculty and staff receive the seasonal influenza vaccine annually or receive an approved vaccine exemption, either for a medical or deeply held religious or personal belief. We sought to understand the underlying principles behind these exemption requests and their interaction with a multidisciplinary exemption review process.

Design:

All of the personal and religious exemption requests at VUMC for 3 consecutive influenza seasons from 2015 to 2018 were analyzed, categorizing these requests by 1 of 12 standardized employee categories and 1 of 18 unique reasons for vaccine exemption.

Setting:

Tertiary-care academic medical center.

Participants:

Healthcare personnel (HCP).

Results:

Among the 3 influenza seasons, 1.1%–2.1% of all VUMC HCP requested religious or personal exemption from vaccination. The frequency of religious and personal exemption approval increased annually from 296 of 452 (65.5%) to 196 of 248 (80.2%) to 283 of 323 (87.6%) over the 3 seasons, representing a statistically significant increase each year. Of the 5 most common reasons against vaccination, 4 were explicitly religious in nature; the most common reason was that the “body is a temple or sacred.” Nonclinical staff submitted the most religious and personal exemption requests of any job category, submitting approximately one-third of all requests every year.

Conclusions:

These results demonstrate how detailed the personal or religious convictions behind vaccine avoidance can be among HCP and how vaccine avoidance stems from much more than simple misinformation regarding vaccination. The intersection between misinformation and personal or religious beliefs provides a unique opportunity to address HCP opinions toward vaccination in an exemption and appeals process like the one described here.

Type
Original Article
Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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