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Expanding mandatory healthcare personnel immunization beyond influenza: Impact of a broad immunization program with enhanced accountability

Published online by Cambridge University Press:  10 November 2020

Thomas R. Talbot*
Affiliation:
Departments of Medicine, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee Quality, Safety, and Risk Prevention, Vanderbilt University Medical Center, Nashville, Tennessee
Ruth Schimmel
Affiliation:
Quality, Safety, and Risk Prevention, Vanderbilt University Medical Center, Nashville, Tennessee
Melanie D. Swift
Affiliation:
Departments of Medicine, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee Occupational Health Clinic, Vanderbilt University Medical Center, Nashville, Tennessee
Lori A. Rolando
Affiliation:
Departments of Medicine, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee Occupational Health Clinic, Vanderbilt University Medical Center, Nashville, Tennessee
Rochelle T. Johnson
Affiliation:
Human Resources, Vanderbilt University Medical Center, Nashville, Tennessee
Jannis Muscato
Affiliation:
Human Resources, Vanderbilt University Medical Center, Nashville, Tennessee
Paul Sternberg
Affiliation:
Department of Ophthalmology, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee Hospital Administration, Vanderbilt University Medical Center, Nashville, Tennessee
Marilyn Dubree
Affiliation:
Hospital Administration, Vanderbilt University Medical Center, Nashville, Tennessee
Paula W. McGown
Affiliation:
Occupational Health Clinic, Vanderbilt University Medical Center, Nashville, Tennessee Faculty/Staff Health and Wellness, Vanderbilt University Medical Center, Nashville, Tennessee
Mary I. Yarbrough
Affiliation:
Departments of Medicine, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee Occupational Health Clinic, Vanderbilt University Medical Center, Nashville, Tennessee Faculty/Staff Health and Wellness, Vanderbilt University Medical Center, Nashville, Tennessee
Gerald B. Hickson
Affiliation:
Department of Pediatrics, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee Quality, Safety, and Risk Prevention, Vanderbilt University Medical Center, Nashville, Tennessee The Center for Patient and Professional Advocacy, Vanderbilt University Medical Center, Nashville, Tennessee (Present affiliation: Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, Minnesota [M.S.])
*
Author for correspondence: Thomas R. Talbot. E-mail: [email protected]

Abstract

Objective:

Evaluation of a mandatory immunization program to increase and sustain high immunization coverage for healthcare personnel (HCP).

Design:

Descriptive study with before-and-after analysis.

Setting:

Tertiary-care academic medical center.

Participants:

Medical center HCP.

Methods:

A comprehensive mandatory immunization initiative was implemented in 2 phases, starting in July 2014. Key facets of the initiative included a formalized exemption review process, incorporation into institutional quality goals, data feedback, and accountability to support compliance.

Results:

Both immunization and overall compliance rates with targeted immunizations increased significantly in the years after the implementation period. The influenza immunization rate increased from 80% the year prior to the initiative to >97% for the 3 subsequent influenza seasons (P < .0001). Mumps, measles and varicella vaccination compliance increased from 94% in January 2014 to >99% by January 2017, rubella vaccination compliance increased from 93% to 99.5%, and hepatitis B vaccination compliance from 95% to 99% (P < .0001 for all comparisons). An associated positive effect on TB testing compliance, which was not included in the mandatory program, was also noted; it increased from 76% to 92% over the same period (P < .0001).

Conclusions:

Thoughtful, step-wise implementation of a mandatory immunization program linked to professional accountability can be successful in increasing immunization rates as well as overall compliance with policy requirements to cover all recommended HCP immunizations.

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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References

Black, CL, Yue, X, Ball, SW, et al. Influenza vaccination coverage among healthcare personnel—United States, 2017–18 influenza season. Morb Mortal Wkly Rep 2018;67:10501054.CrossRefGoogle Scholar
Centers for Disease C, Prevention. Influenza vaccination coverage among health-care personnel—United States, 2012–13 influenza season. Morb Mortal Wkly Rep 2013;62:781786.Google Scholar
Immunization action coalition. Honor roll for patient safety mandatory influenza vaccination for healthcare workers. Immunize.org website. http://Www.Immunize.Org/Honor-Roll/. Accessed April 11, 2019.Google Scholar
Wicker, S, Poland, GA. Measles vaccination in health care personnel: mandates, ethics, and patient safety. Vaccine 2012;30:44074408.CrossRefGoogle Scholar
Mandatory immunization of healthcare personnel against influenza and other infectious diseases. Infectious Diseases Society of America website. http://www.idsociety.org/hcw_policy/. Accessed April 11, 2019.Google Scholar
American Nurses Association makes new recommendation that all nurses should be immunized against vaccine-preventable diseases. Nursing World website. http://www.nursingworld.org/mainmenucategories/policy-advocacy/positions-and-resolutions/anapositionstatements/position-statements-alphabetically/immunizations.html. Published August 20, 2020. Accessed January 3, 2019.Google Scholar
It’s official: VUMC holds Guinness world record for most vaccinationss. Vanderbilt University website. https://news.Vanderbilt.edu/2011/12/01/guinness-vaccination-record-officia/. Published December 1, 2011. Accessed April 11, 2019.Google Scholar
Swift, MD, Aliyu, MH, Byrne, DW, et al. Emergency preparedness in the workplace: the flulapalooza model for mass vaccination. Am J Public Health 2017;107:S168S176.CrossRefGoogle ScholarPubMed
About healthcare associated infections (HAI). Tennessee Department of Health website. https://www.tn.gov/health/cedep/hai.html. Accessed April 11, 2019.Google Scholar
Zipprich, J, Winter, K, Hacker, J, et al. Measles outbreak—California, December 2014–February 2015. MMWR Morb Mortal Wkly Rep 2015;64:153154.Google ScholarPubMed
Hickson, GB, Moore, IN, Pichert, JW, Benegas, M. Balancing systems and individual accountability in a safety culture. In: The Joint Commission Resources, ed. From Front Office to Front Line: Essential Issues for Health Care Leaders, 2nd ed. Oakbrook Terrace, IL: The Joint Commission; 2012:1–35.Google Scholar
Surveillance for healthcare personnel vaccination. Centers for Diesase Control and Prevention website. www.cdc.gov/nhsn/Acute-Care-Hospital/HCP-vaccination/index.html. Accessed on June 3, 2020Google Scholar
Williams, WW, Lu, PJ, O’Halloran, A, et al. Surveillance of vaccination coverage among adult populations—United States, 2015. MMWR Surveill Summ 2017;66:128.Google Scholar
O’Halloran, AC, Lu, PJ, Meyer, SA, et al. Tdap vaccination among healthcare personnel—21 states, 2013. Am J Prev Med 2018;54:119123.Google Scholar
Babcock, HM, Gemeinhart, N, Jones, M, Dunagan, WC, Woeltje, KF. Mandatory influenza vaccination of health care workers: translating policy to practice. Clin Infect Dis 2010;50:459464.CrossRefGoogle ScholarPubMed
Talbot, TR, Johnson, JG, Fergus, C, et al. Sustained improvement in hand hygiene adherence: utilizing shared accountability and financial incentives. Infect Control Hosp Epidemiol 2013;34:11291136.CrossRefGoogle ScholarPubMed