Influenza Vaccination of Health-care Personnel: An Initiative to Improve a Serious Public Health Problem

Anand Parekh, MD, MPH
Office of Public Health and Science
Department of Health and Human Services

September 10, 2008

Influenza causes frequent and serious illnesses in the United States
Influenza vaccine is underutilized, including by health care personnel
There are proven, recommended strategies available to improve vaccination rates
HHS has begun an initiative to reach the Healthy People 2010 objective for health care personnel of 60% vaccination

MMWR 2006;55 (RR-2). February 24, 2006.

*Hofman F, Ferracin C, Marsh G, Dumas R. Infection 2005;34:142-147

Offer influenza vaccine annually
Educate HCP regarding the benefits of influenza vaccination and the potential health consequences of influenza illness
Provide influenza vaccination to HCP at the work site and at no cost
Monitor HCP influenza vaccination coverage and declination; provide feedback to staff and administration
Obtain a signed declination from HCP who decline influenza vaccination
Use the level of HCP influenza vaccination coverage as one measure of a patient safety quality program

American College of Physicians (ACP)³
- October 2007 - Recommendation that annual influenza vaccine should be required for every health care worker with direct patient care activities.
Infectious Diseases Society of America (IDSA)²
- January 2007- Recommendation that U.S. adopt policy to include mandatory annual influenza vaccination among healthcare workers
Joint Commission on Accreditation of Healthcare Organizations (JCAHO)¹
- New standard, effective 1/1/07: Influenza immunization offered to staff and licensed independent practitioners.
National Foundation for Infectious Diseases (NFID)⁴
- Call to Action recommendations and Best Practices for immunizing health care personnel against influenza

¹http://www.jcrinc.com/26813/newsletters/12882/, accessed 11/11/07;
²Pandemic and Seasonal Influenza Principles for U.S. Action, January 2007;
³http://www.acponline.org/college/pressroom/hcw.htm, accessed 11/13/07;
⁴http://www.nfid.org, accessed 05/15/08.

Successful HCP vaccination programs are multifaceted and combine:
- Education campaigns
- Role models
- Improved access
- Measurement and feedback

Two components
Improving HHS health care employee influenza vaccination, with focus on
- Federal Occupational Health
- Indian Health Service
- U.S. Public Health Service Commissioned Officers
- NIH Clinical Center
- CDC
Promoting influenza vaccination to non-federal health care organizations and HCP

HHS will also promote Influenza Vaccination of Health Care Personnel (HCP) nationwide

Healthy People 2010 target: 60% of all HHS HCP will be vaccinated annually By 2010

HHS plans to partner with many other organizations to promote HCP influenza vaccination

Potential Partners include:

Target specific HCP groups in initial phase
Identify critical partners based on impact and access – narrower scope
Meetings scheduled with the various groups
- Long term care
- HCP unions
- Health professions’ schools’ representatives
- Multiple organizations Sept 10, 2008

ASH will offer to co-sign letters to membership of interested HCP organizations
HHS staff are available to either present at upcoming national or regional association meetings or to identify other potential briefers
Write articles for organization newsletters and/or journals
Promote use of HHS toolkit