HHS: Track annual HCW flu vaccine
January 1, 2006 2 minutes read
HHS: Track annual HCW flu vaccine
ACIP calls for mandatory vaccine
If there is a deadly pandemic of avian influenza and a vaccine to prevent it, no one would question whether health care workers would be willing to be vaccinated. But what about flu vaccination when there is no pandemic?
The HHS Pandemic Influenza Plan promotes annual flu vaccination of health care workers but sidesteps the issue of whether they should be required to sign declination statements if they don't receive the vaccine. Instead, it suggests hospitals "ensure that a system is in place for documenting influenza vaccination of health care personnel."
Increasingly, pressure is being placed on hospitals to track health care workers who aren't vaccinated by requiring them to sign a declination statement.
In November, the Association of Professionals in Infection Control and Epidemiology (APIC) in Washington, DC, became the latest group to call for mandatory influenza vaccination of health care workers. It did not specifically address the use of declination statements and did not describe what a "mandatory" policy would entail.
"Each organization needs to be able to have the flexibility to enforce mandates in the way that works best for their organization," says APIC President Sue Sebazco, RN, CIC, who notes that hospitals have implemented some other mandatory immunizations, such as measles, mumps, and rubella.
But Sebazco stressed that health care worker flu vaccination rates are too low, leaving patients at risk. "We don't want our health care workers spreading the virus prior to the onset of their symptoms," she says.
Employee health departments can keep track of influenza vaccinations and improve vaccination rates without using declination statements, asserts Mark Russi, MD, MPH, associate professor of medicine and public health at the Yale University School of Medicine and director of occupational health at Yale-New Haven (CT) Hospital.
Russi uses an occupational health database to track influenza vaccinations, just as he tracks tuberculin skin tests. After the first phase of his influenza vaccination campaign, he targets specific departments with interventions.
"You can run a successful flu vaccine campaign without gathering declination statements on every individual," says Russi, who represents the American College of Occupational and Environmental Medicine (ACOEM) before the Healthcare Infection Control Practices Advisory Committee (HICPAC).
HICPAC recently endorsed declination statements as a tool to improve health care worker flu vaccination. ACOEM opposes them, noting that there is no evidence linking declination statements to higher vaccination rates. Yet "a coercive program has the potential to harm the employer-employee relationship," ACOEM said in a position statement.
The debate over health care worker compliance with flu vaccination could emerge in a new area when an H5N1 vaccine is approved. The HHS plan says that health care workers may be asked to receive a vaccine even if the virus hasn't shown sustained human-to-human transmission.
Health care worker unions oppose mandates, declination statements, and other policies that have punitive overtones. Education about influenza and the vaccine will be the best way to ensure health care worker vaccination, says Bill Borwegen, MPH, health and safety director of the Service Employees International Union.
If there is a deadly pandemic of avian influenza and a vaccine to prevent it, no one would question whether health care workers would be willing to be vaccinated.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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