For HCW flu vaccine, make it free and easy
Strategies show increase in vaccine rates
If you want to raise the influenza vaccination rates of health care workers, make the vaccines free and convenient. Education helps, but a promotional campaign won’t be enough.
That is the conclusion from a comparison of vaccination strategies at California nursing homes, according to a report in the Mortality and Morbidity Weekly Report (MMWR) of the Centers for Disease Control and Prevention.1
The California Department of Health Services conducted a controlled study with 77 Southern California nursing homes in the 2002-2003 flu season. A previous study found problems with vaccine access and misconceptions about influenza vaccination. Public health authorities wanted to know the best way to improve vaccination rates.
Twenty-five nursing homes were in a control group, with no interventions. Fifteen offered an educational campaign only, 15 provided Vaccine Days with free influenza vaccination, and 15 provided both interventions.
The Vaccine Days combined with an educational campaign led to vaccination rates that were twice as high as the control group (53% vs. 27%). The Vaccine Days alone were also effective, with a vaccination rate of 45%. But the nursing homes with an educational campaign alone had a vaccination rate of 34%, which was not significantly higher than the control group.
Vaccines need to be convenient and free of charge, the MMWR authors concluded. "The study of Southern California nursing homes, the only controlled evaluation of efforts to influenza vaccination coverage among health care workers, suggests that publicity and educational messages about the importance of vaccination are only effective when combined with other approaches to increase coverage," they stated.
Other successful strategies outlined in MMWR:
• A mobile vaccination cart.
For two weeks in mid-October, an employee health nurse and two infection control nurses at the Minneapolis Veterans Affairs (VA) Medical Center visit all wards and departments with a mobile vaccination cart.
Employees also are vaccinated at walk-in clinics. With education and improved access, the VA Medical Center gradually increased vaccination rates. In 2003-2004, 65% of the center’s health care workers received the influenza vaccine.
• A Peer Vaccination Program.
In 2000-2001, the Mayo Clinic in Rochester, MN, added a Peer Vaccination Program (PVP) to its usual vaccination clinics. Nurses were able to vaccinate co-workers on all inpatient units. "The PVP eliminated the expense and logistical difficulty of establishing and staffing additional vaccination clinics and made vaccination more convenient for health care workers," according to the MMWR report.
Mayo added incentives, which vaccinated employees could receive from a drawing, and began offering the vaccine in departmental grand rounds. Vaccination has been promoted through newsletters, flyers, e-mails, and a telephone hotline. In the 2003-2004 season, 76.5% of the Mayo Clinic’s 26,261 employees received the vaccine.
Reference
1. Kimura AC, Higa JI, Nguyen C, et al. Interventions to increase influenza vaccination of health care workers — California and Minnesota. MMWR 2005; 54:196-199.
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