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Influenza Vaccination HCP Honor Roll

Influenza Vaccination Honor Roll

Mandatory Influenza Vaccination for Healthcare Personnel

IAC is recognizing the stellar examples of influenza vaccination mandates in healthcare settings. The best way to prevent transmission of influenza to our patients is to mandate vaccination of healthcare personnel. The Influenza Vaccination Honor Roll represents the champions who have taken the lead in mandating influenza vaccination within their organization or institution. To be included in this honor roll, your organization's mandate must require influenza vaccination for employees and must include serious measures to prevent transmission of influenza from unvaccinated workers to patients. Such measures might include a mask requirement, reassignment to non-patient-care duties, or dismissal of the employee.
Position Statements
Leaders in medicine and infectious diseases have spoken: Mandatory influenza vaccination for all healthcare personnel is imperative! Refer to the position statements of these leading medical organizations to guide you in developing and implementing a mandatory influenza vaccination policy at your healthcare institution or medical setting.
American Academy of Family Physicians (AAFP) Mandatory Influenza Vaccination of Health Care Personnel (HCP)
The AAFP supports annual mandatory influenza immunization for health care personnel (HCP) except for religious or medical reasons (not personal preferences). If HCP are not vaccinated, policies to adjust practice activities during flu season are appropriate (e.g. wear masks, refrain from direct patient care).
Released: June 2011
American Academy of Pediatrics (AAP) Policy Statement: Influenza Immunization for All Health Care Personnel: Keep It Mandatory
The purpose of this statement is to reaffirm the American Academy of Pediatrics'™ support for a mandatory influenza immunization policy for all health care personnel. With an increasing number of organizations requiring influenza vaccination, coverage among health care personnel has risen to 75% in the 2013 to 2014 influenza season but still remains below the Healthy People 2020 objective of 90%. Mandatory influenza immunization for all health care personnel is ethical, just, and necessary to improve patient safety. It is a crucial step in efforts to reduce health care associated influenza infections.
Released: October 2015
American College of Physicians (ACP) Policy on Patient Safety and Health Care Provider Immunization
For the safety of the individual health care provider (HCP), fellow HCPs, and the patients we serve, all HCPs should be immune to, or have received appropriate immunizations at the intervals recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, against the following transmissible infectious diseases, unless a medical contraindication exists, or a religious objection to immunization exists:
  • Diphtheria
  • Influenza
  • Hepatitis B
  • Measles/Mumps/Rubella
  • Pertussis
  • Varicella
Background: In 2010, the Board of Regents (BOR) endorsed the following patient safety and quality of care initiative: An annual influenza vaccine should be required for every health care provider with direct patient care activities, unless a medical contraindication to influenza immunization exists, or a religious objection to immunization exists. ACP took a leadership position in endorsing this measure, and multiple other professional societies and academic as well as non-academic medical centers soon followed.
Released: December 2013
American Hospital Association (AHA): AHA Endorses Patient Safety Policies Requiring Influenza Vaccination of Health Care Workers
To protect the lives and welfare of patients and hospital employees, the AHA's Board of Trustees recently approved a policy supporting mandatory patient safety policies that require either influenza vaccination or wearing a mask in the presence of patients across health care settings during flu season. This policy aims is to achieve the highest possible level of protection.
Released: July 22, 2011
American Medical Directors Association (AMDA) Position Statement: Mandatory Immunization for Long Term Care Workers
AMDA - Dedicated to Long Term Care Medicine supports a mandatory annual influenza vaccination for every long-term health care worker who has direct patient contact unless a medical contraindication or religious objection exists.
Released: April 8, 2011; Effective Date: March 2011
American Pharmacists Association (APhA): Requiring Influenza Vaccination for All Pharmacy Personnel
APhA supports an annual influenza vaccination as a condition of employment, training, or volunteering, within an organization that provides pharmacy services or operates a pharmacy or pharmacy department (unless a valid medical or religious reason precludes vaccination).
Released: April 2011
American Public Health Association (APHA) Policy Statement: Annual Influenza Vaccination Requirements for Health Workers
Key Points:
Urges providers, employers, and other organizations to implement comprehensive infection control programs that include vaccination requirements along with vaccination training and education, respiratory protection, standard respiratory precautions, and housekeeping routines in keeping with infection control standards.
Emphasizes that vaccination of health workers is important not only for patient safety but also for their own protection and calls for strengthening both the health sector's commitment to safe working environments and its capacity to achieve national goals for protecting the health workforce from influenza through education and convenient access to employer-provided vaccination.
Strongly recommends that institutions that train health professionals, deliver health care, or provide laboratory or other medical support services require immunizations for personnel at risk for contracting or transmitting vaccine-preventable illnesses.
Encourages institutional, employer, and public health policy to require influenza vaccination of all health workers as a precondition of employment and thereafter on an annual basis, unless a medical contraindication recognized in national guidelines is documented in the worker's health record. An educational component should be created for health workers to learn about vaccine safety science.
Released: April 2011; Policy date: November 2010
Association for Professionals in Infection Control and Epidemiology, Inc. (APIC): Influenza Vaccination Should Be a Condition of Employment for Healthcare Personnel, Unless Medically Contraindicated
Recommendation: Therefore, APIC recommends that acute care hospitals, long term care, and other facilities that employ healthcare personnel require annual influenza immunization as a condition of employment unless there are compelling medical contraindications. This requirement should be part of a comprehensive strategy which incorporates all of the recommendations for influenza vaccination of HCP of the Healthcare Infection Control Practices Advisory Committee (HICPAC) and the Advisory Committee on Immunization Practices (ACIP) for influenza vaccination of HCP. An essential part of this comprehensive strategy includes strict attention to important infection prevention practices such as hand hygiene and respiratory etiquette. Individuals exempted from annual vaccination due to medical contraindications must be educated on the importance of careful adherence to all of the non-vaccine related HICPAC prevention strategies, including hand hygiene and cough etiquette. Further, they may be required to wear a surgical mask when contact with patients or susceptible employees is likely. Additionally, strong leadership commitment that takes into account and collaboratively addresses concerns by employees and the organizations representing them is essential to providing the necessary support and resources to implement such a comprehensive program.
Released: February 2011
Infectious Diseases Society of America (IDSA): Mandatory Immunization of Health Care Personnel Against Influenza and Other Infectious Diseases
Because healthcare personnel (HCP) work in an environment where contact with patients or infective material from patients is routine, HCP are at risk for exposure to vaccine-preventable diseases and possible transmission to patients, their families, and other HCP. Vaccination programs are therefore an essential component of infection prevention and control. Preventing health care-associated transmission of influenza and other infectious diseases can protect patients, HCP, and local communities. For this reason, IDSA supports mandatory immunization of HCP according to recommendations of the Advisory Committee for Immunization Practices (ACIP) of the U.S. Centers for Disease Control and Prevention (CDC).
Revised: December 2013
National Association of County and City Health Officials (NACCHO): Influenza Vaccinations for Healthcare Personnel Policy
NACCHO urges healthcare employers and local health departments (LHDs) to require influenza vaccination for all staff as a condition of employment. This mandate is necessary to achieve the Healthy People 2020 annual goal of 90 percent influenza vaccine coverage for healthcare personnel. Healthcare personnel is defined as anyone who works or volunteers in a healthcare setting and/or an LHD whose job may call for direct patient contact.
Implementation date: November 2012
National Business Group on Health: Hospitals Should Require Flu Vaccination for all Personnel to Protect Patients’ Health and Their Own Health
Employees who invoke either of these exemptions should not engage in direct patient care if they have flu-like symptoms. When seemingly healthy, hospitals should either:
Reassign these employees to non-patient care areas; or
Require them to wear masks at all times during flu season when delivering care to patients
Hospital personnel receiving annual flu vaccinations should include:
All personnel who receive a direct paycheck from the hospital facility;
Credentialed non-employees including licensed, independent practitioners affiliated with the hospital, but not necessarily on the payroll; and
Other non-credentialed, non-employee personnel including health professional students, volunteers, contract employees, construction workers, and medical or pharmaceutical vendors.
Released: October 18, 2011
National Patient Safety Foundation (NPSF) Supports Mandatory Flu Vaccinations for Healthcare Workers
NPSF recognizes vaccine-preventable diseases as a matter of patient safety and supports mandatory influenza vaccination of health care workers to protect the health of patients, health care workers, and the community. NPSF appreciates that where vaccination is not possible for any reason, due to unavailability or medical contraindications of potential vaccine recipients, hospitals and healthcare professionals must use all available alternatives to avoid transmission to patients and coworkers including masks and adjusting job responsibilities.
Released: November 18, 2009
Society for Healthcare Epidemiology of America (SHEA) Position Paper: Influenza Vaccination of Healthcare Personnel
SHEA views influenza vaccination of HCP as a core patient and HCP safety practice with which noncompliance should not be tolerated. It is the professional and ethical responsibility of HCP and the institutions within which they work to prevent the spread of infectious pathogens to their patients through evidence‐based infection prevention practices, including influenza vaccination. Therefore, for the safety of both patients and HCP, SHEA endorses a policy in which annual influenza vaccination is a condition of both initial and continued HCP employment and/or professional privileges. The implementation of this policy should be part of a multifaceted, comprehensive influenza infection control program; it must have full, visible leadership support with the expectation for influenza vaccination fully and clearly communicated to all existing and applicant HCP; and it must have ample resources and support to implement and to sustain the HCP vaccination program. This recommendation applies to all HCP working in all healthcare settings, regardless of whether the HCP have direct patient contact or whether the HCP are directly employed by the facility. It also applies to all students, volunteers, and contract workers. SHEA recommends that only exemptions due to recognized medical contraindications to influenza vaccination be considered.
Released: August 31, 2010
Who's on the Honor Roll?
Who's on the Honor Roll?
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The Influenza Vaccination of the Health Care Workforce Project
Influenza Vaccination of the Health Care Workforce Project
GWU's School of Public Health and Health Services
Vaccinating Healthcare Personnel
Vaccinating Healthcare Personnel
National Adult and Influenza Immunization Summit
A Toolkit for Long-Term Care Employers
A Toolkit for Long-Term Care Employers
Increasing influenza vaccination among healthcare personnel in long-term care settings
Make the Case
Make the Case
Helping promote influenza and Tdap immunization among healthcare workers
Guidance for Developing a Mandatory Influenza Vaccination Program
Guidance for Developing a Mandatory Influenza Vaccination Program
Toolkit for hospital settings
Journal Articles & Editorials
Influenza Vaccination Coverage Among Health Care Personnel United States, 201516 Influenza Season
MMWR - 9/30/16
Association of State Laws and Healthcare Workers' Influenza Vaccination Rates
Journal of the National Medical Association - 2/16
Influenza Immunization for All Health Care Personnel: Keep It Mandatory
Pediatrics - 10/15
Qualitative Evaluation of Rhode Island's Healthcare Worker Influenza Vaccination Regulations
Vaccine - 10/14/14
Influenza Vaccination Performance Measurement among Acute Care Hospital-Based Health Care Personnel – United States, 2013–14 Influenza Season
MMWR - 9/19/14
A Systematic Review of Mandatory Influenza Vaccination in Healthcare Personnel
American Journal of Preventative Medicine - 9/14
Effect of Influenza Vaccination of Healthcare Personnel on Morbidity and Mortality among Patients: Systematic Review and Grading of Evidence
Clinical Infectious Diseases - 1/14
Managing the Human Toll Caused by Seasonal Influenza: New York State's Mandate to Vaccinate or Mask
Commentary by Arthur Caplan, PhD, et al.
JAMA - 10/13
Influenza Vaccination Coverage Among Health-Care Personnel — United States, 2012–13 Influenza Season
MMWR - 9/27/13
Morality of Influenza Vaccine Mandates
Commentary by Arthur Caplan, PhD
Clinical Therapeutics - 2/13
Video Commentary by Arthur L. Caplan, PhD: Why Hospital Workers Should Be Forced to Get Flu Shots
Medscape - 9/13/12
Voluntary to Mandatory: Evolution of Strategies and Attitudes Towards Influenza Vaccination of Healthcare Personnel
Infection Control and Hospital Epidemiology - 1/12
Institutional Requirements for Influenza Vaccination of Healthcare Personnel: Results From a Nationally Representative Survey of Acute Care Hospitals – United States, 2011
Clinical Infectious Diseases - 12/1/11
Increases in Vaccination Coverage of Healthcare Personnel Following Institutional Requirements for Influenza Vaccination: A National Survey of U.S. Hospitals
Vaccine - 11/21/11
Time to Mandate Influenza Vaccination in Health-Care Workers
Perspective by Arthur Caplan, PhD
The Lancet - 7/23/11
Vaccinating Health Care Workers against Influenza: The Ethical and Legal Rationale for a Mandate
American Journal of Public Health - 2/11
Mandatory Influenza Vaccination of Health Care Workers: Translating Policy to Practice
Clinical Infectious Diseases - 2/15/11
Reflections on the Influenza Vaccination of Healthcare Workers
Vaccine - 11/29/10
Mandatory Flu Vaccination of Healthcare Workers: A Patient safety imperative
Infection Control Today - 10/1/10
Mandatory influenza vaccination of healthcare workers: a 5-year study
Infection Control and Hospital Epidemiology - 9/1/10
On Being First: Virginia Mason Medical Center and mandatory influenza vaccination of healthcare workers
Editorial by Thomas R. Talbot, MD, MPH, et al.
Infection Control and Hospital Epidemiology - 9/1/10
Mandating Influenza Vaccination for Health Care Workers: Putting patients and professional ethics over personal preference
Editorial by Gregory A. Poland, MD, MACP, FIDSA
Vaccine - 8/16/10
Is It Ethically Permissible to Mandate Influenza Vaccination for Health Care Workers?
JAAPA - 6/1/10
Mandate to Protect Patients from Health Care-Associated Influenza
Commentary by Andrew T. Pavia, MD, FIDSA
Clinical Infectious Diseases - 2/15/10
Mandatory Influenza Vaccination of Health Care Workers: Translating Policy to Practice
Clinical Infectious Diseases - 2/15/10
Requiring Influenza Vaccination for Health Care Workers: Seven truths we must accept
Vaccine - 1/13/05
>> more journal articles
Related News Coverage & Commentaries
Hospital employee not entitled to religious exemption from flu vaccine requirement
The Washington Post - 4/14/16
Can Your Boss Make You Get Vaccinated?
Bloomberg Businessweek - 1/22/15
Employers Must Understand the Implications of Mandatory Flu Vaccination for Healthcare Workers
Infection Control Today - 5/26/14
Editorial: Flu Vaccine Mandate Protects Patients' Rights: Our View
USA Today - 2/3/13
Don't Be Selfish: Get a flu shot and protect the most vulnerable, bioethicist says by Art Caplan, PhD
NBC News - 1/11/13
Editorial: A Duty of Health Care Workers
New York Times - 9/27/12
Colorado Board Approves Flu-Shot Mandate for Health Care Workers
Denver Post - 2/17/12
Federal Advisors Propose Steps to Boost Health Worker Flu Vaccination
CIDRAP - 2/8/12
Flu Vaccine Requirements Suboptimal among US HCWs
Infectious Disease News - 10/24/11
Mandatory Flu Vaccinations Boost Nurse Compliance with Guidelines
Nursing News - 9/2/11
Opinion: First Do No Harm
Huffington Post - 8/3/10
Editorial: They Should Know Better
New York Times - 4/13/10
Opinion: Health Workers Must Get Flu Shot or Quit: Only half get vaccinated, risking dangerous transmission to patients
Arthur Caplan, PhD. MSNBC.com - 10/8/09
Patient Safety Clarion Call: Honoring mandatory influenza vaccination for health care workers
IAC Press Release Announcing the Honor Roll - 10/9/09
This page was updated on December 19, 2016.
This page was reviewed on December 10, 2015.
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