Honor Roll for Patient Safety: Mandatory Influenza Vaccination Policies for Healthcare Workers

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Vaccination Information for Healthcare Professionals

Honor Roll for Patient Safety

Mandatory Influenza Vaccination Policies for Healthcare Workers

IAC is recognizing the stellar examples of influenza vaccination mandates in healthcare settings. According to bioethicist Arthur Caplan, PhD, Director of the Center for Bioethics at the University of Pennsylvania in Philadelphia, "If you can get close to 100 percent vaccination rates [among healthcare workers], you can cut patient death rates from flu by 40 percent."

The best way to prevent transmission of influenza to our patients is to mandate vaccination of healthcare workers.

Join the Honor Roll Today

Fill out this online form to tell IAC about influenza vaccination mandates in your healthcare setting

To be included in the 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.

The list below represents the champions who have taken the lead in mandating healthcare worker vaccination against influenza.

Position Statements Endorsing Strong Mandates for Healthcare Workers

Infectious Diseases Society of America (IDSA) Policy on Mandatory Influenza Immunization of Heath Care Workers

IDSA supports universal immunization of health care workers (HCWs) against seasonal and 2009 H1N1 influenza by health care institutions (inpatient and outpatient) through mandatory vaccination programs as these programs are likely to be the most effective means to protect patients against the transmission of seasonal and H1N1 influenza by HCWs.

Released: October 8, 2009

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

Federal Mandates

U.S. Department of Defense: Policy for Mandatory Seasonal Influenza Vaccination

Requirements for civilian healthcare personnel who provide direct patient care in DoD military treatment facilities.

Implementation date: April 4, 2008

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Institutional Mandates

Battle Creek Health System, Battle Creek, MI

All healthcare workers and volunteers, as well as clerical, janitorial, and laboratory staff, must receive seasonal influenza vaccine and H1N1 vaccine. Exemption to immunization is allowed for medical and religious reasons. Consequences of vaccine refusal are dismissal of the worker at this institution.

Implementation date: 2007

Barnes Jewish Corporation (BJC) HealthCare, Missouri

BJC HealthCare will require annual influenza vaccinations for all employees; employee vaccinations will be provided on site and free of charge.

Implementation date: 2009

Bronson Methodist Hospital, Kalamazoo, MI

All healthcare workers and volunteers, as well as clerical, janitorial, and laboratory staff, receive seasonal influenza vaccine and H1N1 vaccine. No allowable exemptions; consequence of vaccine refusal is dismissal from the institution.

Implementation date: September 1, 2005

Capital Region Medical Center, Jefferson City, MO

All healthcare workers, as well as clerical, dietary, janitorial, and laboratory staff, must receive both seasonal and H1N1 influenza vaccines. Contracted workers and volunteers are also covered by this policy. Exemption to immunization is only allowed for valid medical contraindications and religious reasons, but employees covered by this policy will be required to wear a mask while at work during influenza season or face dismissal. Any employee, contracted employee, or volunteer who has not received the seasonal or H1N1 influenza vaccination prior to the 30th of November 2009 are required to wear a mask when within 6 feet of a patient until they receive the vaccine. If an employee receives a medical or religious exemption they are required to wear a mask when within 6 feet of a patient until the end of influenza season (April 31, 2010).

Implementation date: September 1, 2009

Children's Hospital of Orange County--CHOC Children's, CA

All healthcare workers and volunteers, as well as clerical, dietary, janitorial, and laboratory staff, must receive seasonal influenza vaccine and H1N1 vaccine. Exemption to immunization is allowed for medical, religious, and other reasons, but employees covered by this policy will be required to wear a mask while at work during influenza season.

Implementation date: October 2009

Children's Hospital of Philadelphia

This policy applies to all Penn Medicine faculty and staff as well as all contracted clinical personnel, students/trainees in clinical setting, clinical research personnel, and volunteers. Influenza vaccine is available free of charge to all Penn Medicine employees. Exemption to immunization may be granted for medical contraindications or religious beliefs. Faculty and staff and personnel covered by this policy who have been granted an exemption will be required to wear a surgical mask or particulate respirator while at work during influenza season.

Implementation date: September 2009

Children's Hospital of The King's Daughters Health System, Norfolk, VA

All healthcare workers, students, and volunteers, as well as clerical, dietary, janitorial, and laboratory staff, must receive seasonal influenza vaccine and H1N1 vaccine. Agency and temporary personnel are also covered by this policy. Exemption to immunization is only allowed for valid medical contraindications and religious reasons, but employees covered by this policy will be required to wear a mask while at work during influenza season or face dismissal.

Implementation date: September 2009

Creighton University

All University health care and child care employees and students placed in clinical health care settings are required to be vaccinated for seasonal and H1N1 influenza at University cost by December 1, 2009.

Implementation date: September 23, 2009

HCA--Fort Walton Beach Medical Center, Fort Walton Beach, FL

All healthcare workers, students, and volunteers, as well as clerical, dietary, janitorial, and laboratory staff, must receive seasonal influenza vaccine. Exemption to immunization is allowed for medical, religious, and other reasons, but employees covered by this policy will be required to wear a mask while at work during influenza season or face dismissal.

Implementation date: November 15, 2009

Hoag Hospital, Newport Beach, CA

All healthcare workers; clerical, dietary, janitorial, laboratory, security staff; students; contract workers, vendors; and volunteers must receive seasonal influenza vaccine and H1N1 vaccine. Exemption to immunization is allowed for medical, religious, and other reasons, but employees covered by this policy will be required to wear a mask while at work during influenza season. Failure to comply with mask policy will result in disciplinary action.

Implementation date: December 1, 2009

Hospital of the University of Pennsylvania

Implementation date: September 2009

Johns Hopkins Health System, Maryland

All staff, students, volunteers, and personnel who have direct patient contact must receive the influenza vaccine or complete an online influenza questionnaire form. The vaccine is provided free to all staff, students, volunteers, and personnel who work in the hospital. Everyone with direct patient contact or working in clinical areas who has not received the influenza vaccine by December 20 must wear a mask within 3 feet of a patient. Vaccinated staff will receive a yellow ID badge clip. After December 20, those who do not have a yellow ID badge clip will be required to wear a mask.

Implementation date: September 2009

Kewanee Hospital, Kewanee, IL

All healthcare workers and volunteers, as well as clerical, dietary, janitorial, and laboratory staff, must receive seasonal influenza vaccine and H1N1 vaccine. Exemption to immunization is allowed for medical and religious reasons, but employees covered by this policy will be required to wear a mask while at work during influenza season.

Implementation date: October 2009

Lakeview Medical Center, Rice Lake, WI

All healthcare workers and clerical staff must receive seasonal influenza vaccine. The vaccine is free of charge for all volunteers, physicians, and students. Exemption to immunization is allowed for medical and religious reasons, but employees covered by this policy will be required to wear a mask while at work during influenza season.

Implementation date: October 1, 2007

Long Beach Memorial Medical Center, Long Beach, CA

All healthcare workers; clerical, dietary, janitorial, laboratory, security staff; students; vendors; and volunteers must receive seasonal influenza vaccine and H1N1 vaccine. Exemption to immunization is allowed for medical, religious, and other reasons, but employees covered by this policy will be required to wear a mask while at work during influenza season.

Implementation date: September 29, 2009

Loyola University Health System, Illinois

Annual flu shots will be mandatory for all employees, faculty, medical and nursing students and other allied groups who work or have clinical training at the Loyola University Medical Center campus in Maywood or its suburban health centers.

Implementation date: September 2009

MedStar Health, Maryland and Washington, DC

Requires all employees to be vaccinated against seasonal influenza. For associates who decide not to have a seasonal flu vaccination, the consequences will be addressed in the disciplinary process.

Implementation date: September 2009

Michigan State University/Kalamazoo Center for Medical Studies

All healthcare workers and residents, as well as clerical, janitorial, and laboratory staff, must receive seasonal influenza vaccine and H1N1 vaccine. Exemption to immunization is allowed for medical and religious reasons. Consequences of vaccine refusal are dismissal of the worker at this institution and partner hospitals.

Implementation date: January 1, 2008

Miller Children's Hospital, Long Beach, CA

Implementation date: September 29, 2009

New York-Presbyterian Hospital, New York

All employees of the hospital must receive the H1N1 vaccine and seasonal influenza vaccine. NewYork-Presbyterian Hospital does not recognize religious or philosophical objections to mandatory influenza vaccination. Exemption to immunization for medical contraindications only, but employees covered by this policy will be required to wear a surgical mask or particulate respirator while at work during influenza season. Voluntary resignation for those without a verified medical contraindication.

Effective: September 2009

Pacific Hospital of Long Beach, CA

All healthcare workers, students, and volunteers, as well as clerical, dietary, janitorial, and laboratory staff, are required to receive seasonal influenza vaccine and H1N1 vaccine. Exemption to immunization is allowed for medical, religious, and other reasons, but employees covered by this policy will be required to wear a mask while at work during influenza season and/or be reassigned to non-patient-care duties.

Implementation date: September 29, 2009

Saddleback Memorial Medical Center, Laguna Hills, CA

Groups divided into two tiers. Tier one includes all staff, contract workers, students, and MDs with direct patient contact or contact with the patient care environment. Vaccines are mandatory for tier one group with masking in patient care areas mandatory if vaccine has not been received by 11/01/09. Tier two employees (those who do not work in a patient care environment) will be required to vaccinate or mask if and when vaccine supplies are determined to be adequate and flu levels rise.

Implementation date: November 1, 2009

Saint Alphonsus Regional Medical Center, Boise, Idaho

All healthcare workers and volunteers, as well as clerical, dietary, janitorial, and laboratory staff, must receive seasonal influenza vaccine. Exemption to immunization is allowed for medical and religious reasons, but employees covered by this policy will be required to wear a mask while at work during influenza season. If they refuse to wear a mask, they are subject to dismissal or termination of employment for not complying with hospital policy.

Implementation date: October 1, 2009

Spectrum Health Hospitals, Grand Rapids, MI

All healthcare workers and volunteers, as well as clerical, dietary, janitorial, and laboratory staff, must receive seasonal influenza vaccine. Employees can not just opt out, but may file a request for medical exemption, subject to review by a committee; religious exemptions are not considered. Seasonal influenza vaccine is mandated for all employees, also mandated for medical staff by the Medical Executive Committee, although bylaws do not provide for loss of privileges on this basis.

Implementation date: September 2009

St. Joseph Health System, Orange, CA

All healthcare personnel, all employees (clinical and non-clinical), licensed independent practitioners, temporary workers, students, clergy, volunteers, and vendors must receive seasonal influenza vaccine and H1N1 vaccine. Exemption to immunization is only allowed for valid medical contraindications and religious reasons, but employees covered by this policy will be required to wear a mask while at work during influenza season and/or be reassigned to non-patient-care duties.

Implementation date: December 1, 2009

St. Jude Medical Center, Fullerton, CA

All employees must receive seasonal influenza vaccine and H1N1 vaccine. Exemption to immunization is allowed for medical, religious, and other reasons, but employees covered by this policy will be required to wear a mask while at work during influenza season or opt for a leave of absence.

Implementation date: September 21, 2009

Swedish Medical Center, Englewood, CO

All healthcare workers, students, and volunteers, as well as clerical, dietary, janitorial, and laboratory staff, are required to receive seasonal influenza vaccine and H1N1 vaccine. The influenza vaccines are available free of charge to all staff, students, and volunteers. Exemption to immunization is allowed for medical, religious, and other reasons, but employees covered by this policy will be required to wear a mask while at work during influenza season.

Implementation date: October 15, 2009

TriHealth, Good Samaritan and Bethesda North Hospitals, Cincinnati, OH

All employees of the hospital must receive the H1N1 vaccine and seasonal influenza vaccine. TriHealth does not recognize religious or philosophical objections to mandatory influenza vaccination. Consequences of vaccine refusal include reassignment to non-patient-care areas and wearing a mask while at work during influenza season will be required.

Implementation date: December 1, 2009

UC ((University of California) Davis Health System, Sacramento, CA

All healthcare workers, students, and volunteers, as well as clerical, dietary, janitorial, and laboratory staff, are required to receive seasonal influenza vaccine and H1N1 vaccine. Exemption to immunization is allowed for medical and religious reasons, but employees covered by this policy will be required to wear a mask while at work during influenza season.

Implementation date: September 12, 2009

UC (University of California) Irvine Healthcare, Orange, CA

To ensure mandatory immunization against influenza, all UC Irvine Healthcare (includes Medical Center staff and School of Medicine staff) personnel that have any duties or presence at the entire UC Irvine Medical Center campus (clinical and non-clinical) or affiliated clinical areas are covered under this policy, which includes, but is not limited to: medical center employees, licensed independent practitioners, temporary workers, students, researchers, volunteers, physicians and other School of Medicine staff. This policy encompasses all influenza vaccines recommended by the Centers for Disease Control and Prevention. Exemption to immunization is allowed for medical, religious, and other reasons, but employees covered by this policy will be required to wear a mask while at work during influenza season.

Implementation date: July 2009

Virginia Mason Medical Center, Seattle, WA

Mandatory influenza vaccination policy for employees. PowerPoint presentation slides provide details about the award-winning program.

Implementation date: 2005

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Medical Practice Mandates

Affiliates In Medical Specialties Medical Group, Inc., West Hills, CA
Agape Outreach, Arlington, TX
Atlanta ID Group, Georgia
CenterPointe Resources (Full Life Hospice, Hometown Home Health), Tulsa and Oklahoma City, OK
Laredo Pediatrics & Neonatology PA, Laredo, TX
Longs Peak Family Practice, Longmont, CO
North Valley Family Physicians, Colusa, CA
Open Door Family Medical Centers, New York
Pharr Pediatric Clinic, Pharr, TX
Priority Care Pediatrics, Kansas City, MO
Saltzer Medical Group, Nampa, Idaho
Sound Health Care Center, Port Orchard, WA
Woodcreek Healthcare, Bonney Lake and Puyallup, Washington

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News and Articles

Vaccines in the News: Mandates & Exemptions

The latest media coverage about influenza mandates for healthcare workers.

Journal Articles: Healthcare Personnel

IAC's selection of vaccine-related articles.

Patient Safety Clarion Call: Honoring mandatory influenza vaccination for health care workers

Press release, October 9, 2009

Editorial Commentary: Mandate to Protect Patients from Health Care-Associated Influenza

By Andrew T. Pavia, Clinical Infectious Diseases, February 15, 2010

Mandatory Influenza Vaccination of Health Care Workers: Translating Policy to Practice

Clinical Infectious Diseases, February 15, 2010