Mandatory influenza vaccination as a condition of employment did not lead hospital employees to quit, according to a analysis of four years of vaccination rates at Loyola University Medical Center in Illinois.
Loyola developed a facility-wide policy that made flu vaccination a condition of employment. Results were presented June 9 at the 40th Annual Conference of the Association for Professionals in Infection Control and Epidemiology.
"'First, do no harm' is our mandate as health care workers," said Jorge Parada, MD, MPH, FACP, study author and professor of medicine at Loyola University Chicago Stritch School of Medicine, in a press release. "We should do all we can to not pass along illness to our patients."
Loyola introduced an active flu vaccine declination system in 2008. Employees were required by to state "yes" or "no" when asked to be vaccinated and to provide reasoning for why they declined the vaccine. This brought the center's overall vaccination rate up to 72%, compared to the CDC's goal of getting more than 60% of health care providers vaccinated.
In 2009 Loyola extended this mandate to students, volunteers and contractors. In the first year of the mandatory policy (2009-2010 season), 99.2% of employees received the vaccine, 0.7% were exempted for religious/medical reasons, and 0.1% refused vaccination and chose to quit. In 2012, 98.7% were vaccinated, 1.2% were exempted and 0.06% refused vaccination.
Of the five people who refused vaccination in the mandatory period during 2012, three were unpaid volunteers who later received a vaccine and returned to Loyola. The other two were part-time staff who spent only 10% of their time at Loyola. The final vaccine-refusal rate was 0.002%. Over the course of four years, fewer than 15 health care providers or volunteers out of approximately 8,000 people quit because of mandated vaccination.
"Near-universal flu immunization is achievable and sustainable with a mandatory vaccination policy," Dr. Parada said. "Our employees and associates now understand that this is the way we do business. Just as construction workers must wear steel-toed boots and hard hats on job sites, health care workers should get a flu shot to work in a hospital. We believe that patient and staff safety have been enhanced as a result."
Association for Professionals in Infection Control and Epidemiology has published a position paper with recommendations and rationale for mandatory influenza immunization.