In the current issue of CID, investigators at BJC HealthCare in St. Louis report on a mandatory influenza vaccination policy instituted during the 2008-2009 season. All employees who were not vaccinated or who didn't have an approved exemption, where not scheduled to work beyond Dec 15 and were terminated on January 15th if still not vaccinated. They achieved an impressive true vaccinated proportion of 98.4%. Quite an achievement for patient safety. Only eight employees out of 25,561 were terminated and 321 (1.2%) had approved exemptions.
An editorial by Andrew Pavia provides a nice balanced summary of healthcare worker vaccination policies and successes. Mandatory vaccination policies have been implemented by several organizations including Virginia Mason Medical Center (Seattle, WA), Hospital Corporation of America, Johns Hopkins Health System, University of Iowa Hospitals, Hospital of the University of Pennsylvania, Children’s Hospital of Philadelphia, and the Department of Defense. Dr. Pavia is right to suggest that influenza vaccination targets should be set at 90% or higher; however, it's unlikely these targets can be widely achieved without mandates similar to what BJC has just described.