Pushing the Needle on Influenza Vaccination

Despite continued debates about the use of influenza vaccination mandates in healthcare settings (see prior discussions just on this blog here, here, here, here, and here), facilities continue to move toward implementing some form of ‘mandatory’ program to ensure sustained high levels of influenza vaccination coverage among their staff.  A new article published in JAMA Network Open documents this increase with an update to a multi-year survey project asking about facility infection prevention practices.  I use the word ‘mandatory’ in quotes above on purpose because, as I detailed in an accompanying editorial, the definition of a mandate, when it comes to vaccination policy, is not standardized.

“…Most importantly, it does not appear that mandate was defined. Among respondents who reported having a vaccination mandate, only 74% reported having penalties for noncompliance and 13% allowed declination without a specified reason. Of those reporting no mandate, 21% reported penalties for noncompliance with hospital policy on influenza vaccination and 41% reported requirements for wearing masks if unvaccinated. An article in a bioethics journal5 offers the following criteria for using the term mandate in this setting: limiting acceptable reasons for refusal, penalizing nonparticipation, and enforcing these expectations. By these criteria, it is not clear how many programs described in this survey should appropriately be referred to as mandatory—the number may be higher or lower than that reported, although an increase over time seems likely.

The authors of the survey article also note that the VA is moving to a mandatory vaccine or mask policy this year, which will again increase the number of facilities using some type of mandate.  Hopefully, the VHA will take advantage of their more comprehensive healthcare delivery system to evaluate the impact of the program on both inpatient AND outpatient influenza among their patients, something that has been a persistent gap in prior reports.

ALSO, did you appreciate how easy it was to click the link and access the whole article?  Note that the article and the accompanying editorial are in JAMA Network Open, a new, fully open access journal “in which all content is made freely available to all readers immediately on publication. ….[they] will publish online only, every Friday.” Read more here.


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