Skip to main content Accessibility help
×
Home
Hostname: page-component-99c86f546-7mfl8 Total loading time: 0.202 Render date: 2021-12-07T01:27:22.837Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Impact of mandatory vaccination of healthcare personnel on rates of influenza and other viral respiratory pathogens

Published online by Cambridge University Press:  05 August 2021

Michael S. Simberkoff*
Affiliation:
Veterans’ Affairs (VA) New York Harbor Healthcare System and NYU Grossman School of Medicine, New York, New York
Susan M. Rattigan
Affiliation:
University of Florida, Gainesville, Florida
Charlotte A. Gaydos
Affiliation:
Johns Hopkins University School of Medicine, Baltimore, Maryland
Cynthia L. Gibert
Affiliation:
Veterans’ Affairs Medical Center, Washington, DC
Geoffrey J. Gorse
Affiliation:
VA St Louis Health Care System St Louis, Missouri Saint Louis University School of Medicine, St. Louis, Missouri
Ann-Christine Nyquist
Affiliation:
Children’s Hospital Colorado, Aurora, Colorado University of Colorado School of Medicine, Aurora, Colorado
Connie S. Price
Affiliation:
University of Colorado School of Medicine, Aurora, Colorado Denver Health and Hospital, Aurora, Colorado
Nicholas Reich
Affiliation:
University of Massachusetts, Amherst, Massachusetts
Maria C. Rodriguez-Barradas
Affiliation:
Michael E. DeBakey VA Medical Center, Houston, Texas Baylor College of Medicine, Houston, Texas
Mary Bessesen
Affiliation:
University of Colorado School of Medicine, Aurora, Colorado VA-Eastern Colorado Healthcare System, Denver, Colorado
Alexandria Brown
Affiliation:
University of Massachusetts, Amherst, Massachusetts
Derek A.T. Cummings
Affiliation:
University of Florida, Gainesville, Florida
Lewis J. Radonovich Jr.
Affiliation:
Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Pittsburgh, Pennsylvania
Trish M. Perl
Affiliation:
Johns Hopkins University School of Medicine, Baltimore, Maryland University of Texas Southwestern Medical Center, Dallas, Texas
*
Author for correspondence: Michael S. Simberkoff, E-mail: mike.simberkoffmd@va.gov

Abstract

Objective:

The implementation of mandatory influenza vaccination policies among healthcare personnel (HCP) is controversial. Thus, we examined the affect of mandatory influenza vaccination policies among HCP working in outpatient settings.

Setting:

Four Veterans’ Affairs (VA) health systems and three non-VA medical centers.

Methods:

We analyzed rates of influenza and other viral causes of respiratory infections among HCP working in outpatient sites at 4 VA health systems without mandatory influenza vaccination policies and 3 non-VA health systems with mandatory influenza vaccination policies.

Results:

Influenza vaccination was associated with a decreased risk of influenza (odds ratio, 0.17; 95% confidence interval [CI], 0.13–0.22) but an increased risk of other respiratory viral infections (incidence rate ratio, 1.26; 95% CI, 1.02–1.57).

Conclusions:

Our fitted regression models suggest that if influenza vaccination rates in clinics where vaccination was not mandated had equalled those where vaccine was mandated, HCP influenza infections would have been reduced by 52.1% (95% CI, 51.3%–53.0%). These observations, their possible causes, and additional strategies to reduce influenza and other viral respiratory illnesses among HCP working in ambulatory clinics warrant further investigation.

Type
Original Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

a

The ResPECT Team: The Johns Hopkins University (Baltimore, MD): Trish Perl, MD, MSc; Justin Getka, BA; Tina Hoang, MS; Rose Kajih, PharmD; Amanda Krosche, BS; Meghan Kubala, MS, MD; Jenna Los, MLA; Liandra Presser, MD; Kathleen Pulice, MS; Margaret Spach, DDS. VA New York Harbor Healthcare System (New York, NY): Michael S. Simberkoff, MD; Cynthia Akagbosu, BA, MA; Madeline Dansky, BA; Benedict J. Frederick, BA; Marilyn Last, RN; Scott Laverie, RN; Courtney Pike, BA; Shefali Rikhi, BS; Nicole Spector, RN; Christine A. Reel-Brander, RN. Denver Health & Hospital Authority (Denver, CO): Connie Price, MD; Katie Gorman, BS; Amy Irwin, DNP, RN; Sean O’Malley; Kevin Silva, BS. UT Southwestern Medical Center (Dallas, TX): Trish M. Perl, MD, MSc; Deepa Raj, MPH. VA Eastern Colorado Healthcare System (Denver, CO): Mary Bessesen, MD; Jill C. Adams, BSN, BA; Shannon Kingery, BS; Stefanie Tuder, BS; Erron Fruchter-Palmer, MPH. Children’s Hospital Colorado (Denver, CO): Ann-Christine Nyquist, MD, MSPH; Megan Brocato, BA. VA Washington DC Medical Center (Washington, DC): Cynthia Gibert, MD, MSc; Laura Chopko, BA; Kathy Haines, MSW, MPH; Caitlin Langhorne, MPH; Dana Silver, BA; Courtney Southard, MPH. VA Michael C. DeBakey Medical Center (Houston, TX): Maria C. Rodriguez-Barradas, MD; Barbara Kertz, MS; Mahwish Mushtaq, MD, MPH; Blanca Vargas, MD. Centers for Disease Control and Prevention, National Institute for Occupational Safety & Health (Pittsburgh, PA): Edward Fisher, MS; Ronald Shaffer, PhD; Lewis J. Radonovich, MD. Veterans’ Health Administration Office of Public Health (Gainesville, FL): Aaron Eagan, MPH, RN. HandyMetrics Corporation (Toronto, Ontario, Canada): Melanie Lipka, BS; Michael Tsang, PhD. Laboratory Core at Johns Hopkins University (Baltimore, MD): Charlotte Gaydos, DrPH, Jeffrey Holden, MA; Alexandra Valsamakis, MD, PhD. Laboratory Core at VA St. Louis Health Care System and St. Louis University School of Medicine (St. Louis, MO): Geoffrey J. Gorse, MD; Michelle Mitchell, BS; Gira B. Patel, MS; Yinyi Yu, BS, Tamara Blevins, MS. REDCap Core at Johns Hopkins University (Baltimore, MD): Andre Hackman, BA, Michael Sherman, BS. Statistical and Epidemiologic Core (University of Florida, Gainesville, FL):

References

Fiore, AE, Uyeki, TM, Broder, K, et al. Prevention and control of influenza with vaccines: recommendations of the advisory committee on immunization practices (ACIP). Mortal Wkly Rep Recomm Rep 2010;59(RR-8):162.Google Scholar
Black, CL, Yun, X, Ball, SW, et al. influenza vaccination coverage among health care personnel—United States, 2015–16 influenza season. Morb Mortal Wkly Rep 2016;65. 10091015.Google ScholarPubMed
Bardhenheier, B, Lindley, MC, Yue, X, et al. Influenza vaccination coverage among health care personnel—United States, 2018–2019 influenza season. Centers for Disease Control and Prevention website. https://www.cdc.gov/flu/fluvaxview/hcp-coverage_1819estimates.htm Published September 26, 2019. Accessed July 19, 2019.Google Scholar
Greene, MT, Fowler, KE, Ratz, D, et al. Changes in influenza vaccination requirements for healthcare personnel in US hospitals. JAMA Netw Open 2018; e180143.CrossRefGoogle ScholarPubMed
Blank, C, Gemeinhart, N, Dunagan, WC, Babcock, HM. Mandatory employee vaccination as a strategy for early and comprehensive health care personnel immunization coverage: Experience from 10 influenza seasons. Am J Infect Cont 2020;48:11331138.CrossRefGoogle ScholarPubMed
Pitts, SI, Maruther, NM, Millar, KR, et al. A systemic review of mandatory influenza vaccination in healthcare personnel. Am J Prev Med 2014;47:330–40.CrossRefGoogle Scholar
Radonovich, LJ Jr, Bessesen, MT, Cummings, DA, et al. The respiratory protection effectiveness clinical trial (ResPECT): a cluster-randomized comparison of respirator and medical mask effectiveness against respiratory infections in healthcare personnel. BMC Infect Dis 2016;16:243.CrossRefGoogle ScholarPubMed
Radonovich, LJ Jr, Simberkoff, MS, Bessesen, MT, et al. N95 respirators versus medical masks for preventing influenza among health care personnel: a randomized clinical trial. JAMA 322:824833.CrossRefGoogle Scholar
Flannery, B, Lippard, J, Zimmerman, RK, et al. Early estimates of seasonal influenza vaccine effectiveness–United States, January 2015. Morb Mort Wkly Rpt 2015; 64:1015.Google ScholarPubMed
Appiah, GD, Blanton, L, D’Mello, T, et al. Influenza activity–United States, 2014—15 season and composition of the 2015—16 influenza vaccine. Morb Mort Wkly Rpt 2015; 64:583–90.Google ScholarPubMed
Feemaster, KA, Prasad, P, Smith, MJ, et al. Employee designation and health care worker support of an influenza vaccine mandate at a large pediatric tertiary care hospital. Vaccine 2011;29:17621769.CrossRefGoogle Scholar
Cowling, BJ, Fang, VJ, Nishiura, H, et al. Increased risk of noninfluenza respiratory virus infections associated with receipt of inactivated influenza vaccine. Clin Infect Dis 2012;54:17781783.CrossRefGoogle ScholarPubMed
Laurie, KL, Horman, W, Carolan, LA, et al. Evidence for viral interference and cross-reactive protective immunity between Influenza B virus lineages. J Infect Dis 2018;217:548559.CrossRefGoogle ScholarPubMed
van Houten, CB, Cohen, A, Engelhard, D, et al. Antibiotic misuse in respiratory tract infections in children and adults-a prospective, multicentre study. TAILORED Treatment. Eur J Clin Microbiol Infect Dis 2019;38:505514.CrossRefGoogle ScholarPubMed
Van Hooste, WLC, Bekeart, M. To be or not to be vaccinated? The ethical aspects of influenza vaccination among healthcare workers. Int J Environ Res Public Health 2019 Oct 18;16:3981.CrossRefGoogle ScholarPubMed
Supplementary material: File

Simberkoff et al. supplementary material

Simberkoff et al. supplementary material

Download Simberkoff et al. supplementary material(File)
File 15 KB

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Impact of mandatory vaccination of healthcare personnel on rates of influenza and other viral respiratory pathogens
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Impact of mandatory vaccination of healthcare personnel on rates of influenza and other viral respiratory pathogens
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Impact of mandatory vaccination of healthcare personnel on rates of influenza and other viral respiratory pathogens
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *