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Expanding mandatory healthcare personnel immunization beyond influenza: Impact of a broad immunization program with enhanced accountability

Published online by Cambridge University Press:  10 November 2020

Thomas R. Talbot Open the ORCID record for Thomas R. Talbot [Opens in a new window] ,
Ruth Schimmel ,
Melanie D. Swift ,
Lori A. Rolando ,
Rochelle T. Johnson ,
Jannis Muscato ,
Paul Sternberg ,
Marilyn Dubree ,
Paula W. McGown  and
Mary I. Yarbrough
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Thomas R. Talbot*
Affiliation:
Departments of Medicine, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee Quality, Safety, and Risk Prevention, Vanderbilt University Medical Center, Nashville, Tennessee
Ruth Schimmel
Affiliation:
Quality, Safety, and Risk Prevention, Vanderbilt University Medical Center, Nashville, Tennessee
Melanie D. Swift
Affiliation:
Departments of Medicine, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee Occupational Health Clinic, Vanderbilt University Medical Center, Nashville, Tennessee
Lori A. Rolando
Affiliation:
Departments of Medicine, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee Occupational Health Clinic, Vanderbilt University Medical Center, Nashville, Tennessee
Rochelle T. Johnson
Affiliation:
Human Resources, Vanderbilt University Medical Center, Nashville, Tennessee
Jannis Muscato
Affiliation:
Human Resources, Vanderbilt University Medical Center, Nashville, Tennessee
Paul Sternberg
Affiliation:
Department of Ophthalmology, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee Hospital Administration, Vanderbilt University Medical Center, Nashville, Tennessee
Marilyn Dubree
Affiliation:
Hospital Administration, Vanderbilt University Medical Center, Nashville, Tennessee
Paula W. McGown
Affiliation:
Occupational Health Clinic, Vanderbilt University Medical Center, Nashville, Tennessee Faculty/Staff Health and Wellness, Vanderbilt University Medical Center, Nashville, Tennessee
Mary I. Yarbrough
Affiliation:
Departments of Medicine, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee Occupational Health Clinic, Vanderbilt University Medical Center, Nashville, Tennessee Faculty/Staff Health and Wellness, Vanderbilt University Medical Center, Nashville, Tennessee
Gerald B. Hickson
Affiliation:
Department of Pediatrics, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee Quality, Safety, and Risk Prevention, Vanderbilt University Medical Center, Nashville, Tennessee The Center for Patient and Professional Advocacy, Vanderbilt University Medical Center, Nashville, Tennessee (Present affiliation: Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, Minnesota [M.S.])
*
Author for correspondence: Thomas R. Talbot. E-mail: tom.talbot@vumc.org
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Abstract

Objective:

Evaluation of a mandatory immunization program to increase and sustain high immunization coverage for healthcare personnel (HCP).

Design:

Descriptive study with before-and-after analysis.

Setting:

Tertiary-care academic medical center.

Participants:

Medical center HCP.

Methods:

A comprehensive mandatory immunization initiative was implemented in 2 phases, starting in July 2014. Key facets of the initiative included a formalized exemption review process, incorporation into institutional quality goals, data feedback, and accountability to support compliance.

Results:

Both immunization and overall compliance rates with targeted immunizations increased significantly in the years after the implementation period. The influenza immunization rate increased from 80% the year prior to the initiative to >97% for the 3 subsequent influenza seasons (P < .0001). Mumps, measles and varicella vaccination compliance increased from 94% in January 2014 to >99% by January 2017, rubella vaccination compliance increased from 93% to 99.5%, and hepatitis B vaccination compliance from 95% to 99% (P < .0001 for all comparisons). An associated positive effect on TB testing compliance, which was not included in the mandatory program, was also noted; it increased from 76% to 92% over the same period (P < .0001).

Conclusions:

Thoughtful, step-wise implementation of a mandatory immunization program linked to professional accountability can be successful in increasing immunization rates as well as overall compliance with policy requirements to cover all recommended HCP immunizations.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 42 , Issue 5 , May 2021 , pp. 513 - 518
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Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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