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Use of a comprehensive program to review religious and personal seasonal influenza vaccination exemption requests by healthcare personnel

Published online by Cambridge University Press:  29 October 2020

Benjamin C. Boone ,
Rochelle T. Johnson ,
Lori A. Rolando  and
Thomas R. Talbot Open the ORCID record for Thomas R. Talbot [Opens in a new window]
Benjamin C. Boone
Affiliation:
Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
Rochelle T. Johnson
Affiliation:
Department of Human Resources, Vanderbilt University Medical Center, Nashville, Tennessee
Lori A. Rolando
Affiliation:
Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
Thomas R. Talbot*
Affiliation:
Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
*
Author for correspondence: Thomas R. Talbot, E-mail: tom.talbot@vumc.org
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Abstract

Objective:

Vanderbilt University Medical Center (VUMC) requires that all faculty and staff receive the seasonal influenza vaccine annually or receive an approved vaccine exemption, either for a medical or deeply held religious or personal belief. We sought to understand the underlying principles behind these exemption requests and their interaction with a multidisciplinary exemption review process.

Design:

All of the personal and religious exemption requests at VUMC for 3 consecutive influenza seasons from 2015 to 2018 were analyzed, categorizing these requests by 1 of 12 standardized employee categories and 1 of 18 unique reasons for vaccine exemption.

Setting:

Tertiary-care academic medical center.

Participants:

Healthcare personnel (HCP).

Results:

Among the 3 influenza seasons, 1.1%–2.1% of all VUMC HCP requested religious or personal exemption from vaccination. The frequency of religious and personal exemption approval increased annually from 296 of 452 (65.5%) to 196 of 248 (80.2%) to 283 of 323 (87.6%) over the 3 seasons, representing a statistically significant increase each year. Of the 5 most common reasons against vaccination, 4 were explicitly religious in nature; the most common reason was that the “body is a temple or sacred.” Nonclinical staff submitted the most religious and personal exemption requests of any job category, submitting approximately one-third of all requests every year.

Conclusions:

These results demonstrate how detailed the personal or religious convictions behind vaccine avoidance can be among HCP and how vaccine avoidance stems from much more than simple misinformation regarding vaccination. The intersection between misinformation and personal or religious beliefs provides a unique opportunity to address HCP opinions toward vaccination in an exemption and appeals process like the one described here.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 42 , Issue 5 , May 2021 , pp. 507 - 512
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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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References

Advisory Committee on Immunization P, Centers for Disease C, Prevention. Immunization of healthcare personnel: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2011;60:1–45.Google Scholar
Talbot, TR, Babcock, H, Caplan, AL, et al. Revised SHEA position paper: influenza vaccination of healthcare personnel. Infect Control Hosp Epidemiol 2010;31:987–995.CrossRefGoogle ScholarPubMed
Mandatory immunization of healthcare personnel against influenza and other infectious diseases. Infectious Diseases Society of America. http://www.Idsociety.Org/Hcw_Policy/. Accessed April 11, 2019.Google Scholar
American College of Physicians calls for immunizations for all health care providers. American College of Physicians website. https://www.acponline.org/acp-newsroom/american-college-of-physicians-calls-for-immunizations-for-all-health-care-providers. Accessed on October 14, 2020.Google Scholar
Antommaria, AH, Prows, CA. Content analysis of requests for religious exemptions from a mandatory influenza vaccination program for healthcare personnel. J Med Ethics 2018;44:389–391.CrossRefGoogle ScholarPubMed
Karanfil, LV, Bahner, J, Hovatter, J, Thomas, WL. Championing patient safety through mandatory influenza vaccination for all healthcare personnel and affiliated physicians. Infect Control Hosp Epidemiol 2011;32:375–379.CrossRefGoogle ScholarPubMed
Leibu, R, Maslow, J. Effectiveness and acceptance of a health care-based mandatory vaccination program. J Occup Environ Med 2015;57:58–61.CrossRefGoogle ScholarPubMed
Babcock, HM, Gemeinhart, N, Jones, M, Dunagan, WC, Woeltje, KF. Mandatory influenza vaccination of health care workers: translating policy to practice. Clin Infect Dis 2010;50:459–464.CrossRefGoogle ScholarPubMed
Ajenjo, MC, Woeltje, KF, Babcock, HM, Gemeinhart, N, Jones, M, Fraser, VJ. Influenza vaccination among healthcare workers: ten-year experience of a large healthcare organization. Infect Control Hosp Epidemiol 2010;31:233–240.CrossRefGoogle ScholarPubMed
Rakita, RM, Hagar, BA, Crome, P, Lammert, JK. mandatory influenza vaccination of healthcare workers: a 5-year study. Infect Control Hosp Epidemiol 2010;31:881–888.CrossRefGoogle ScholarPubMed
Pitts, SI, Maruthur, NM, Millar, KR, Perl, TM, Segal, J. A systematic review of mandatory influenza vaccination in healthcare personnel. Am J Prev Med 2014;47:330–340.CrossRefGoogle ScholarPubMed
Black, CL, Yue, X, Ball, SW, et al. Influenza vaccination coverage among health care personnel—United States, 2017–18 influenza season. Morb Mortal Wkly Rep 2018;67:1050–1054.CrossRefGoogle ScholarPubMed
Nowalk, MP, Lin, CJ, Raymund, M, Bialor, J, Zimmerman, RK. Impact of hospital policies on health care workers’ influenza vaccination rates. Am J Infect Control 2013;41:697–701.CrossRefGoogle ScholarPubMed
Talbot, TR, Schimmel, R, Swift, M, et al. Expanding mandatory healthcare personnel immunization beyond influenza: impact of a broad immunization program with enhanced accountability. Infection Control Hosp Epidemiol 2020; in press.CrossRefGoogle Scholar
Huynh, S, Poduska, P, Mallozzi, T, Culler, F. Mandatory influenza vaccination of health care workers: a first-year success implementation by a community health care system. Am J Infect Control 2012;40:771–773.CrossRefGoogle ScholarPubMed
Smith, DR, Van Cleave, B. Influenza vaccination as a condition of employment for a large regional healthcare system. WMJ 2012;111:68–71.Google Scholar
O’Reilly, FW, Cran, GW, Stevens, AB. Factors affecting influenza vaccine uptake among healthcare workers. Occup Med (Lond) 2005;55:474–479.CrossRefGoogle Scholar
Watanakunakorn, C, Ellis, G, Gemmel, D. Attitude of healthcare personnel regarding influenza immunization. Infect Control Hosp Epidemiol 1993;14:17–20.CrossRefGoogle ScholarPubMed
Weingarten, S, Riedinger, M, Bolton, LB, Miles, P, Ault, M. Barriers to influenza vaccine acceptance. a survey of physicians and nurses. Am J Infect Control 1989;17:202–207.CrossRefGoogle ScholarPubMed
Hofmann, F, Ferracin, C, Marsh, G, Dumas, R. Influenza Vaccination of healthcare workers: a literature review of attitudes and beliefs. Infection 2006;34:142–147.CrossRefGoogle ScholarPubMed
Ludwig-Beymer, P, Gerc, SC. An influenza prevention campaign: the employee perspective. J Nurs Care Qual 2002;16:1–12.CrossRefGoogle ScholarPubMed
McEwen, M, Farren, E. Actions and beliefs related to hepatitis b and influenza immunization among registered nurses in Texas. Public Health Nurs 2005;22:230–239.CrossRefGoogle ScholarPubMed
Norton, SP, Scheifele, DW, Bettinger, JA, West, RM. Influenza vaccination in paediatric nurses: cross-sectional study of coverage, refusal, and factors in acceptance. Vaccine 2008;26:2942–2948.CrossRefGoogle ScholarPubMed
Ofstead, CL, Tucker, SJ, Beebe, TJ, Poland, GA. Influenza vaccination among registered nurses: information receipt, knowledge, and decision-making at an institution with a multifaceted educational program. Infect Control Hosp Epidemiol 2008;29:99–106.CrossRefGoogle ScholarPubMed
Palmore, TN, Vandersluis, JP, Morris, J, et al. A successful mandatory influenza vaccination campaign using an innovative electronic tracking system. Infect Control Hosp Epidemiol 2009;30:1137–1142.CrossRefGoogle ScholarPubMed
Song, JY, Park, CW, Jeong, HW, Cheong, HJ, Kim, WJ, Kim, SR. Effect of a hospital campaign for influenza vaccination of healthcare workers. Infect Control Hosp Epidemiol 2006;27:612–617.CrossRefGoogle ScholarPubMed
Opel, DJ, Sonne, JA, Mello, MM. Vaccination without litigation—addressing religious objections to hospital influenza-vaccination mandates. N Engl J Med 2018;378:785–788.CrossRefGoogle ScholarPubMed
Hollmeyer, HG, Hayden, F, Poland, G, Buchholz, U. Influenza vaccination of healthcare workers in hospitals—a review of studies on attitudes and predictors. Vaccine 2009;27:3935–3944.CrossRefGoogle ScholarPubMed
CDC vaccine excipient and media summary, 2019. Centers for Disease Control and Prevention website. https://Vaccine.Guide/Vaccine-Ingredients/Overview/Cdc-Vaccine-Excipient-and-Media-Summary/. Published 2019. Accessed August 13, 2020.Google Scholar