The study’s lead author, infectious disease specialist Hilary Babcock, M.D., says the success of the mandatory program demonstrates it is possible to implement a vaccination campaign on a large scale in a health-care setting.
“As a patient safety initiative, we knew the flu shot was safe and effective, and the best way to protect patients was to be sure that employees were vaccinated,” she says.
For 10 years, BJC – affiliated with Washington University School of Medicine – offered the influenza vaccine free of charge to its employees, conducted extensive education campaigns about the benefits of the shot and provided incentives to employees. While vaccination rates were consistently above the national average, they remained below BJC’s target of 80 percent. The nonprofit health care organization includes 13 hospitals in St. Louis, southern Illinois and mid-Missouri.
In 2006, 54 percent of BJC employees received the influenza vaccine, only slightly above average for health-care workers nationwide. In 2007, BJC employees who declined to get a flu shot were asked to sign a statement saying they understood the risk to themselves, their patients and their families. That year, the vaccination rose to 71 percent, still below BJC’s target rate.
Then in 2008, with a focus on patient safety, BJC made the influenza vaccine mandatory for all its employees, regardless of whether they worked directly with patients. Again, the health system provided educational programs about the benefits of the vaccine and made the shot available at no charge to employees at multiple times and locations.
Employees could request religious or medical exemptions, which were reviewed by human resources and occupational health nurses, respectively. Interestingly, many fewer employees sought medical or religious exemptions than had signed declination statements in the previous year.
Overall, 25,561 (98.4 percent) of BJC employees received an influenza vaccine in 2008. In addition, 90 employees (.3 percent) received religious exemptions, and 321 (1.2 percent) received medical exemptions. Medical exemptions included severe allergy to eggs, prior allergic reactions to the flu vaccine and a history of Guillain-Barré syndrome.
“Some of the requests for medical exemptions reflected misinformation about the vaccine and influenza,” says Babcock, an associate professor of medicine, who conducted the study with senior author Keith Woeltje, M.D., Ph.D., associate professor of medicine. For example, some requests cited asthma, cancer or a suppressed immune system, even though these conditions increase the risk of flu-related complications and are reasons to get vaccinated.
In all, eight employees were terminated because they were not vaccinated or granted an exemption. Most of these employees did not submit an exemption request.
Babcock attributes success of the program to the support of hospital leadership and consistent communication from BJC staff that emphasized patient safety. “Overall, the program went very smoothly,” she says. “We were able to talk with the people who had concerns about the vaccine and allay their fears. A large number of employees were really glad that we had made it mandatory and that co-workers were being vaccinated.”
At the two teaching hospitals that are part of BJC HealthCare, Barnes-Jewish Hospital and St. Louis Children’s Hospital, all 907 medical residents and fellows complied with the mandatory policy; five received medical or religious exemptions.
Although physicians employed by BJC were required to get the flu shot, most physicians affiliated with BJC HealthCare are in private practice or are employed by Washington University School of Medicine and are not covered by the mandatory policy.
In the United States, influenza is associated with 36,000 deaths and more than 200,000 hospitalizations each year, and it is the leading cause of vaccine-preventable death. Other vaccines, including those for the measles, mumps, rubella and chicken pox, already are required by many health-care organizations, including BJC.
Babcock says she now plans to collect data for the 2009 flu season, when employees have been required to get both the seasonal flu vaccine and the H1N1 vaccine.
Babcock HM, Gemeinhart N, Jones M, Dunagan WC, Woeltje KF. Mandatory Influence Vaccination of Health Care Workers: Translating Policy to Practice. Online in Clinical Infectious Diseases.
Washington University School of Medicine's 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked third in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC HealthCare.
Caroline Arbanas | EurekAlert!
Study suggests possible new target for treating and preventing Alzheimer's
02.12.2016 | Oregon Health & Science University
The first analysis of Ewing's sarcoma methyloma opens doors to new treatments
01.12.2016 | IDIBELL-Bellvitge Biomedical Research Institute
A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.
Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...
In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.
“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...
The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.
The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...
Broadband rotational spectroscopy unravels structural reshaping of isolated molecules in the gas phase to accommodate water
In two recent publications in the Journal of Chemical Physics and in the Journal of Physical Chemistry Letters, researchers around Melanie Schnell from the Max...
The efficiency of power electronic systems is not solely dependent on electrical efficiency but also on weight, for example, in mobile systems. When the weight of relevant components and devices in airplanes, for instance, is reduced, fuel savings can be achieved and correspondingly greenhouse gas emissions decreased. New materials and components based on gallium nitride (GaN) can help to reduce weight and increase the efficiency. With these new materials, power electronic switches can be operated at higher switching frequency, resulting in higher power density and lower material costs.
Researchers at the Fraunhofer Institute for Solar Energy Systems ISE together with partners have investigated how these materials can be used to make power...
16.11.2016 | Event News
01.11.2016 | Event News
14.10.2016 | Event News
02.12.2016 | Medical Engineering
02.12.2016 | Agricultural and Forestry Science
02.12.2016 | Physics and Astronomy