Wednesday, February 27, 2013

Hospitals with flu vaccination mandates for health care workers that include consequences for noncompliance saw greater increases in vaccination rates than hospitals that had mandates without consequences or no mandates at all, according to a study published online in the American Journal of Infection Control.

In fact, the change in the vaccination rates in hospitals with mandates that included consequences was almost double the rate for hospitals that had mandates without consequences.

States have started passing legislation regulating health care worker flu vaccination, and an increasing number of hospitals have started implementing policies in attempt to reach the Healthy People 2020 goal of having 90 percent of health care workers vaccinated. Only two-thirds of health care workers were vaccinated against the flu last year. This can leave patients at risk and hospitals short-staffed because of absenteeism.

The study, conducted by Mary Patricia Nowalk, PhD, RD and Richard Zimmerman, MD, MPH and their colleagues at the University of Pittsburgh, offers insight into the impact hospital policies and state laws have on health care worker vaccination rates.

The study surveyed 150 hospitals that require employees to receive a vaccination against the seasonal flu. Of those hospitals, there were 84 with policies that include consequences for workers who did not comply and 66 hospitals that had policies without consequences.

The researchers found that among those hospitals with consequences, 66.7 percent required workers who did not comply to wear a mask, 28.5 percent terminated the position of those who did not comply, 14.3 percent required workers to take classes or receive additional education, 6 percent restricted those workers from patient care duties, and 3.6 percent required temporary suspension or unpaid leave.

When the researchers asked which factors led to the implementation of a mandate, hospitals most frequently cited the previous year’s vaccination rates. Those hospitals without consequences attached to their mandate more often cited the state law or statues and the Joint Commission recommendations, while those hospitals with consequences more often cited experience with similar policies at other facilities.

The article is available online:

An interview with study PI Richard Zimmerman, MD, MPH,  can be viewed at:

The grantee description page can be found here: