ORIGIN: Community Guide systematic review
Publication Date: 12/07/2009
Vaccine coverage for vaccine preventable disease is an essential public health goal. Vaccination against specific diseases is particularly important for high risk populations, which may include individuals of a certain age (e.g., greater than 68 years for Pneumococcal Polysaccharide) or with specified medical conditions (e.g., HIV/AIDS for influenza). CDC: General Recommendations on Immunization.
Laws and policies require vaccination (subject to enumerated exceptions) as a condition of certain jobs. In some states, state law or hospital policies require hospital staff to be vaccinated against influenza. In Rhode Island, for example, health care workers with direct patient contact must be vaccinated for measles, mumps, and rubella. RI Code R. 14-090-007. Illinois requires rubella vaccinations for nursery workers. Ill. Admin. Code tit. 77, § 250.1820.
In a systematic review, a Community Guide expert panel attempted to systematically review the evidence concerning the impact of requiring vaccinations outright or as a condition of specified activities such as employment as a healthcare worker. Ndaiye SM, Hopkins DP, Shefer AM, et al. Interventions to improve influenza, pneumococcal polysaccharide, and hepatitis B vaccination coverage among high-risk adults: a systematic review. Am J Prev Med 2005;28(5S):248-79. The reviewers were unable to locate any studies that measured the impact of these laws in the U.S. As a result, the reviewers concluded there is insufficient evidence to currently evaluate the effectiveness of these laws and policies as public health measures aimed at protecting vulnerable populations against specific diseases.
The Centers for Disease Control and Prevention has compiled and provided online access to state laws requiring or encouraging vaccination of health care workers.
Additional Resources: Centers for Disease Control and Prevention
A Public Health Law Research Program “Evidence Brief” summarizes the research assessing the effect of a specific law or policy on public health.
Evidence Briefs are prepared by the staff of the National Program Office. Briefs are based on systematic literature reviews conducted by highly-regarded scholars and published by credible organizations or peer-reviewed journals. Evidence Briefs digest the best available evidence, but readers should bear in mind that even the best evidence may have limitations or deficiencies.
The evidence briefs are organized by topic and intervention. Each law or policy is classified as “effective,” “uncertain” or “harmful,” according to the conclusions of the expert reviewers. These are not independent conclusions of the NPO, nor do they reflect the views of the Robert Wood Johnson Foundation.
Each Evidence Brief includes links to the study on which it is based. In many cases, the study is available in the public domain, but access to some may require a subscription.