OT: Mandatory healthcare worker influenza immunization

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http://www.medscape.com/viewarticle/567336

This article was Supported by an independent educational grant from GlaxoKline

Expert Column

Healthcare Worker Influenza Immunization

Pritish K. Tosh, MD; A. Poland, MD

Medscape Infectious Diseases. 2007; ©2007 Medscape

Posted 12/21/2007

Introduction Immunization of healthcare workers (HCWs) against influenza is a patient safety and quality-of-care issue. Annual vaccination of HCWs against influenza has been recommended by the US Centers for Disease Control and Prevention (CDC) since 1981.

....Mandatory HCW Influenza Vaccination

Although efforts to improve influenza immunization have been modestly successful in increasing HCW vaccination, vaccination rates rarely exceed 70% even after aggressive programs are instituted. This has led to the proposition that influenza vaccination be made mandatory for HCWs.[37,38] An influenza vaccine mandate, while allowing for informed declination, has been supported by the following health organizations: Infectious Diseases Society of America, Society of Hospital Epidemiologists of America, Expert Panel on Strengthening Adult Immunization, Association of Perioperative Registered Nurses, Association of Professionals in Infection Control, ACIP, Minnesota Department of Health, American Society of Health System Pharmacists, American Academy of Pediatrics, Healthcare Infection Control Practices Advisory Committee, US Public Health Service, American Medical Association, and American College of Physicians, among others.[39] Additionally, several states have enacted legislation requiring influenza vaccination for HCWs in long-term care facilities.[22]

Previous HCW mandates -- including rubella vaccination, hepatitis B vaccination, and annual screening for tuberculosis -- have resulted in nearly universal compliance with the recommendation and are generally accepted by HCWs.[37,38] After instituting a mandatory influenza vaccination policy for HCWs, institutions, such as the Virginia Mason Clinic, have seen compliance rates exceeding 98%.[40] After decades of effort to increase voluntary influenza immunization among HCWs, a universal mandate appears to be needed to protect patients from a completely preventable infection.

Pritish K. Tosh, MD, Fellow, Infectious Diseases, Mayo Clinic, Rochester, Minnesota A. Poland, MD, Lowell Leary Professor of Medicine, Mayo Clinic College of Medicine; Director, Mayo Vaccine Research Group; Director, Program in Translational Immunovirology and Biodefense, Mayo Clinic and Foundation, Rochester, Minnesota

Disclosure: Pritish K. Tosh, has disclosed no relevant financial relationships.Disclosure: A. Poland, MD, has disclosed that he has served as a consultant to

Dynavax,

Novavax,

Merck,

Protein Sciences,

GlaxoKline,

Novartis Vaccines,

CSL Biotherapies,

and Avianax.

Dr. Poland has also disclosed that he has received research grants from Novavax and Merck.

Dr. Poland has also disclosed that he has served as a chair for the novel vaccine DMSB for Merck.