From the Journals

Many hospitals had no mandatory flu vaccine requirements in 2017

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Knowledge gaps remain on vaccination benefit

This study suggests a significant increase in use of mandatory influenza vaccination policies during 2013-2017, driven mainly by increases at non–Veterans Affairs (VA) hospitals and little change at VA facilities. However, there are some caveats to the findings that should be considered, Hilary M. Babcock, MD, MPH, wrote in an editorial referencing the study.

The sample for the 2013 and 2017 surveys included different facilities and different size facilities, so direct comparisons cannot be made, according to Dr. Babcock.

Moreover, the survey questions were worded somewhat differently in the two surveys, and it does not appear that “mandate” was defined by the study authors, she said in her editorial.

The VA recently issued a directive that all health care personnel should receive influenza vaccination and wear masks during influenza season. This new directive provides an “excellent opportunity” to address knowledge gaps regarding the effects of influenza vaccination of health care personnel on patient outcomes, according to Dr. Babcock.

“While the assumption that decreasing the risk of influenza in health care personnel will result in decreased risk of influenza in patients cared for by those health care personnel is common sense, for acute care settings, it is still largely an assumption,” Dr. Babcock wrote. “Hopefully, the Veterans Health Administration will combine this initiative with thoughtful, planned, patient outcome assessments to help define the anticipated benefit of these efforts.”

Dr. Babcock is with Washington University and the BJC HealthCare Infection Prevention & Epidemiology Consortium, both in St. Louis. These comments are derived from her editorial in JAMA Network Open (2018;1[2]:e180144). Dr. Babcock reported no conflict of interest disclosures related to her editorial.


FROM JAMA Network Open

By contrast, the proportion of VA hospitals with such requirements increased only slightly, from 1.3% in 2013 to just 4.1% in 2017 (P = .29), the report showed.

Penalties for not complying with the policy were not universal in hospitals with mandates, they added. Only 74% said they had such penalties, and 13% allowed health care personnel to decline influenza vaccination without a specified reason.

After the survey responses were received, the VA issued a directive stating that all health care personnel should receive annual influenza vaccination and should wear masks during influenza season, Dr. Greene noted.

That directive is in line with recommendations from the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices, which have stated that all health care personnel should receive influenza vaccination each year.

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