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

In addition, the U.S. Department of Health & Human Services has set a goal of 90% of health care personnel to be vaccinated by 2020, Dr. Green and his coauthors noted.

Mandating influenza vaccination is just one proven successful strategy for increasing coverage at hospitals, according to the study authors. Other approaches include influenza education, incentives, free and easy access to vaccination, and annual campaigns directed at health care personnel, as well as written policies describing the vaccination goal.

“Regardless of whether an organization has an official mandate for vaccinations, establishing a written policy that states the organizational commitment to increasing vaccination rates is among the recommended strategies for improving vaccination coverage among health care personnel,” they wrote.

Dr. Greene and his coauthors reported receiving grants from the Blue Cross Blue Shield of Michigan Foundation and the U.S. Department of Veterans Affairs Patient Safety Center of Inquiry during the conduct of the study. One study coauthor reported personal fees from Jvion and from Doximity outside the submitted work.

SOURCE: Greene MT et al. JAMA Network Open. 2018;1(2):e180143.


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