A recent study analyzed influenza vaccination mandates among health care personnel in U.S. hospitals, highlighting changes since 2017. Researchers found a significant increase in vaccination requirements, particularly within the U.S. Department of Veterans Affairs hospitals.
Investigators surveyed 881 nonfederal general medical and surgical hospitals and 127 U.S. Department of Veterans Affairs (VA) hospitals in April 2021. The findings revealed that 96% of VA hospitals required staff to receive influenza vaccinations or obtain an exemption, a substantial increase from 4% in 2017. In contrast, nonfederal hospitals saw a smaller rise in mandates, from 69% in 2017 to 74% in 2021. The overall response rate to the survey was 48%, with 471 respondents included in the analysis.
The increase in mandates within VA hospitals followed the implementation of the Veterans Health Administration directive 1192.01 in August 2020, which required VA health care personnel (HCP) to receive annual influenza vaccinations or secure exemptions as a condition of employment. “Our findings show the impact of one of the largest health care systems in the U.S. taking a stand and putting a policy in place that is based on a bedrock ethical principle of medicine: Do no harm," stated lead author Todd Greene, Ph.D., M.P.H.
The study, published in JAMA Network Open, also reported that 23% of nonfederal hospitals strongly encouraged but did not require influenza vaccinations. Regardless of mandates, 81% of nonfederal hospitals required unvaccinated workers to wear masks around patients during flu season. This approach aimed to reduce the transmission of influenza within health care settings.
The research team has been surveying hospitals on this topic since 2013, and their latest survey underscored the role of institutional policies in increasing vaccination rates among HCP, despite the challenges posed by vaccine hesitancy and the decline in vaccination rates during the COVID-19 pandemic.
The lead author noted that surveys of American health care workers showed that flu vaccination percentages had dropped over time, from 91% during the 2019-2020 season to 81% by the 2022-2023 season. Dr. Greene added, “For people working in the care environment, the benefits of getting vaccinated generally outweigh any potential risks.” The study emphasized the importance of balancing vaccination mandates with exemptions and penalties for noncompliance to ensure high vaccination coverage among HCP.
The study, funded by the VHA National Center for Patient Safety, underscored ongoing efforts to improve patient safety through increased influenza vaccination coverage among health care personnel.