More hospitals mandate flu shots for workers
More hospitals mandating flu vaccinations for staff
Seattle’s Virginia Mason Medical Center stood alone seven years ago when the hospital first required its staff to receive influenza vaccinations. But these days, the start of the flu season means Virginia Mason’s phones ring off the hook with calls from other providers asking for tips on how to start their own immunization programs.
Banner Health, a 21-hospital system based in Phoenix and with hospitals in seven states, called for advice, as Virginia Mason is widely acknowledged as the first major hospital that has implemented such a program. Banner started its pilot program last year called “No Flu for You.” This year, they’re rolling out the program full scale for its 36,000 workers.
“This program is around to make our patients as healthy as possible when we are taking care of them,” said Dr. Marjorie Bessel, chief medical officer for Banner’s Arizona East region.
Banner used the Immunization Action Coalition’s website as a resource. The St. Paul, Minn.-based IAC works with the Centers for Disease Control and Prevention to develop immunization recommendations.
Contra Costa County, Calif., last week also announced its own employee vaccination requirement. The order was sent to hospitals, emergency medical service providers, ambulatory health clinics, skilled-nursing facilities and other healthcare facilities in the county, and got the backing of Kaiser Permanente.
Earlier this year, the National Business Group on Health joined the American Hospital Association, the American College of Physicians and others in supporting mandatory flu shots.
Virginia Mason planned to begin the season’s vaccination process Sept. 18, and they’ve seen success since 2005, immunizing nearly all of its 5,000 workers. There are a few outliers— those with medical conditions, union affiliations or religious beliefs that exempt them from the vaccinations.
BJC Health Care in St. Louis followed with its own requirement in 2007. The system vaccinated 98.4% of its 25,980 active employees in 2008, according to a Washington University School of Medicine report released in 2010. About 0.3%, or 90, gained religious exemptions, while 321, or 1.2%, received a medical exemption. Eight employees, or .03% of the workforce, were terminated after failing to receive a vaccination in time.
HHS reported that for the 2006 flu season, 42% of healthcare workers were immunized. The rate for the 2010 season was 63.5%. However, at places where vaccinations were mandated, 98.1% of workers were immunized. The 2009 outbreak of H1N1 increased those rates by forcing more hospitals to develop a program. It also affected Virginia Mason’s existing program. The staff at the 248-bed hospital needed second immunizations that season, this time to protect them from swine flu.
Starting in 2013, the CMS will require acute-care hospitals to report healthcare flu vaccinations as part of the agency’s hospital inpatient quality reporting program. The government already offers bonus payments to hospitals that voluntarily report immunization rates. Some providers, where immunizations aren’t mandatory, offer raffle prizes and other incentives for employee vaccination.
A National Vaccine Advisory Committee report from this year recommended mandatory policies for providers struggling to hit targeted employee vaccination rates. However, the group noted that religious beliefs, allergies to vaccines, and union objections can pose obstacles. The country’s largest nurses’ union, National Nurses United, has opposed NVAC’s recommendation, saying it shouldn’t be a condition of employment.
The exemption policy at Virginia Mason was the result of a 2006 U.S. District Court ruling in favor of the Washington Nurses Association. The union claimed the mandatory vaccination policy should have been negotiated as part of its collective bargaining agreement.
Lammert said the benefits are worth the program’s costs, which include the vaccinations and personnel: “It’s really helped change our culture and how we look at our obligation to the patient.”
Richard Watts of Banner Good Samaritan Medical Center receives a flu shot.