Improving employee vaccination rates against seasonal influenza in a large NYC public healthcare system

NYC Health and Hospitals Corporation (HHC) is largest municipal hospital and health care system serving 1.3 million New Yorkers annually; providing medical, mental health and substance abuse services through 11 acute care hospitals, 4 SNF, 6 D&TCs, 80 community based clinics and home care. HHC employs over 42,000 healthcare workers (HCW), affiliate health care professionals, students and volunteers. Seasonal influenza responsible for 36,000 deaths (1990-1999)and 226,000 hospitalizations annually with rates of serious illness and death among persons aged >65 or <2 and persons with medical conditions (high risk for complications). Annual influenza vaccination is most effective method for preventing influenza and complications. Worldwide spread of H1N1 virus in 2009 emphasizes importance of prevention. HCWs not targeted for flu vaccines. Governor Patterson initiated mandate for HCWs for flu vaccine in 2009. Mandatory flu vaccinations supported by Infectious Disease Society of America: "most effective means to protect patients against transmission of seasonal and H1N1 flu by HCW"; National Patient Safety Foundation and Dr. Caplan, Director of Bioethics at University of Pennsylvania: "Close to 100% vaccination rates can cut patient deaths by 40%". Joint Commission added HCW influenza vaccination as standard in Infection Control chapter in 2009. HHC began tracking HCW influenza vaccination rates in 2008 with corporate compliance of 51%; range 36% to 74%. 2009 Goal set at 60%. Facilities launched vaccination campaigns; utilized creative strategies including: providing vaccines 24/7; on site/unit vaccination; raffles; awards; incentives and modeling. Significant increase in vaccine rates for 2009 with some facilities reaching 90+%.