Oral

The health care consumer has the right to assume that health workers in all settings where service is provided, and the agencies that employ them, will take all measures to prevent transmission of communicable pathogens. Influenza and its complications account for the greatest number of vaccine-preventable deaths worldwide and in the U.S., and primary prevention by vaccination is the most effective and efficient means of protection against influenza. Since 1984, the U.S. Centers for Disease Control and Prevention (CDC) and its Advisory Committee on Immunization Practices (ACIP) have recommended immunization against influenza for health care workers (HCWs), recognizing their risk of workplace exposure. The Hospital Infection Control Practices Advisory Committee (HICPAC) likewise made this recommendation to prevent nosocomial influenza transmission to patients, which has been documented in both acute care hospitals and long-term care facilities. In 1989, the American Public Health Association (APHA) recommended requiring immunization of laboratory and healthcare workers and students against all vaccine-preventable diseases, specifically including influenza. With mounting concern about failure to meet the Healthy People 2010 Objective of 68% coverage and the implications of the high level of susceptibility among health workers, other professional associations have similarly recommended influenza vaccination requirements for HCWs to protect workers themselves as well as the patients with whom they come in contact: American College of Physicians (ACP), Association of Practitioners of Infection Control (ACIP), National Patient Safety Foundation (NPSF), Infectious Diseases Society of America (IDSA), Society of Hospital Epidemiologists of America (SHEA), the American Academy of Pediatrics (AAP), and the Association of Practitioners of Infection Control (APIC). By 2008, 15 states had issued requirements for health worker influenza immunization and, by mid-2010, over 60 institutions across at least 20 states reported successfully implementing mandatory programs. To maintain Joint Commission accreditation, hospitals, long-term care facilities, and home health providers must not only offer vaccine and monitor staff coverage each year, but also continually take steps to raise staff vaccination rates the following year. In 2010, APHA adopted a position statement that broadly addressed a 4-pronged rationale for requiring annual vaccination: ethics, social justice, science, and law. Recognizing that mandates are not a panacea, presenters will address the challenge: How to achieve adequate influenza vaccine uptake by health workers? How can workers, employers, and communities be engaged to address this concern?

Session Objectives: • Discuss the epidemiology of influenza vaccination coverage among health workers over the last two decades, the evolving recommendations and guidelines for influenza prevention in health care settings, and the evidence demonstrating the comparative effectiveness of various approaches to promoting influenza vaccination among health workers • Discuss the ethical and scientific rationale, including behavioral science, underlying proposals to mandate influenza vaccination for health workers and students in health care and laboratory professions • Identify entities that are the source of vaccination requirements (employers; regulatory agencies such as state health departments, OSHA, or licensing authorities; legislatures; or voluntary standards-setting bodies such as Joint Commission), compare the effectiveness of each entity and discuss whether such requirements should be implemented at the national or state level

CE Credits: Medical (CME), Health Education (CHES), Nursing (CNE), Public Health (CPH) , Masters Certified Health Education Specialist (MCHES)