Promoting institutional mandates for influenza vaccination through a Harnessing public-private initiative, lessons from Pennsylvania

There is growing evidence that requiring the influenza vaccination at institutional level is the most effective way of attaining >90% (universal) influenza vaccine coverage among employees. During the summer of 2011, the Pennsylvania Department of Health in collaboration with the Hospital and Health System Association of Pennsylvania, the Center for Vaccine Ethics and Policy (University of Pennsylvania) and the Pennsylvania Patient Safety Authority and the Pennsylvania Immunization Coalition, launched a statewide initiative to encourage institutional mandates for influenza vaccination among Pennsylvania healthcare facilities. Before the campaign, 8 of ~250 licensed hospitals and 5 of ~830 licensed long term care facilities (LTCFs) in Pennsylvania were known to have achieved universal vaccine coverage. The campaign involved conducting 13 regional seminars during the summer; engaging institutions with universal coverage in sharing best practices; deploying a training website; offering post-training technical assistance and asking HCF's to sign a pledge that they would move towards requiring influenza vaccination by 2013. The number of institutions known to have universal coverage increased to 26 three months into the campaign. By December of 2011, 19 additional institutions had signed a pledge to move towards requiring influenza vaccination by 2013. The number of institutions requiring influenza vaccination among HCP in Pennsylvania has increased, and so has the momentum among institutions to move towards mandating. In the absence of federal and state legislation, state-based immunization campaigns involving the state and professional organizations have the potential to increase momentum towards institutional mandates for influenza vaccination.