BJC Health Care, a multi-hospital health care system in the Midwest, implemented a mandatory influenza vaccination policy for its approximately 26,000 employees in 2008 after several years of free vaccinations, extensive educational efforts, and incentives failed to increase the employee vaccination rate to the system's goal of 80 percent. The new policy improved the vaccination rate to 98 percent compared with rates of 71 percent in 2007 and 54 percent in 2006.

Medical and religious exemptions were granted to 411 employees under the mandatory policy in 2008. Eight workers who were not vaccinated or granted exemptions were terminated for not complying with the policy.

"Mandatory programs work and can be implemented at large health care facilities or systems successfully," said study author Hilary Babcock, MD, of the Washington University School of Medicine in St. Louis. "Staff influenza vaccination rates are being discussed as a possible patient safety indicator that could be used for accreditation or public reporting, which would increase the likelihood of more programs developing mandatory policies."

The study's findings reveal that such policies result in extremely high vaccination coverage rates among health care workers, said the author of an accompanying editorial, Andrew Pavia, MD, FIDSA, of the University of Utah in Salt Lake City. "Health care organizations should be expected to achieve influenza vaccine coverage that optimizes patient safety," wrote Dr. Pavia, who proposed an employee vaccination rate of 90 percent as an appropriate target. "Organizations can then choose to achieve the target with less coercive methods if they can, or if necessary, choose to mandate vaccination."

Note: If no author is given, the source is cited instead.

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