Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Clin Infect Dis. 2011 Dec;53(11):1051-9. doi: 10.1093/cid/cir633.
Many health professional organizations now endorse influenza vaccination as a condition of employment in healthcare settings. Our objective was to describe institutional requirements for influenza vaccination of healthcare personnel (HCP) among US hospitals during the 2010-2011 influenza season.
A survey was mailed in 2011 to a nationally representative sample of 998 acute care hospitals. An institutional requirement was defined as "a policy that requires HCP to receive or decline influenza vaccination, with or without consequences for vaccine refusal." A weighted analysis included univariate analyses and logistic regression.
Of responding hospitals (n = 808; 81.0%), 440 (55.6%) reported institutional requirements for influenza vaccination. Although employees were uniformly subject to requirements, nonemployees often were not. The proportion of requirements with consequences for vaccine refusal was 44.4% (n = 194); where consequences were imposed, nonmedical exemptions were often granted (69.3%). Wearing a mask was the most common consequence (74.2% of 194 requirements); by contrast, 29 hospitals (14.4%) terminated unvaccinated HCP. After adjustment for demographic factors, the following characteristics remained significantly associated with requirements: location in a state requiring HCP to receive or decline influenza vaccine, caring for inpatients that are potentially vulnerable to influenza, use of ≥9 Advisory Committee on Immunization Practices-recommended, evidence-based influenza vaccination campaign strategies, and for-profit ownership.
Influenza vaccination requirements were prevalent among hospitals of varying size and location. However, few policies were as stringent or as comprehensive as those endorsed by health professional organizations. Because influenza vaccination requirements are a viable alternative for hospitals unable to achieve high coverage through voluntary policies, there is still substantial room for improvement.
许多健康专业组织现在认可流感疫苗接种作为医护人员在医疗机构就业的条件。我们的目的是描述美国医院在 2010-2011 年流感季节期间医护人员（HCP）流感疫苗接种的机构要求。
2011 年，向全国范围内具有代表性的 998 家急症护理医院发送了一份调查。机构要求定义为“要求 HCP 接种或拒绝接种流感疫苗的政策，无论疫苗接种拒绝是否有后果”。加权分析包括单变量分析和逻辑回归。
在回复的医院（n = 808；81.0%）中，440 家（55.6%）报告了流感疫苗接种的机构要求。尽管员工一律遵守要求，但非员工通常不遵守。对疫苗接种拒绝有后果的要求比例为 44.4%（n = 194）；在施加后果的情况下，经常给予非医疗豁免（69.3%的 194 项要求）。戴口罩是最常见的后果（194 项要求中的 74.2%）；相比之下，有 29 家医院（14.4%）终止了未接种疫苗的 HCP。在调整人口统计学因素后，以下特征仍然与要求显著相关：所在州要求 HCP 接种或拒绝流感疫苗、照顾可能易受流感影响的住院患者、使用≥9 项免疫实践咨询委员会推荐的、基于证据的流感疫苗接种运动策略以及营利性所有权。
不同规模和地点的医院普遍存在流感疫苗接种要求。然而，很少有政策像健康专业组织所认可的那样严格或全面。由于流感疫苗接种要求是无法通过自愿政策实现高覆盖率的医院的可行替代方案，因此仍有很大的改进空间。
