Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Division of Healthcare Quality Promotion, National Center for Emerging Infectious and Zoonotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Am J Prev Med. 2019 Jun;56(6):e177-e183. doi: 10.1016/j.amepre.2019.01.011. Epub 2019 Apr 17.
Healthcare personnel influenza vaccination can reduce influenza illness and patient mortality. State laws are one tool promoting healthcare personnel influenza vaccination.
A 2016 legal assessment in 50 states and Washington DC identified (1) assessment laws: mandating hospitals assess healthcare personnel influenza vaccination status; (2) offer laws: mandating hospitals offer influenza vaccination to healthcare personnel; (3) ensure laws: mandating hospitals require healthcare personnel to demonstrate proof of influenza vaccination; and (4) surgical masking laws: mandating unvaccinated healthcare personnel to wear surgical masks during influenza season. Influenza vaccination was calculated using data reported in 2016 by short-stay acute care hospitals (n=4,370) to the National Healthcare Safety Network. Hierarchical linear modeling in 2018 examined associations between reported vaccination and assessment, offer, or ensure laws at the level of facilities nested within states, among employee and non-employee healthcare personnel and among employees only.
Eighteen states had one or more healthcare personnel influenza vaccination-related laws. In the absence of any state laws, facility vaccination mandates were associated with an 11-12 percentage point increase in mean vaccination coverage (p<0.0001). Facility-level mandates were estimated to increase mean influenza vaccination coverage among all healthcare personnel by 4.2 percentage points in states with assessment laws, 6.6 percentage points in states with offer laws, and 3.1 percentage points in states with ensure laws. Results were similar in analyses restricted only to employees although percentage point increases were slightly larger.
State laws moderate the effect of facility-level vaccination mandates and may help increase healthcare personnel influenza vaccination coverage in facilities with or without vaccination requirements.
医护人员流感疫苗接种可降低流感发病率和患者死亡率。州法律是促进医护人员流感疫苗接种的工具之一。
2016 年对 50 个州和华盛顿特区进行了法律评估，确定了以下法律：（1）评估法：要求医院评估医护人员的流感疫苗接种状况；（2）提供法：要求医院向医护人员提供流感疫苗；（3）保证法：要求医院要求医护人员证明已接种流感疫苗；（4）手术口罩法：要求未接种疫苗的医护人员在流感季节佩戴手术口罩。流感疫苗接种率使用 2016 年向国家医疗保健安全网络报告的短期急性护理医院（n=4370）的数据进行计算。2018 年的分层线性模型检验了在州内嵌套的医疗机构层面上，报告的疫苗接种与评估、提供或保证法律之间的关联，以及在员工和非员工医护人员以及仅员工之间的关联。
18 个州有一项或多项与医护人员流感疫苗接种相关的法律。在没有任何州法律的情况下，医疗机构疫苗接种强制令与平均疫苗接种覆盖率增加 11-12 个百分点（p<0.0001）相关。在有评估法的州，评估法州的所有医护人员的平均流感疫苗接种率增加了 4.2 个百分点，在有提供法的州增加了 6.6 个百分点，在有保证法的州增加了 3.1 个百分点。在仅分析员工的情况下，结果相似，尽管百分点增幅略大。
州法律缓和了医疗机构疫苗接种强制令的效果，并可能有助于在有或没有疫苗接种要求的医疗机构中提高医护人员流感疫苗接种率。
