RESUMO
Although influenza (flu) and COVID-19 vaccines are highly recommended for healthcare workers, it is known that vaccination rates are suboptimal in healthcare settings. There is a need to optimize vaccination rates among healthcare workers as there are direct correlations to increased patient safety and protection of staff from healthcare associated infections. Our health care organization employed some novel strategies to increase the uptake of both flu and COVID-19 vaccinations by identifying and addressing common barriers. Barriers were identified through team meetings, review of previous years' vaccination trends, and historical information. Strategies to overcome these barriers included dissemination of information through various team meetings; identifying peer vaccination champions among specific groups that had historically low vaccination rates; creating a sense of urgency with weekly announcements regarding vaccinations; and computer screensavers with graphics promoting vaccinations. We believed education was key to success. Our focus was not only on the vaccination rates, but also on compliance which is defined as either getting the vaccine or submitting a declination after completing an education module. These efforts resulted in the organization achieving more than 95% compliance for both vaccinations. Our vaccination uptake rates for influenza were greater than 85% and updated COVID-19 vaccination rates were around 42%. We believe that the grass-root level work initiated for this year's campaign was one of the drivers for our success and some aspects could be replicated for vaccinating the public as well.
RESUMO
OBJECTIVE: Achieving high healthcare personnel (HCP) influenza vaccination rates has typically required mandating vaccination, which is often challenging to implement. Our objective was to achieve >90% employee influenza vaccination without a mandate. DESIGN: Prospective quality improvement initiative SETTING AND PARTICIPANTS: All employees of a 2-hospital, 1,100-bed, community-based academic healthcare system. METHODS: The multimodal HCP vaccination campaign consisted of a mandatory declination policy, mask-wearing for non-vaccinated HCP, highly visible "I'm vaccinated" hanging badges, improved vaccination tracking, weekly compliance reports to managers and vice presidents, disciplinary measures for noncompliant HCP, vaccination stations at facility entrances, and inclusion of a target employee vaccination rate (>75%) metric in the annual employee bonus program. The campaign was implemented in the 2011-2012 influenza season and continued throughout the 2012-2013 through 2014-2015 influenza seasons. Employee compliance, vaccination, exemption and declination rates were calculated and compared with those of the seasons prior to the intervention. RESULTS: Compared with vaccination rates of 57%-72% in the 3 years preceding the intervention, employee influenza vaccination increased to 92% in year 1 and 93% in years 2-4 (P<.001). The proportion of employees declaring medical/religious exemptions or declining vaccination decreased during the 4 years of the program (respectively, 1.2% to 0.5%, P<.001; 4.4% to 3.8%, P=.001). CONCLUSIONS: An integrated multimodal approach incorporating peer pressure, accountability, and financial incentives was associated with increased employee vaccination rate from ≤72% to ≥92%, which has been sustained for 4 influenza seasons. Such programs may provide a model for behavioral change within healthcare organizations.
