S Carrots and Sticks: Influenza Vaccination of Healthcare Workers. Susan E Coffin, MD, MPH Children’s Hospital of Philadelphia July, 2011. Rationale behind HCW influenza vaccination Implementing a mandatory flu vaccination program at CHOP Impact of mandate HCW attitudes
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Susan E Coffin, MD, MPH
Children’s Hospital of Philadelphia
Implementing a mandatory flu vaccination program at CHOP
Impact of mandate
Nosocomial influenza ratesOverview
*2000-2004; complications determined by detailed chart review
Coffin, ICHE, 2009.
Salgado, ICHE, 2004
Talbot, ICHE, 2005
1) Bryant, ICHE 2004; 2) Tapiainen ICHE 2005; 3) Spillman, 40th National Immunization Conference Atlanta, March 2006
Flu is bad for me and my patients.
I will get vaccinated.
Flu vaccine is unsafe.
Employer: “Get Vaccinated!”
I don’t get flu.
Flu vaccine doesn’t work.
I don’t get flu vaccine.
You Can’t Make Me!!!
“I realize I am eligible for the flu shot and that my refusal of it may put patients, visitors, and family with whom I have contact, at risk should I contract the flu. Regardless . . .”
Adoption was associated with doubling of immunization rates (35% to 70% over 4 yr period)
Spillman SS presented at 40th National Immunization Conference Atlanta, March 2006
CON influenza*Are Declination Forms Enough?
HCW vaccination no longer a “passive decision”
Provides final opportunity to frame issue
Creates focus on individual accountability
Shugarman, J Am Med Dir Assoc, 2006
53% MD groups >80% (19/36)
22% MD groups fully vaccinated (8/36)
81% of MDs vaccinated (623/777)
16% MD groups >80% (5/31)
July, 2009: “The CHOP Patient Safety Committee recommends mandatory annual influenza vaccine for all staff* working in buildings where patient care was provided or whom provide patient care.”
*includes clinicians, support staff, volunteers, students; vendors informed of policy and asked to ensure compliance.
25% clinical (n=1450)
- Mary Cooney
Infection Prevention and Control
- Keith St. John
- Eileen Sherman
Infectious Diseases Epidemiology Research Group
- Kristen Feemster
- Priya Prasad
All CHOP Healthcare Workers