Archive for: Pandemic Influenza

AOHP asks healthcare organizations to ‘consider’ mandatory flu shot policies

By: May 22nd, 2018 Email This Post Print This Post

The Association of Occupational Health Professionals in Healthcare (AOHP) has joined the growing ranks of industry groups that are calling for hospitals and other healthcare facilities to consider a vaccination policy that makes annual flu shots mandatory for healthcare workers, which AOHP defines as any paid or unpaid person working in any healthcare setting.

AOHP, which calls itself “the only national professional organization with the exclusive mission of addressing the needs and concerns of occupational health professionals in healthcare settings,” recently released a position statement that recommends annual flu shots along with other mandatory vaccinations, including hepatitis B and MMR, for healthcare workers.

AOHP also asks administrators “to consider a policy that makes annual influenza vaccination mandatory (with medical exemptions) or offer alternatives to vaccination such as requiring the use of surgical masks for patient care by healthcare workers who refuse the vaccine.” It says the vaccines should be offered for free and must comply with state and federal regulations.

Mandatory flu vaccination for healthcare personnel is already recommended by organizations such as the Society for Healthcare Epidemiology of America (SHEA), the Pediatric Infectious Diseases Society (PIDS), and the Infectious Diseases Society of America (IDSA).

Many healthcare workers know that getting a flu shot each fall helps protect not only themselves, but coworkers, friends, family, and, most notably, patients. Some have legitimate objections to being vaccinated, such as an allergy or a strong religious belief. However, there are still healthcare workers who simply oppose the mandatory nature of these policies.

Despite that, the Centers for Disease Control and Prevention, which recommends flu shots for all healthcare personnel, reported a vaccination rate of over 95% during the 2015-16 flu season for healthcare workers whose employers required them to get vaccinated for seasonal influenza, which compared to a 79% vaccination rate overall among healthcare workers.

“Over and over again, the research has shown that the mandatory vaccination policies are the strongest indicator of high vaccination rates among healthcare personnel,” says Terri Rebmann, PhD, RN, CIC, FAPIC, the director of the Institute for Biosecurity at Saint Louis University and a professor in epidemiology and biostatistics at the university.

She adds: “It’s really important for healthcare personnel to be vaccinated because they are in really close contact with the most vulnerable of our populations. If the healthcare personnel become infected, regardless of whether or not they have symptoms, when they shed the influenza virus during patient care activities, they can then expose those really high-risk patients.”

Editor’s note: With the next flu season right around the corner, Rebmann will host on July 31 an HCPro webinar entitled “Infection-Free Vaccination: Safely Storing, Handling, Injecting, and Infusing Medications.” During the 90-minute webinar, she will explain how improper administration of vaccines can result in injuries or prevent the vaccines from providing optimal protection. She will also discuss the components of safe storage, handling, injection, and infusion practices for vaccines and how to put them into action. Click here for more information.

New HHS fact sheet gives guidance for handling long-term patient surge

By: February 27th, 2018 Email This Post Print This Post

One of the deadliest flu seasons in recent memory has prompted the Department of Health & Human Services (HHS) to release a fact sheet that gives guidance on handling an influx of patients flocking to healthcare facilities for treatment of the flu and other seasonal illnesses.

While the latest briefing from the CDC suggests that this flu season has peaked, the fact sheet provides useful information healthcare facility emergency planners should consider when developing plans to deal with a similar surge of sick patients in the future. Note that this fact sheet states “these considerations are different than those of planning to handle surge from a no-notice, short duration event” like the recent mass shootings in Orlando, Las Vegas, and Parkland, Florida.

The HHS fact sheet states that “all hospitals must have an emergency operations plan” to deal with a long-term surge. Among the strategies it recommends are expanding normal clinic hours to limit the number of clinic patients coming to the ED, rescheduling elective procedures to free up beds, and setting up “surge sites” such as tents or mobile units located next to the ED.

It also recommends preventive steps that could minimize the surge during a severe flu season, including the use of telehealth, telephone prescribing, virtual information, community paramedicine programs, and risk communications and creating media campaigns encouraging vaccinations, handwashing, and other infection control practices.

The HHS fact sheet states that “there is little an individual hospital or health system can do to prevent patient surge from seasonal illness, but a region or healthcare coalition, in partnership with public health, can use coordinated strategies to help provide situational awareness to support patient surge management throughout the community.”

To download the fact sheet from the HHS website, click right here.

Flu activity is ‘still high and widespread,’ claiming lives and costing employers

By: February 5th, 2018 Email This Post Print This Post

This deadly flu season rages on with, as of Friday, 53 children nationwide having died from the flu. Hospitalization rates are the highest they have been since CDC started tracking that in 2010. And there still may be several more weeks remaining in this flu season, the top CDC official warned late last week.

In a Friday briefing, Anne Schuchat, MD, acting director of CDC, said, “Unfortunately, our latest tracking data indicate flu activity is still high and widespread.”

Schuchat, who is leading CDC’s flu-fighting efforts after the resignation of Brenda Fitzgerald, said it is still not too late to get a flu vaccine. She recommends citizens to do so if they haven’t already despite the resistance of Influenza A H3N2 viruses.

Schuchat also encourages everyone to wash their hands and properly cover mouths when coughing or sneezing. One Florida nurse shared the same sentiment, albeit with a little more sass, in a recent video that went viral over the weekend.

While the loss of life is the main concern for CDC, Schuchat this morning pointed out on Twitter that the flu leads to billions of dollars in lost productivity each year.

(Pink, however, stiff-armed the flu to sing the national anthem at the Super Bowl.)

Schuchat’s tweet included a link to a website encouraging employers to protect their workforce. There, CDC data shows how vaccinations cut down on flu-related illnesses and medical visits–and, in turn, lost productivity for employers.

Mandatory vaccinations are a hot topic in healthcare. CDC has advocated for years that all healthcare workers get vaccinated annually. A couple of weeks ago, we wrote in this space about some things that healthcare leaders should ponder when considering making flu shots mandatory at their hospital or clinic.

Establishing a mandatory flu vaccine policy before the end of this deadly flu season is probably unrealistic at this point given the hoops that must be jumped through to make that happen. But perhaps this can get the ball rolling for next year.

Considering mandatory flu shots at your healthcare facility? Ponder this

By: January 25th, 2018 Email This Post Print This Post

As we wrote in this space a couple of days ago, CDC says it’s not too late to get your flu shot amid one of the most severe flu seasons in years and highly recommends it.

Obviously, folks who work in healthcare should strongly consider getting vaccinated as long as they don’t have a health condition that could be compromised by the vaccine or object to it on religious grounds. Not only are caregivers likely to come into contact with infected citizens, they can also spread it to others even if they don’t feel sick.

Both CDC’s Advisory Committee on Immunization Practices and its Healthcare Infection Control Practices Advisory Committee recommend that all U.S. healthcare workers get vaccinated annually. But in many states, they are not required by law to do so.

Some healthcare facilities, of course, have required that employees get vaccines. In some cases, that has led to legal challenges from employees and unions. But for the most part, it seems that caregivers have been willing to comply with such mandates.

Are you considering the institution of a mandatory flu vaccine policy in your healthcare facility, too? Here, from the November 2016 edition of HCPro newsletter Briefings on Accreditation and Quality, are some things for healthcare leaders to consider:

  • Do you have unionized employees? Be sure to check your contract to see if a flu shot policy needs to be negotiated.
  • Which employees do you want to cover? And how will you handle non-employees, including volunteers and contractors?
  • How will you handle exceptions: Under what circumstances will you grant a waiver; who will decide if an employee seeking a waiver is eligible?
  • If you mandate the policy, who will preside over waivers?
  • Who will be the point person who considers employee requests for waivers? Should it be a medical expert, someone from Human Resources or both?
  • If you require shots, consider informing individuals during the interview process.

CDC urges vaccinations in midst of severe flu season

By: January 23rd, 2018 Email This Post Print This Post

If you have yet to get your flu shot, it’s not too late, says CDC, which is urging citizens “to take every advantage that you can to protect yourself” from what officials are calling one of the most severe flu seasons in years.

The dominant strain this flu season, influenza A (H3N2), is present in every state, and there is severe flu activity in 32 states, CDC reports. The elderly and young children are most at risk of severe disease or death.

In North Carolina alone, 42 adults have already died from the flu this season, CDC Director Brenda Fitzgerald said in a recent interview with Reuters. She added that of the 30 children throughout the country who have died from the flu so far this season, about 85% had not been vaccinated.

“Please get your children vaccinated,” Fitzgerald told Reuters.

The vaccine is estimated to be only about 30% effective against the H3N2 strain. However, CDC leadership said the vaccine has been shown in studies to reduce severity and duration if people do become infected.

And while you’re at it, Fitzgerald said, take other precautions such as washing hands frequently and steering clear of others who are sick.

This, of course, goes without saying for healthcare workers, who will see their fair share of flu patients walk through their doors the rest of this season.

Study: Influenza vaccination rates differ between hospital and non-hospital settings

By: June 29th, 2012 Email This Post Print This Post

A study appearing in  Infection Control and Hospital Epidemiology looks at how and why healthcare workers in non-hospital settings differ in their acceptance of influenza vaccination, and in particular the vaccination for H1N1.

Read the rest of this entry »

Study: Residents short on H1N1 PPE and infection prevention sense

By: May 29th, 2012 Email This Post Print This Post

While training as doctors during the 2009 H1N1 pandemic, residents in four healthcare facilities showed a lack of knowledge about PPE use and when not to report to work because of illness, according to a study in the American Journal of Infection Control.

Read the rest of this entry »

Sidestepping healthcare worker flu shot mandates

By: February 28th, 2012 Email This Post Print This Post

The issue of mandatory flu shots for healthcare workers continues to be a hot topic, with federal vaccination-expert panels making recommendations and professional healthcare associations opining in on both side of the argument. Below is a thoughtful article from HealthLeaders Media weighing voluntary versus mandatory vaccinations.


How to sidestep hospital flu shot mandates

Alexandra Wilson Pecci, for HealthLeaders Media, February 14, 201

Should vaccinations against influenza be mandatory for healthcare workers?

A debate is currently raging about whether the decision to get a flu shot should be made by a nurse, or by his or her employer. In Massachusetts, one in five employees at acute care hospitals declined to be vaccinated last fall.

Last week, the National Vaccine Advisory Committee (NVAC) recommended that hospitals, physician practices, and other healthcare organizations “strongly consider” imposing a flu shot mandate among employees if they fail to achieve 90% voluntary immunization.

Organizations such as the American Hospital Association and American Academy of Family Physicians support mandatory flu vaccines for healthcare workers, with exceptions in the case of health or religious opposition. But nurses have provided some of the most vocal opposition to such mandates; just read some of the individual comments and the summary of public comments about the issue.

Although the nurses’ union National Nurses United “maintains the position that every RN should be vaccinated against the flu,” it opposes vaccine mandates, saying that such programs “engender distrust and resistance among employees; offer a disincentive to providing vaccination education to employees, and raise ethical and legal questions about the personal employment rights of employees.”

The union also argues that “issues such as vaccination supply and efficacy make it such that the vaccine cannot be relied upon to exclusively provide adequate protection from the flu virus.”

In its written policy provided to HealthLeaders Media, the American Nurses Association “urges all registered nurses to get vaccinated every year to protect themselves, their families, and the patients they serve.”  However, it “does not support mandatory influenza vaccination requirements for healthcare workers unless they adhere to certain guidelines to ensure they are fair, equitable and nondiscriminatory.”

The ANA believes a mandate should be implemented only if:

  • The mandatory policy comes from the highest level of legal authority, ideally state government
  • Suitable exemptions, such as for those allergic to components of the vaccine, are included
  • Discriminating against or disciplining nurses who choose not to participate is prohibited
  • The policy is part of a comprehensive infection control program that includes personal protective equipment, such as N95 respirators, to increase safety
  • Vaccinations are free and provided at convenient times and locations to foster compliance
  • The employer negotiates with worker union representatives to resolve any differences when the policy is implemented at a health care facility

But voluntary measures don’t seem to work as well. According to the CDC, “during the 2010-2011 influenza season, coverage for influenza vaccination among healthcare workers was estimated at 63.5%.” However, “coverage was 98.1% among healthcare workers who had an employer requirement for vaccination.”

I personally feel very conflicted about this issue. On one hand, I totally understand nurses’ resistance to vaccine mandates as a condition of employment. Something seems very wrong with being forced to inject something into your body.

But I’m also the mom of a little girl who had surgery twice before she was five months old. It was late autumn, and the hospital was heavily restricting visitors because of a local flu outbreak. Only immediate family—and absolutely no kids—could visit my daughter after her surgery.

Our pediatrician vehemently insisted that I, my husband, our parents, and any other adult who came into contact with her be vaccinated against the flu. I personally harangued my relatives—who had no health or religious reasons for not getting the vaccine—until they complied. Not only was I worried about her surgical complications, I was worried that my unvaccinated infant would be exposed to a flu outbreak.

I knew that the flu vaccine would not be 100% effective, but I still felt better about having that extra level of protection. A heavy padlock might not keep a determined intruder out of your home for long, but locking the door is safer than leaving it open.

At the end of the day, no one should be forced to get a flu vaccine as a condition of employment; there are too many legal and ethical problems with doing so. However, mandates with provisions and conditions such as those outlined by the ANA seem warranted.

In the meantime, healthcare groups that oppose a mandate, but support vaccinations should take much stronger action to achieve higher voluntary vaccination rates.

Source: HealthLeaders Media



Needlesticks more likely during pandemic clinics

By: February 17th, 2012 Email This Post Print This Post

Healthcare workers giving lots flu shots in clinics during a pandemic are at higher risk of experiencing needlestick injuries, according to a study published in the American Journal of Infection, February 2.

“Needlestick injury surveillance during mass vaccination clinics”  looked at needlestick injuries to healthcare workers in the Denver Metropolitan region health department clinics during the H1N1 pandemic. The study found that the injury rate was 4.9 times the mean rate compared that of non-pandemic vaccination clinics from 2003 to 2009.

The study also found an increased trend in needlestick injuries with vaccination inexperience.

“These findings can be used to improve future mass vaccination clinic safety,” the study included.

Federal recommendations inch toward mandatory flu shots

By: February 13th, 2012 Email This Post Print This Post

A federal panel of vaccine advisors proposed recommendations that could lead to mandatory influenza vaccinations for healthcare workers.

The National Vaccine Advisory Committee (NVAC) received a report on February 7 from the Health Care Personnel Influenza Vaccination Subgroup following the publishing of draft recommendations and the public comment period beginning last November, according to CIDRAP News.

Recommendations approved by the majority of the working group say that healthcare facilities should continue to establish among workers flu prevention education, integrated vaccination programs, and standardized vaccination rate reporting, according to CIDRAP.

The report also says that facilities failing to achieve and maintain a 90% worker vaccination rate with voluntary measures “should strongly consider requiring mandatory flu vaccination,” reports CIDRAP.

The NVAC recommendations now go to the Department of Health and Human Services.

IAC updates flu shot honor roll

By: February 7th, 2012 Email This Post Print This Post

The Immunization Action Coalition (IAC) has added 28 healthcare institutions to its Honor Roll for Patient Safety.

The recognition, honors hospitals, medical practices, professional organizations, and government entities that require mandatory influenza vaccination policies for healthcare workers.

Click here to view the new additions and information applying for the IAC honor roll.


Colorado considers mandatory flu shots

By: January 30th, 2012 Email This Post Print This Post

The Colorado State Board of Health will vote next month on whether to mandate flu shots for healthcare workers.

The board is considering a recommendation by state health officials requiring influenza immunizations “for nearly all hospital and nursing-home employees, with no religious or other personal exemptions, saying patient protections outweigh individual choice,” reports The Denver Post, January 26.

The proposed rule would work in concert with state and national goals to increase healthcare worker influenza immunizations to 90% by 2014.

High-risk facilities that did not reach required immunization rates would have to switch to a mandatory flu shot policy, according to the Post. Lower risk businesses, such as assisted living and home health, would have more leeway on establishing flu shot policies for workers.

The rule would not affect medical and dental practices since the state does not license those types of healthcare facilities, the Post reports.

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