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 At the University of Texas MD Anderson Cancer Center in Houston,
just 56 percent of employees got vaccinated during the 2006-2007 flu
season, researchers report in the American Journal of Infection
Control.
But after several years of stepped up outreach efforts and on-site
vaccination programs that culminated in a mandatory vaccination
policy, the study found that 94 percent of employees got inoculated
for the 2013-2014 flu season.
“Mandatory flu vaccination programs are the most effective mechanism
for increasing health care worker vaccination rates,” said lead
study author Dr. Elizabeth Frenzel, a researcher in infection
control and employee health at MD Anderson.
While unvaccinated health workers in any setting may contract
influenza and spread it to patients, the stakes are even higher for
people with cancer, Frenzel added by email.
“Cancer patients and other patients with compromised immune systems
experience significant mortality rates after flu infection
progresses to more serious respiratory infections – so literally
their lives may be at stake when care givers, including healthcare
workers and family members, aren’t vaccinated,” Frenzel said.
Up to 28 percent of cancer patients may die from severe flu-related
respiratory infections, the study team notes in its report.
At the start of the study in 2006, Frenzel and colleagues collected
data on healthcare worker vaccinations for the 656-bed cancer center
with more than 19,000 employees.
That year, they found some workers treating the most vulnerable
cancer patients had even lower vaccination rates than the system
wide average – 47 percent among people caring for immune-compromised
or high-risk patients and 41 percent among inpatient nursing units.
Starting in 2007, the cancer center expanded access to vaccinations
with more hours and locations for on-site flu vaccine clinics,
initially focused on nurses and workers treating high-risk patients.
In 2009, MD Anderson started a pilot mandatory vaccination program.
This required all workers to get the vaccine or sign a waiver
indicating they declined to do so for medical or personal reasons.
Later, this policy became system-wide and all workers had to display
a sticker on their employee badge proving they got vaccinated or
wear a surgical mask when caring for patients during flu season.
Failure to comply could result in termination.
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Over the first flu season of the study, 2006-2007, the cancer center
treated 47 confirmed influenza infections that patients caught
outside the hospital and three cases – or 6 percent of the total –
that patients contracted during their hospital stay.
By the end of the study, during the 2013-2014 flu season, only 2.3
percent of confirmed influenza cases involved patients who caught
the virus while they were hospitalized. That flu season, the cancer
center treated 173 patients who caught flu in the community and 4
who contracted it in the hospital.
One shortcoming of the study is that very few patients caught
influenza in the hospital during any flu season, the authors note.
It’s also possible that the lab test used to confirm flu cases might
have underestimated the number of infections.
Even so, a growing number of medical centers are moving to mandatory
flu vaccination policies as part of a larger infection control
effort, said Dr. Tom Talbot, chief hospital epidemiologist at
Vanderbilt University Medical Center in Nashville, Tennessee.
To work well, these policies should include a careful review of why
workers refuse the vaccine and an effort to communicate the safety
and science of inoculations to people who are declining for
non-medical reasons, added Talbot, who wasn’t involved in the study.
Mandatory vaccination policies should also expand beyond influenza
to include other inoculations recommended by the U.S. Centers for
Disease Control and Prevention, Talbot added by email.
“Given the rise in measles cases in the U.S. and the risk of
transmission in healthcare facilities, the problems with pertussis,
and the decreasing rate of immunization of health care workers
against hepatitis B, this expansion is essential,” Talbot said.
SOURCE: http://bit.ly/23Hxilz American Journal of Infection Control,
online May 5, 2016.
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