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September 2010
Policy and Advocacy
IDSA, SHEA Strengthen HCW Influenza Immunization Policies
Groups call for influenza vaccination to be condition of employment

IDSA and the Society for Healthcare Epidemiology of America (SHEA) recently adopted stronger policies supporting universal influenza vaccination for health care workers (HCW), calling for influenza immunization to be a requirement of employment. Stressing HCW vaccination as a core patient safety issue and a professional and ethical responsibility, the groups now recommend exemptions to mandatory influenza immunization only in cases of medical contraindications.

IDSA strengthened its policy in July to specify that influenza vaccination should be a condition of employment and to remove declination for religious reasons. The current IDSA policy, created in 2007 and previously revised in 2009 (see Oct. 2009 IDSA News article), is available on the IDSA website. A SHEA position paper, which IDSA endorsed, outlining SHEA’s updated position appears in the October 2010 issue of Infection Control and Hospital Epidemiology. The paper updates a statement SHEA issued in 2005.

“The scientific evidence shows significant reductions in the risk of influenza in both acute and long-term care settings as a result of strong immunization policies and programs,” IDSA President Richard Whitley, MD, FIDSA, said in a SHEA/IDSA press release. “Vaccination of health care personnel saves patients’ lives and reduces illness. It also protects the individual worker from falling ill during influenza outbreaks and from missing work, which further impacts patient care.”

IDSA and SHEA both agree that mandatory vaccination should be part of a comprehensive influenza infection control program, including hand hygiene and cough etiquette, identifying and isolating infected patients, appropriate personal protective equipment, and restriction of ill health care personnel and visitors.

Last year’s influenza season highlighted the need for stronger policies for HCW influenza vaccination, particularly given the low immunization rates in many voluntary programs. Even with the greater concern surrounding influenza during the 2009 H1N1 pandemic, only 39 percent of health care professionals said they intended to get vaccinated, according to a 2009 RAND Corp. survey.

IDSA and SHEA are continuing to push for stronger HCW influenza immunization policies nationwide. In an Aug. 31 letter (PDF) to Department of Health and Human Services (HHS) Secretary Kathleen Sebelius, we urged HHS to adopt the new position as its own: “Universal vaccination of [health care personnel] is the cornerstone to a comprehensive national effort to prevent the spread of influenza during a seasonal influenza outbreak or a pandemic,” the groups wrote.

In September, the American Academy of Pediatrics (AAP) announced a similar policy, recommending that all health personnel should be required to receive an annual influenza vaccine, except for medical exemptions. Unlike the IDSA and SHEA position, however, the policy allows for religious exemptions to influenza vaccination. The policy, available online (PDF), appears in the Oct. 2010 issue of Pediatrics.
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