Transcript Mandatory Influenza Vaccination for HCW

Mandatory Influenza
Vaccination for HCW
CAPT John Tueller
Preventive Medicine Dept.
Naval Medical Center San Diego
Disclaimer
The views expressed in this presentation
are my own and do not necessarily reflect
the official policy or position of the
Department of the Navy, Department of
Defense, or the United States Government.
NMCSD Overview
• Main campus: 250-bed inpatient facility
and outpatient clinics
• Nine outlying branch clinics
• 125,000 beneficiaries for flu vaccination
• 6,300 total staff
– 3,300 military
– 2,300 DoD civilians
– 700 contract staff
Seasonal Flu Vaccination in DoD
• Long required for all military personnel,
whether HCW or not.
• Encouraged for DoD civilian HCW.
• Starting in 2009, required for civilian “HCP”
in DoD facilities as a condition of
employment.
NMCSD Staff Seasonal Flu Vaccine Compliance
100.0%
Percent Compliance
90.0%
80.0%
70.0%
60.0%
Military
Civilian
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
2005-06
2006-07
2007-08
Season
2008-09
2009-10
Declination Reasons, 2006-07
(n=263)
20% - Fear of side effects
16% - Too busy
14% - Vaccine causes flu
9% - Not required for my job
8% - Don’t need it; I never get sick
8% - Received it elsewhere
6% - Medical contraindication
Preparing for 2009-10
• HR negotiates with unions (3)
• Executive leadership decides who are
“healthcare providers”
• IT develops “automated” staff vaccination
tracking tool
• Exemption process – medical, religious
• Publish NMCSD policy statement
• Periodic information messages to staff
Majority of staff are “HCP”
CDC: “...the term HCP refers to all paid and unpaid
persons working in health-care settings who have the
potential for exposure to infectious materials, including
body substances, contaminated medical supplies and
equipment, contaminated environmental surfaces, or
contaminated air. HCP might include (but are not limited
to) physicians, nurses, nursing assistants, therapists,
technicians, emergency medical service personnel,
dental personnel, pharmacists, laboratory personnel,
autopsy personnel, students and trainees, contractual
staff not employed by the health-care facility, and
persons (e.g., clerical, dietary, housekeeping,
maintenance, and volunteers) not directly involved in
patient care but potentially exposed to infectious agents
that can be transmitted to and from HCP.”
Challenges in 2009-10
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Two vaccines.
Seasonal vaccine delayed/interrupted.
Novel H1N1 was predominant virus.
DoD elected to require H1N1 vaccine
only for military personnel.
• Vaccination campaign (both vaccines)
lasted 2 months longer than usual.
• Growing pains with electronic tracker.
• Overall mild flu season.
NMCSD Staff Seasonal Flu Vaccine Compliance
100.0%
Percent Compliance
90.0%
80.0%
70.0%
60.0%
Military
Civilian
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
2005-06
2006-07
2007-08
Season
2008-09
2009-10
NMCSD Staff Flu Vaccine Compliance
100.0%
Percent Compliance
90.0%
80.0%
70.0%
60.0%
Military
Civilian
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
2005-06
2006-07
2007-08
2008-09
Season
2009-10
(Seasonal)
2009-10*
(H1N1)
Different for 2010-11?
•
•
•
•
•
•
Only one vaccine
Uninterrupted supply
Union negotiations already done
Improved documentation of vaccinations
Improved electronic tracking tool
Set deadline for compliance, or face
administrative action
Questions?