Barriers and Strategies to Improving Influenza Vaccination among Health Care Personnel

Lack of access to influenza vaccine

• Provide free vaccine at the workplace
• Offer vaccine at multiple times and locations convenient to all workers on all shifts during the flu season
• Use a mobile vaccination cart to take influenza vaccinations to staff
• Provide staff with a voucher for vaccination at a drugstore or clinic
• Partner with a larger health care organization (e.g., hospital) to provide vaccinations
• Work with pharmacy consultants to offer influenza vaccinations for facility staff
• Work with visiting nurses associations or other community immunizers to provide vaccination on-site
• Offer influenza vaccine at mandatory trainings, departmental conferences, and other meetings

Beliefs

• Belief that influenza is not a serious illness/not a risk for young or healthy people
• Belief that influenza vaccine is not effective
• Belief that influenza vaccine causes illness/side effects
• Fear of injections

• Provide a strong educational program for staff.
  • Focus on protecting the worker and their family as well as the residents in the educational materials
  • Share CDC’s Influenza Vaccine Information Statements
  • Share the Joint Commission’s Influenza and Influenza Vaccine Myths and Reality [108 KB, 2 pages] fact sheet
  • Use a declination form [66 KB, 1 page] to learn why staff are declining vaccination to focus your own messages
  • Ask vaccinated health care personnel to encourage their coworkers to get vaccinated

Lack of enthusiasm about influenza vaccination

• Establish a culture of prevention in your organization with the following ideas
  • Publicize a “vaccine day” in combination with education to offer influenza vaccinations
  • Emphasize that flu vaccination protects the employees, their loved ones and those they work with
  • Encourage employees to set an example; remind them that their action and recommendation carries a lot of weight in others’ decisions to get vaccinated
  • Encourage employees via e-mail, posters, an employee newsletter, and any other communication tools used in your workplace to get the vaccine
  • Track and report vaccination rates to staff and supervisors
  • Remind unvaccinated employees with e-mail, letters, encouragement from supervisors, and telephone calls
  • Provide contests or incentives to get vaccinated (small gift cards, raffles, pizza party, etc.)
  • Vaccinate the medical director and all managers in front of the staff
  • Foster team building to increase trust and cooperation
    • Team building may lead to increased compliance with organizational goals including immunization

High staff turnover

• Offer influenza vaccination education multiple times during the flu season
• Offer opportunities to be vaccinated at multiple times and locations convenient to all workers on all shifts during the flu season
• Educate and vaccinate staff as part of new employee orientations
• Establish a process to determine and track proof of influenza vaccination each year for each employee
• Establish a written influenza vaccination policy for employees
• Work with pharmacy consultants to offer influenza vaccination for facility staff, as a standard procedure

HCP represent diverse cultures

• Access guidance from the HHS National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care
• Provide educational materials in multiple languages, including
  • CDC’s Vaccine Information Statements
  • Flu information: MedlinePlus and Public Health–Seattle & King County
• MedlinePlus provides tutorials and videos on health topics that might be good for low literacy groups

Lack of centralized workplace

• Educate and vaccinate staff as part of new employee orientation, training, and meetings
• Establish a process to determine and track proof of influenza vaccination each year for each employee

Lack of incentive for employer to cover cost of influenza vaccination

• LTC organizations could advertise high HCP influenza vaccination rates to consumers to indicate patient safety
• Share CDC’s Business Toolkit [1.8 MB, 15 pages] to demonstrate that employers across sectors think it makes good sense to promote influenza vaccination of employees
• Educate staff about expanded health insurance coverage for influenza vaccinations under the Affordable Care Act
  • Employee health insurance plans may now cover influenza vaccination for your employees
  • Other health insurance plans that staff may participate in (such as a spouse’s insurance plan) may now cover influenza vaccinations
  • Staff who do not qualify for employer-provided insurance may be able to get insurance through state Health Insurance Marketplaces