Do declination statements increase health care worker influenza vaccination rates?

In response to health care worker influenza vaccination rates that are below desired targets, strategies designed to stimulate vaccination have been proposed, including the use of declination statements for those refusing vaccination. The impact of these statements has not been thoroughly investigated and may be affected by their specific language and context. This review examines the available data on the use and impact of declination statements to increase health care worker vaccination rates and notes some potential pitfalls and issues that may arise with their use.