Michelle Murti1, Michael Otterstatter2, Alison Orth3, Robert Balshaw4, Khalif Halani5, Paul D Brown6, Samar Hejazi7, Darby Thompson8, Sandra Allison9, Aamir Bharmal10, Meena Dawar11, Dee Hoyano12, Victoria Lee13, Monika Naus14, Sue Pollock15, John Bevanda16, Sandy Coughlin17, John Fitzgerald18, Dave Keen19, Melanie Maracle20, Stacy Sprague21, Bonnie Henry22. 1. Fraser Health Authority, 13450 102nd Ave., Suite 400, Surrey, BC V3T0H1, Canada; University of British Columbia, 2206 East Mall, Vancouver, BC V6T1Z3, Canada; Public Health Ontario, 480 University Ave., Suite 300, Toronto, ON M5G1V2, Canada. Electronic address: michelle.murti@oahpp.ca. 2. BC Centre for Disease Control, 655 W 12th Ave., Vancouver, BC V5Z4R4, Canada; University of British Columbia, 2206 East Mall, Vancouver, BC V6T1Z3, Canada. Electronic address: Michael.otterstatter@bccdc.ca. 3. Fraser Health Authority, 13450 102nd Ave., Suite 400, Surrey, BC V3T0H1, Canada. Electronic address: alison.orth@fraserhealth.ca. 4. BC Centre for Disease Control, 655 W 12th Ave., Vancouver, BC V5Z4R4, Canada; University of Manitoba, 753 McDermot Ave., Third Floor, Winnipeg, MB R3E0T6, Canada. Electronic address: Robert.balshaw@umanitoba.ca. 5. Emmes Canada, 4664 Lougheed Hwy., Suite 200, Burnaby, BC V5C3Y2, Canada. Electronic address: khalani@emmes.com. 6. Fraser Health Authority, 13450 102nd Ave., Suite 400, Surrey, BC V3T0H1, Canada. Electronic address: paul.brown@fraserhealth.ca. 7. Fraser Health Authority, 13450 102nd Ave., Suite 400, Surrey, BC V3T0H1, Canada. Electronic address: samar.hejazi@fraserhealth.ca. 8. Emmes Canada, 4664 Lougheed Hwy., Suite 200, Burnaby, BC V5C3Y2, Canada. Electronic address: dthompson@emmes.com. 9. Northern Health Authority, 299 Victoria St., Suite 600, Prince George, BC V2L5B8, Canada; University of British Columbia, 2206 East Mall, Vancouver, BC V6T1Z3, Canada. Electronic address: Sandra.allison@northernhealth.ca. 10. Fraser Health Authority, 13450 102nd Ave., Suite 400, Surrey, BC V3T0H1, Canada; University of British Columbia, 2206 East Mall, Vancouver, BC V6T1Z3, Canada. Electronic address: aamir.bharmal@fraserhealth.ca. 11. Vancouver Coastal Health Authority, 601 West Broadway, 11th Floor, Vancouver, BC V5Z4C2, Canada; University of British Columbia, 2206 East Mall, Vancouver, BC V6T1Z3, Canada. Electronic address: meena.dawar@vch.ca. 12. Island Health Authority, 1952 Bay St., Victoria, BC V8R1J8, Canada; University of British Columbia, 2206 East Mall, Vancouver, BC V6T1Z3, Canada. Electronic address: dee.hoyano@viha.ca. 13. Fraser Health Authority, 13450 102nd Ave., Suite 400, Surrey, BC V3T0H1, Canada; University of British Columbia, 2206 East Mall, Vancouver, BC V6T1Z3, Canada. Electronic address: Victoria.lee@fraserhealth.ca. 14. BC Centre for Disease Control, 655 W 12th Ave., Vancouver, BC V5Z4R4, Canada; University of British Columbia, 2206 East Mall, Vancouver, BC V6T1Z3, Canada. Electronic address: monika.naus@bccdc.ca. 15. Interior Health Authority, 505 Doyle Ave., Kelowna, BC V1Y0C5, Canada; University of British Columbia, 2206 East Mall, Vancouver, BC V6T1Z3, Canada. Electronic address: sue.pollock@interiorhealth.ca. 16. Interior Health Authority, 505 Doyle Ave., Kelowna, BC V1Y0C5, Canada. Electronic address: john.bevanda@interiorhealth.ca. 17. Providence Health Care, 1081 Burrard St., Vancouver, BC V6Z1Y6, Canada. Electronic address: scoughlin@providence.bc.ca. 18. Island Health Authority, 1952 Bay St., Victoria, BC V8R1J8, Canada. Electronic address: john.fitzgerald@viha.ca. 19. Fraser Health Authority, 13450 102nd Ave., Suite 400, Surrey, BC V3T0H1, Canada. Electronic address: dave.keen@fraserhealth.ca. 20. Northern Health Authority, 299 Victoria St., Suite 600, Prince George, BC V2L5B8, Canada. Electronic address: melanie.maracle@northernhealth.ca. 21. Vancouver Coastal Health Authority, 601 West Broadway, 11th Floor, Vancouver, BC V5Z4C2, Canada. Electronic address: stacy.sprague2@vch.ca. 22. Office of the Provincial Health Officer, PO Box 9648 STN PROV GOVT, Victoria, BC, V8W9P4, Canada; University of British Columbia, 2206 East Mall, Vancouver, BC V6T1Z3, Canada. Electronic address: bonnie.henry@gov.bc.ca.
Abstract
OBJECTIVES: In 2012, British Columbia (BC) implemented a province-wide vaccinate-or-mask influenza prevention policy for healthcare workers (HCWs) with the aim of improving HCW coverage, and reducing illness in patients and staff. We assess post-policy impacts of HCW vaccination status on their absenteeism. METHODS: We matched individual HCW payroll data from December 1, 2012 to March 31, 2017 with annually self-reported vaccination status for BC health authority employees to assess sick rates (sick time as a proportion of sick time and productive time). We modelled adjusted odds ratios (OR) of taking any sick time, relative rates (RR) of sick time taken, and predicted mean sick rates by vaccination status in influenza (December 1-March 31) and non-influenza seasons (April 1 to November 30). We used two methods to assess changes in influenza season sick rates for HCWs who had a change in their vaccination status over the five years. RESULTS: HCWs who reported 'early' vaccination (before December 1 when the policy is in effect) were less likely to take sick time (OR 0.874, 95%CI: 0.866-0.881) and took less sick time (RR 0.907, 95%CI: 0.901-0.912) in influenza season compared to HCWs who did not report vaccination; whereas HCWs who reported 'late' (between December 1 and March 31, and subject to masking until vaccinated) had similar sick rates to HCWs who did not report vaccination. These trends were also observed in non-influenza season. Influenza season sick rates were similar for HCWs that had at least one year of 'early' vaccination and one year where vaccination was not reported over the five year period. CONCLUSIONS: Overall absenteeism is lower among HCWs who report vaccination versus those who do not report. However, absenteeism behaviours appear to be influenced by individual level factors other than vaccination status.
OBJECTIVES: In 2012, British Columbia (BC) implemented a province-wide vaccinate-or-mask influenza prevention policy for healthcare workers (HCWs) with the aim of improving HCW coverage, and reducing illness in patients and staff. We assess post-policy impacts of HCW vaccination status on their absenteeism. METHODS: We matched individual HCW payroll data from December 1, 2012 to March 31, 2017 with annually self-reported vaccination status for BC health authority employees to assess sick rates (sick time as a proportion of sick time and productive time). We modelled adjusted odds ratios (OR) of taking any sick time, relative rates (RR) of sick time taken, and predicted mean sick rates by vaccination status in influenza (December 1-March 31) and non-influenza seasons (April 1 to November 30). We used two methods to assess changes in influenza season sick rates for HCWs who had a change in their vaccination status over the five years. RESULTS: HCWs who reported 'early' vaccination (before December 1 when the policy is in effect) were less likely to take sick time (OR 0.874, 95%CI: 0.866-0.881) and took less sick time (RR 0.907, 95%CI: 0.901-0.912) in influenza season compared to HCWs who did not report vaccination; whereas HCWs who reported 'late' (between December 1 and March 31, and subject to masking until vaccinated) had similar sick rates to HCWs who did not report vaccination. These trends were also observed in non-influenza season. Influenza season sick rates were similar for HCWs that had at least one year of 'early' vaccination and one year where vaccination was not reported over the five year period. CONCLUSIONS: Overall absenteeism is lower among HCWs who report vaccination versus those who do not report. However, absenteeism behaviours appear to be influenced by individual level factors other than vaccination status.