Thomas R Talbot1,2, Ruth Schimmel2, Melanie D Swift1,3, Lori A Rolando1,3, Rochelle T Johnson4, Jannis Muscato4, Paul Sternberg5,6, Marilyn Dubree6, Paula W McGown3,7, Mary I Yarbrough1,3,7, Gerald B Hickson8,2,9. 1. Departments of Medicine, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee. 2. Quality, Safety, and Risk Prevention, Vanderbilt University Medical Center, Nashville, Tennessee. 3. Occupational Health Clinic, Vanderbilt University Medical Center, Nashville, Tennessee. 4. Human Resources, Vanderbilt University Medical Center, Nashville, Tennessee. 5. Department of Ophthalmology, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee. 6. Hospital Administration, Vanderbilt University Medical Center, Nashville, Tennessee. 7. Faculty/Staff Health and Wellness, Vanderbilt University Medical Center, Nashville, Tennessee. 8. Department of Pediatrics, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee. 9. The Center for Patient and Professional Advocacy, Vanderbilt University Medical Center, Nashville, Tennessee (Present affiliation: Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, Minnesota [M.S.]).
Abstract
OBJECTIVE: Evaluation of a mandatory immunization program to increase and sustain high immunization coverage for healthcare personnel (HCP). DESIGN: Descriptive study with before-and-after analysis. SETTING: Tertiary-care academic medical center. PARTICIPANTS: Medical center HCP. METHODS: A comprehensive mandatory immunization initiative was implemented in 2 phases, starting in July 2014. Key facets of the initiative included a formalized exemption review process, incorporation into institutional quality goals, data feedback, and accountability to support compliance. RESULTS: Both immunization and overall compliance rates with targeted immunizations increased significantly in the years after the implementation period. The influenza immunization rate increased from 80% the year prior to the initiative to >97% for the 3 subsequent influenza seasons (P < .0001). Mumps, measles and varicella vaccination compliance increased from 94% in January 2014 to >99% by January 2017, rubella vaccination compliance increased from 93% to 99.5%, and hepatitis B vaccination compliance from 95% to 99% (P < .0001 for all comparisons). An associated positive effect on TB testing compliance, which was not included in the mandatory program, was also noted; it increased from 76% to 92% over the same period (P < .0001). CONCLUSIONS: Thoughtful, step-wise implementation of a mandatory immunization program linked to professional accountability can be successful in increasing immunization rates as well as overall compliance with policy requirements to cover all recommended HCP immunizations.
OBJECTIVE: Evaluation of a mandatory immunization program to increase and sustain high immunization coverage for healthcare personnel (HCP). DESIGN: Descriptive study with before-and-after analysis. SETTING: Tertiary-care academic medical center. PARTICIPANTS: Medical center HCP. METHODS: A comprehensive mandatory immunization initiative was implemented in 2 phases, starting in July 2014. Key facets of the initiative included a formalized exemption review process, incorporation into institutional quality goals, data feedback, and accountability to support compliance. RESULTS: Both immunization and overall compliance rates with targeted immunizations increased significantly in the years after the implementation period. The influenza immunization rate increased from 80% the year prior to the initiative to >97% for the 3 subsequent influenza seasons (P < .0001). Mumps, measles and varicella vaccination compliance increased from 94% in January 2014 to >99% by January 2017, rubella vaccination compliance increased from 93% to 99.5%, and hepatitis B vaccination compliance from 95% to 99% (P < .0001 for all comparisons). An associated positive effect on TB testing compliance, which was not included in the mandatory program, was also noted; it increased from 76% to 92% over the same period (P < .0001). CONCLUSIONS: Thoughtful, step-wise implementation of a mandatory immunization program linked to professional accountability can be successful in increasing immunization rates as well as overall compliance with policy requirements to cover all recommended HCP immunizations.