Estimated Cost of Health Care Personnel Influenza Vaccination Programs

Background:
The Advisory Committee on Immunization Practices (ACIP) has long recommended that health care personnel (HCP) who have contact with high risk patients should receive influenza vaccine annually. Yet their vaccination rate in the US remains low (41.7%). The Task Force on Community Preventive Services has recommended multi-component interventions to increase demand for and access to influenza vaccination in health care settings. Such programs may be effective, but can be complex and costly.

Objectives:
To evaluate the cost of a factorial intervention to promote influenza vaccination among employees of a large health system that included incentives, mass vaccination clinics and mobile vaccination carts.

Methods:
Estimated costs included nurse and contracted emergency medical technician (CEMT) time for staffing mass clinics, mobile vaccination carts staffed by CEMT, incentives including paid time off, parties, gift cards, and food at mass clinics, overhead, vaccines and materials. Not included were costs associated with time spent by the investigators and the publicity materials. Control sites received education and publicity only while intervention sites also received both incentives and carts, incentives only, or carts only. Minimum and maximum costs per vaccinated employee (VE) by type of intervention were estimated.

Results:
Vaccination rates by intervention were 39.4% in “incentives + carts” facilities, 41.3% in “incentives only” facilities, 38.4% in “carts only” facilities, and 37.3% in “control” facilities (P=.002). Minimum cost was $24.55/VE for “incentives + carts” facilities, $20.37/VE in “incentives only” facilities, $23.23/VE in “carts only” facilities and $18.03/VE in “control” facilities. Maximum cost increased to $30.43/VE for “incentives + carts” facilities, $24.97/VE in “incentives only” facilities, $26.55/VE in “carts only” facilities and $20.60/VE in “control” facilities.

Conclusions:
Vaccination rates differed significantly across interventions, while the cost to provide influenza vaccine free of charge to HCP varied by $6.00-$10.00/VE.