Employee Influenza Immunizations and Declination Forms: Third Time Lucky?

Background:
Creating safe healthy communities for health care employees and patients includes health care worker influenza immunizations, which have historically been low in the USA. Recently, some of state governments have mandated declination forms for health care workers not willing to be immunized.
In 1997, Southern California Kaiser Permanente's employee influenza vaccination rate was approximately 30%. In 1998, a voluntary employee declination form was offered, so employees not wishing to take the vaccine could state their reasons for declining. That year the employee immunization rate was 43.6%. In 2007, SB739 amended the California State Health and Safety Code, making declination forms mandatory for all acute care hospitals. Southern and Northern California Kaiser Permanente in turn made Flu Declination Forms mandatory for all employees. The employee flu immunization rate increased to 65% in 2007-08, with the remainder signing declination forms, which were available throughout the flu immunization period.

Setting:
Southern California Kaiser Permanente.

Population:
Southern California Kaiser Permanente offers comprehensive health and medical care through 12 Medical Center areas (hospital and clinic buildings) serving over 3 million members.

Project Description:
For the 2008 -09 flu immunization season, the declination forms were not made available until mid-November, so more attention could be given to convincing employees to be immunized. After the first 4 weeks of flu vaccine availability, the numbers of employees accepting the vaccine was double that for the same period the previous year.

Results/Lessons Learned:
Final results were not available at abstract deadline time. However, a detailed analysis of final acceptance of vaccines, (which after the first four weeks was double that of the previous year) and reasons for declination will be presented, to ascertain how much the third attempt at a combination of vaccines and declination forms increased employee flu immunization rates, and why.