Harnessing Public-Private Efforts to Promote Institutional Mandates for Influenza Vaccination, Lessons From Pennsylvania

Background:

There is growing evidence that requiring the influenza vaccination at institutional level is the most effective way of attaining >90% (universal) coverage among employees. During the summer of 2011, the Hospital and Health System Association of Pennsylvania, in collaboration with the Center for Vaccine Ethics and Policy (University of Pennsylvania), the Pennsylvania Department of Health, the Pennsylvania Patient Safety Authority and the Pennsylvania Immunization Coalition, launched a statewide initiative to encourage institutional mandates for influenza vaccination among PA healthcare facilities. We report lessons learned 3 months into the campaign.

Setting:  Before the campaign, only 8 of ~250 licensed hospitals and 5 of ~830 licensed long term care facilities (LTCFs) in Pennsylvania had achieved universal coverage.

Population:  Pennsylvania healthcare personel, fulltime and part time, volunteers and contractors.

Project Description:  The campaign involved conducting 13 regional seminars during the summer; engaging institutions with universal coverage in sharing best practices; deploying a training website with resources; an audio conference; offering post-training technical assistance and asking HCF’s to sign a pledge that they would move towards requiring influenza vaccination by 2013.

Results/Lessons Learned:  The number of institutions with universal coverage increased from 13 pre-campaign to 26 three months into the campaign.  By December of 2011, 19 additional institutions had signed a pledge to move towards requiring influenza vaccination by 2013. The number of institutions requiring influenza vaccination among HCP in Pennsylvania has increased, and so has the momentum by institutions to move towards mandatory influenza vaccination. Deploying a training website and issuing joint press releases were useful for disseminating best practices and campaign resources. Posting an honor roll of institutions with successful programs and having institutions sign a pledge were invaluable strategies for stimulating change. In the absence of a federal and state legislation requiring influenza vaccination, state-wide educational initiatives have the potential to increase momentum towards institutional mandates.