Less Health Care Workers Getting Flu Vaccinations

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Influenza vaccination rates among Oregon’s health care personnel have not recovered from significant declines suffered during the COVID-19 pandemic, new Oregon Health Authority (OHA) data show.

According to the Healthcare Worker Influenza Vaccination Dashboard published by OHA’s Healthcare-Associated Infections (HAI) Program, 64% of the state’s eligible health care workers from all facility types were vaccinated against the flu during the 2022-2023 flu season. This is similar to the 2021-2022 flu season rate of 63% — a concern for state officials trying to prevent the virus’s spread to people most at risk of severe illness and death.

The influenza vaccination rate among eligible health care workers had dropped by 25% between the 2019-2020 and 2022-2023 influenza seasons.

“Health care workers are the first line of defense in protecting vulnerable patients and preventing a severe respiratory virus season from becoming a catastrophic one,” said Rebecca Pierce, Ph.D., HAI Program manager. “That’s why influenza vaccination of health care workers is a key strategy for infection control in health care facilities.”

OHA requires annual reporting of health care worker influenza vaccination data from four facility types – ambulatory surgery centers, dialysis centers, hospitals (including inpatient psychiatric facilities) and nursing facilities.

Data are self-reported by facilities and include aggregate counts of health care workers, filterable by health care worker category; who received an influenza vaccination; who declined; who had a medical contraindication; or who had an unknown vaccination status. The Healthcare Worker Influenza Vaccination Dashboard displays influenza vaccination data filterable by facility type, county, and worker classification. The dashboard also shows trends by flu season and facility-specific data.

According to the 2022-2023 dashboard, hospitals reported the highest vaccination rates among workers at 69%, followed by ambulatory surgery centers at 67%; nursing facilities at 41%; and inpatient psychiatric facilities and dialysis facilities, both the lowest at 35%. Rates for dialysis centers and hospitals saw a slight increase from the 2021-2022 season but were still below the rates for prior flu seasons.

“Influenza vaccinations among health care workers were significantly impacted during the pandemic, which is likely reflective of historically low rates of influenza during the 2020-2021 and 2021-2022 flu seasons,” Pierce said. “However, flu transmission has returned to pre-pandemic levels. It’s important that we focus on rebuilding flu vaccination rates for this critical, front-line workforce.”

The proportion of eligible health care workers who declined flu vaccination has increased over the years. For the 2022-2023 flu season, 15% declined, compared to 11% for the 2021-2022 season. Additionally, a high proportion (21%) of health care workers reported having an unknown vaccination status, which may contribute to low vaccination rates – and illustrates the need for improvement in facility-level documentation of vaccination status.

The U.S. Department of Health and Human Services developed Healthy People 2020 with 10-year objectives for improving the health of all Americans, including showing progress toward a 90% influenza vaccination goal for the health care workforce. However, because Healthy People 2030 does not include a goal focused on increasing flu vaccinations among health care workers, Oregon continues to use the Healthy People 2020 goal as a way of directing public health action and showing where more support and education is needed.

To achieve 90% influenza vaccination coverage, Pierce said there are important steps health care facilities can take. Among public health recommendations is encouraging health care workers, including those not employed by the facility—contractors and volunteers—to get vaccinated at the beginning of every influenza season. Facilities can also host promotional activities, such as holding mass vaccination fairs, providing vaccines at no cost to employees, starting incentive programs, and documenting all health care workers’ vaccination status and requiring a declination form for health care workers who decline vaccination.

OHA has developed a toolkit for health care employers and workers to help them improve employee flu vaccinations rates at their facilities to protect patients, themselves and their families.

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