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[Evidence summary]: What evidence is there for mandatory flu vaccination for healthcare workers? [v1.0]

dc.contributor.authorNational Health Library & Knowledge Service (NHLKS)
dc.contributor.authorCarrigan, Marie
dc.contributor.authorHalton, Linda
dc.date.accessioned2020-09-03T09:16:30Z
dc.date.available2020-09-03T09:16:30Z
dc.date.issued2020-09-02
dc.identifier.urihttp://hdl.handle.net/10147/628192
dc.descriptionThe World Health Organisation (WHO)and other international bodies strongly recommend the flu vaccination for health care workers (HCWs) yet vaccination uptake remains low. During the 2018/2019 influenza season in Ireland, the uptake of the influenza vaccination among all hospital HCWs was 53.2% and 42.2% for HCWs working in long term care facilities.This was below the uptake target of 65%2. In response to a low uptake of the flu vaccination in HCWs, the Royal College of Physicians in Ireland called for an introduction of a mandatory seasonal flu vaccination for HCWs in high risk clinical settings3.Mandatory vaccination is the most effective intervention for improving vaccine uptake13, 14, 19.Mandatory influenza vaccination policies are increasingly common in the United States but there are substantial barriers to adopting such policies. Qualitative data reveal multiple reasons why HCWs disapprove of mandated vaccination. These include beliefs that the decision to be vaccinated is personal, fears of side effects,and concern that influenza vaccines are ineffective20, 22.The National Institute for Health and Care Excellence (NICE) do not recommend mandatory flu vaccination. In guidance published in 2018, the committee expressed concerns about the challenges that mandatory vaccination of staff would have, including evidence indicating that such policies can negatively affect staff morale and undermine autonomy10. Lytras [et al]conducted a systematic review and meta-regression analysis to explore interventions to increase seasonal flu vaccination coverage13. Mandatory vaccination was the most effective intervention followed by ‘soft’ mandates such as declination statements, indicating that they could be an important element in a vaccination programme. Other intervention components, such as increased access, increased awareness and incentives for which the difference did not reach statistical significancewere found to be less effective; in combination though, their cumulative effect could match that of declination statements and be offered as an alternative to a mandatory flu vaccination programmes. Bechini [et al] found that there was no definitive evidence of which types of interventions would be more useful for improving flu vaccine uptake among HCWs although mandatory vaccination seems to be the most useful single intervention and educational campaigns alone do not have an impact on vaccination coverage19. Jenkin [et al] noted that it was hard to separate the benefit of one intervention as distinct from the others when a part of multi-faceted interventions14. NICE point out that the quantitative evidence relating to interventions to increase flu vaccine uptake was of variable quality with most rated low or verylow10. Downgrading was largely due to risk of bias and evidence of serious heterogeneiity in pooled analyses. NICE explored the use of declination statements but noted that the qualitative evidence indicated that employees have mixed feelings about declination policies10. NICE endorse a multi-faceted approach and recommend a range of interventions so that organisations can tailor their approach to local needs, targeting demand (by increasing awareness, education and incentives)and supply (for example using mobile vaccination carts and off-site or out-of-hours access). They recommend a full participation vaccination strategy, with nationally agreed opt out criteria10.en_US
dc.language.isoenen_US
dc.publisherHealth Service Executiveen_US
dc.relation.ispartofseriesEvidence summariesen_US
dc.subjectCORONAVIRUSen_US
dc.subjectCOVID-19en_US
dc.subjectIMMUNISATIONen_US
dc.subjectVACCINATIONen_US
dc.subjectINFLUENZAen_US
dc.subjectHEALTHCARE WORKERSen_US
dc.title[Evidence summary]: What evidence is there for mandatory flu vaccination for healthcare workers? [v1.0]en_US
dc.typeOtheren_US
refterms.dateFOA2020-09-03T09:16:31Z


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