The AAP recommends implementation of a mandatory influenza immunization policy for all health care personnel. Immunization of health care personnel is a critically important step to substantially reduce health care–associated influenza infections. Despite the efforts of many organizations to improve influenza immunization rates with the use of voluntary campaigns, influenza coverage among health care personnel remains unacceptably low. See the AAP policy and Implementation Guidance for Influenza Immunization for All Health Care Personnel: Keep it Mandatory.
Pediatric practices that wish to implement a mandatory influenza vaccination policy for employees have several options. Each option has benefits and challenges that should be considered.
Provide the influenza vaccine in the office and bill the employee's insurance,
Ask the employee to document that they have been vaccinated at another location, such as their adult health care provider or other community immunizer, or
Purchase and administer the vaccine in the office for all employees as part of office expenses.
Providing the vaccine in the work setting at no cost to the employee has been shown to increase vaccination rates the most. Influenza vaccination may be a wise investment for practices, potentially reducing the spread of influenza as well as the amount of time off or sick pay for staff that may be incurred compared to the lower cost of the vaccine.
There are a variety of influenza vaccines available for people in different age groups. While most vaccines that are licensed for children are also licensed for older age groups, if vaccine supply is limited, practices may wish to order a different product for employees. Influenza vaccine availability can be tracked online.
If the office provides the vaccine for employees, written documentation should be provided to the employee to submit to their medical home for inclusion in their medical record. Offices should also consider entering each employee’s vaccination into the state immunization registry if that registry includes adults. Payment from insurance companies may be difficult to obtain so it is advisable to first check with the insurance carrier as some plans will not consider claims submitted by pediatricians for services provided to the adult parent/caregiver since the pediatrician is not the primary care provider for the adult.
All employees who encounter patients, including front desk staff, need to be vaccinated every year. Some staff may need encouragement and education about the importance of influenza vaccination to protect patients. Information can be found from the Centers for Disease Control and Prevention or IZSummit.
Some practices offer incentives for employees who receive influenza vaccine, such as tying receipt of vaccine to holiday bonuses, offering paid time off to attend an offsite facility for vaccination, or providing a small gift card or raffle. Contests between sites or types of staff have been effective in some settings. Other practices have negative incentives, such as requiring those who are not vaccinated to wear a mask or be reassigned duties, so they have limited exposure to others during influenza season.
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