And the Answer Is...

Answer: State laws mandating vaccination

Researchers recently rated individual state laws regarding healthcare worker (HCW) flu vaccination by assigning point values to the various elements of the local mandates, from simply having such a rule in place to requiring HCWs to formally decline immunization and employers to respond with consequences for noncompliance. The higher a state’s total score, the more stringent its rules for HCW vaccination.

Average flu vaccination rate for HCWs increased from 22.5% between 2000 to 2005, when only Maine and New Hampshire had laws requiring HCW vaccination, to 50.9% between 2006 and 2011, when 19 states added similar legislation. HCWs who worked in states with more comprehensive immunization laws were more likely to get flu shots, said study lead author Dr. Chyongchiou Jeng Lin, an associate professor of family medicine at the University of Pittsburgh School of Medicine. The study also showed that laws requiring vaccination of HCWs in acute care facilities increased vaccination coverage by 73%, and every point increase assigned to state law scores bumped up the likelihood of vaccination by 1%.

Dr. Lin was involved in a previous study that showed hospital-mandated flu vaccination and consequences for noncompliance nearly doubled immunization rates compared with requiring vaccination without consequences. Adding a state law that required HCW flu immunization to the equation tripled vaccination rates at hospitals that already demanded HCW vaccination and held dissenting staff members accountable.

During the 2015-2016 flu season, HCW vaccination coverage was 85% at facilities where vaccination was required, according to the Centers for Disease Control and Prevention. That rate is close to the 90% coverage goal set by the federal government’s Healthy People 2020 initiative.

—Dan Cook