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Laws on immunizing patients, HCWs vary widely by state
Centers for Disease Control and Prevention: Unclear if more laws make people safer
The Centers for Disease Control and Prevention (CDC) launched a study in 2005 to determine what states have laws regulating vaccinations for health care workers and patients, and it revealed in the published results that there are wide variations from state to state.
The CDC researchers say the results set the stage for future research to determine whether more laws could serve as effective tools to combat infectious diseases, but they do not conclude that more statutes would equal better protection.
More research is needed to provide evidence that laws "are an effective tool for ensuring coverage of vaccines for health care workers and others," says lead author Megan Lindley, MPH, of the CDC's National Center for Immunization and Respiratory Diseases. The authors of the study write that school entry laws nationwide have succeeded in maintaining high vaccination levels among children, thus reducing the incidence of diseases that vaccines can prevent. State laws geared toward immunization of other population segments are inconsistent, and there are no federal immunization laws. The authors say the study is the first to review laws mandating immunization of health care workers and patients in a variety of settings in all 50 states and Washington, DC. "There aren't very many laws, period," Lindley points out.
Laws pertaining to vaccination of health care workers and patients vary widely by state in terms of specific vaccines required, where the health care workers are employed, and the people covered, the report states. Mandatory vaccination laws most often pertained to patients or residents in institutional settings such as prisons or facilities for the developmentally disabled.
Only 32 states had some type of law about administering vaccines to health care workers. Of those, the laws in 21 states were for voluntary immunization of health care workers and the laws in 15 states were for mandatory vaccination. The majority of laws for voluntary immunization of health care workers, enacted in 20 states, concerned hepatitis B immunization; only three states — New Hampshire, North Carolina, and Kentucky — had laws mandating that health care workers be vaccinated against influenza (with no exceptions for those who wish to decline). The data are current as of June 2005.
"We are looking for tools so people can be vaccinated against diseases," Lindley said. "State laws are one of the tools that could be used. It's premature to use our data to say there ought to be a law, even if we suspect that if we had better laws we would have better [immunization] coverage."
The American Nurses Association (ANA) opposes mandatory vaccination for nurses as a condition of employment and states that the decision to be immunized should be made based on personal choice. The ANA does strongly encourage nurses to be immunized, however, especially against hepatitis B and influenza.
Model legislation could help states that want to implement vaccination requirements in various health care settings, the study concludes. Such requirements for health care workers and patients, properly enforced, should be an effective tool in reducing infections associated with health care and should increase the overall quality of medical care, according to the authors.
(Editor's note: For more information, contact Lindley at email@example.com. The report on the study, "Assessing state immunization requirements for healthcare workers and patients," appears in the June 2007 issue of the American Journal of Preventive Medicine, available at www.ajpm-online.net/current. Click on "Assessing State Immunization Requirements for Healthcare Workers and Patients.")
Waverly Health succeeds by 'busting' flu myths
To boost its influenza vaccine rate among employees, Waverly (IA) Health Center (WHC) borrowed from the popular Discovery Channel series "MythBusters" and created its own "FluBusters" program, which resulted in a nearly 95% immunization rate in its staff.
"Waverly Health Center is fortunate to have an excellent infection control department who actively takes control of influenza," according to David Rathe, DO, director of the Waverly Infection Control Committee.
WHC's FluBusters committee members teamed up with employee health to create a "Vaccine Mobile" that traveled to all departments throughout the campaign week, offering the injectable flu vaccine and the FluMist nasal vaccine. Detailed vaccine information sheets were posted, and "MythBusters" cards were made available in every department to help dismiss any concerns regarding flu vaccinations. Staff members were photographed and included on posters displayed throughout the health center to encourage others to become FluBusters.
Paycheck stuffers were inserted into all paychecks with stickers that contained the "Be a FluBuster!" campaign logo, and after staff members were vaccinated, they received a sticker that said "I'm a FluBuster!" A caramel apple sundae party was given for all staff members who received a flu vaccination.
"This recognition is a tremendous honor, and I know Waverly Health Center can achieve a voluntary 98% staff vaccination rate with more education," says Dixie Kramer, RN, occupational health manager. "In the future, I would like to have a physician from our infection control committee present information to help educate staff about the influenza vaccine, including its effectiveness and safety, to dismiss any myths individuals may have."
[Editor's note: For more information on the Waverly Health Center program, contact: David Rathe, DO, Director, Waverly Infection Control Committee, Waverly Health Center, Rohlf Memorial Clinic, 220 10th St. SW, Waverly, IA 50677. Phone: (319) 352-4340 or Dixie Kramer, RN, Manager, Occupational Health, Waverly Health Center. Phone: (319) 352-4948.]