Mandatory Flu Shots Linked with Reduced Sick Day Use

Health care workers who were required to get a flu vaccine took far fewer sick days for flu-related symptoms than did health care workers who were not required to get vaccinated, a new study finds.

Health care personnel working in outpatient facilities with mandatory influenza vaccination policies took fewer sick days than those working in sites without vaccination policies, according to a study presented on October 3, 2013, at ID Week in San Francisco.

Using data collected as part of the Respiratory Protection Effectiveness Clinical Trial (ResPECT), a multi-season, randomized study evaluating the best ways to prevent occupational exposure to respiratory infections among health care professionals, the researchers evaluated the effect of mandatory influenza vaccination policies in place at private outpatient sites and the lack of such policies in Veterans Administration (VA) sites on the number of sick days taken due to acute respiratory illness.

A total of 1077 health care professionals participated in the study, reporting influenza vaccination and the number of sick days taken each week over a 12-week period during acute respiratory illness season due to flu, cold, or respiratory-related symptoms. The researchers calculated the sick day ratio by dividing the total number of such sick days by the number of personnel at a site. Work policies, personal protective equipment use, and disease burden at each health care site were considered in the analysis. Hand hygiene and facial protective equipment use during interactions with patients were also observed to calculate their effect.

The average influenza vaccination rate at private sites with mandatory vaccine policies was 88.3%, compared with just 58.5% at VA sites where vaccination was not required. Exposure to patients with respiratory illness was 11.1% at VA sites, compared with 6.7% at private sites. The average sick day ratio for facilities with mandatory vaccination policies was dramatically lower than that at VA sites (0.55 vs. 0.92). No significant difference in compliance with hand hygiene and facial protective equipment use were observed between private and VA sites.

The results indicate that higher influenza vaccination rates are associated with fewer flu-related sick days taken by health care professionals. The researchers note, however, that other factors such as sick leave policy, geographical location, patient population, and disease burden, may also affect the number of sick days taken. The increased exposure to acute respiratory illness observed in VA sites, for example, may help to explain the increase in sick days taken by employees. Despite this potential explanation of the results, the researchers note that similar hand hygiene and facial equipment use compliance rates observed in the 2 facility types suggest that vaccination rates may be responsible for reducing symptomatic absenteeism. The researchers conclude that more study is needed to investigate the effect of mandatory influenza vaccination policies.