A successful mandatory influenza vaccination campaign using an innovative electronic tracking system

Infect Control Hosp Epidemiol. 2009 Dec;30(12):1137-42. doi: 10.1086/648084.


Background: Although influenza vaccination of healthcare workers reduces influenza-like illness and overall mortality among patients, national rates of vaccination for healthcare providers are unacceptably low. We report the implementation of a new mandatory vaccination policy by means of a streamlined electronic enrollment and vaccination tracking system at the National Institutes of Health (NIH) Clinical Center.

Objective: To evaluate the outcome of a new mandatory staff influenza vaccination program.

Methods: A new hospital policy endorsed by all the component NIH institutes and the Clinical Center departments mandated that employees who have patient contact either be vaccinated annually against influenza or sign a declination specifying the reason(s) for refusal. Those who fail to comply would be required to appear before the Medical Executive Committee to explain their rationale. We collected in a database the names of all physician and nonphysician staff who had patient contact. When a staff member either was vaccinated or declined vaccination, a simple system of badge scanning and bar-coded data entry captured essential data. The database was continuously updated, and it provided a list of noncompliant employees with whom to follow up.

Results: By February 12, 2009, all 2,754 identified patient-care employees either were vaccinated or formally declined vaccination. Among those, 2,424 (88%) were vaccinated either at the NIH or elsewhere, 36 (1.3%) reported medical contraindications, and 294 (10.7%) declined vaccination for other reasons. Among the 294 employees without medical contraindications who declined, the most frequent reason given for declination was concern about side effects.

Conclusions: Implementation of a novel vaccination tracking process and a hospital policy requiring influenza vaccination or declination yielded dramatic improvement in healthcare worker vaccination rates and likely will result in increased patient safety in our hospital.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Humans
  • Immunization Programs / methods*
  • Immunization Programs / organization & administration
  • Influenza Vaccines* / therapeutic use
  • Mandatory Programs / organization & administration*
  • Medical Records Systems, Computerized*
  • National Institutes of Health (U.S.) / organization & administration*
  • Patient Compliance
  • Personnel, Hospital*
  • United States


  • Influenza Vaccines