Measurement of Influenza Vaccination Coverage among Healthcare Personnel in US Hospitals

OBJECTIVE. To characterize practices related to measuring influenza vaccination rates among healthcare personnel in US hospitals. DESIGN. Descriptive survey. SETTING. Nonfederal, short-stay hospitals that provide general medical and surgical services, identified by use of the 2004 American Hospital Association Annual Survey Database. PARTICIPANTS. Healthcare personnel from 996 randomly sampled US hospitals stratified by region and bed size. METHODS. A self-administered questionnaire was distributed in 2006 to infection control coordinators to gather data on policies and practices related to the provision of the influenza vaccine and on the measurement and reporting of influenza vaccination rates. Descriptive statistics and associations were calculated, and logistic regression was conducted. RESULTS. The response rate was 56% (ie, 555 of 996 US hospitals responded to the questionnaire). Weighting accounted for sampling design and nonresponse. Most hospitals provided the influenza vaccine to employees (100%), credentialed medical staff ( ie, independent practitioners; 94%), volunteers (86%), and contract staff (83%); provision for students and residents was less frequent (58%). Only 69% of hospitals measured vaccination rates ( mean coverage rate, 55%). Most hospitals that measured coverage included employees (98%) in the vaccination rates, whereas contract staff (53%), credentialed medical staff ( 56%), volunteers ( 56%), and students and residents (30%) were less commonly included. Among hospitals measuring coverage, 44% included persons for which vaccine was contraindicated, and 51% included persons who refused vaccination. After adjustment for region and size, hospitals with vaccination plans written into policy (odds ratio, 2.0 [95% confidence interval, 1.22-7.67]) or that addressed internally reporting coverage (odds ratio, 4.8 [95% confidence interval, 2.97-7.66]) were more likely to measure coverage than were hospitals without such plans. CONCLUSIONS. Hospitals vary in terms of the groups of individuals included in influenza vaccination coverage measurements. Standardized measures may improve comparability of hospital-reported vaccination rates. Measuring coverage in a manner that facilitates identification of occupational groups with low vaccination rates may inform development of targeted interventions.