Mandatory seasonal influenza vaccination or masking of British Columbia health care workers: Year 1

Abstract

OBJECTIVE:The Influenza Prevention Policy ("the Policy") aims to increase seasonal influenza vaccination coverage among British Columbia (BC) health care workers (HCWs). PARTICIPANTS:HCWs who work in publicly funded facilities and attend patient care areas. CONCLUSION: Implementation of the Policy was associated with increased HCW vaccination; the Policy was upheld by an independent arbitrator. Further research is required to correlate HCW vaccination coverage rates with changes in influenza incidence and its complications. Continued stakeholder engagement is vital to achieve a collaborative decision-making process.

Interventions to increase seasonal influenza vaccine coverage in healthcare workers: A systematic review and meta-regression analysis

“…Most studies were BnA without a control group, [27][28][29][30][31][32][33][38][39][40][42][43][44][45][46]48 43,56 Five studies 35,41,54,58,71 evaluated separately more than one intervention on the same population or using the same controls, and 2 studies 27,28 were also performed on the same population. In two studies, 34,42 the same intervention was evaluated in independent populations or settings. As a result, the 46 studies contributed a total of 53 comparisons, nested within 47 clusters (Table 1).…”

“…The majority of comparisons examined an intervention with multiple simultaneous components; the exception was "hard" mandates, which were assessed in 8 comparisons (7 studies, all uncontrolled BnA 28,29,42,54,56,66,67 ) with no other simultaneous component. In one study the mandatory policy included termination of employment for unvaccinated workers, but due to reactions this was ultimately put in abeyance 42 ; we considered this intervention as a "hard" mandate nonetheless, in an "intention-totreat" manner. Regarding the remaining intervention components, increased access (mostly involving mobile carts) was assessed in 23 comparisons, increased awareness in 27, education in 18, incentives in 11, and "soft" mandates in 7.…”

“…Regarding post-vs pre-pandemic studies, we did not observe statistically significant interaction for any intervention component but the term for "hard" mandates came very close to significance (p D 0.0506); indeed, among the studies assessing "hard" mandates, the 2 that had been conducted before the 2009 H1N1 pandemic 28,56 showed greater effectiveness than those conducted afterwards. 29,42,54,66,67 Finally, in the model that included an intercept and the intervention year, no temporal trend for the effectiveness of the reviewed interventions was identified (yearly change ratio of RR unvacc D 1.00, 95% CI: 0.98-1.03, p D 0.62).…”

Vaccination of healthcare workers: A review

“…[88][89][90][91][92] However, low compliance can also occur, which makes enforcement difficult and fraught with legal challenges. This happened to a British Columbia province-wide mandate, 93 which, unlike the other examples discussed here, was enacted by a body not directly responsible for its local implementation.…”

Influenza immunization among Canadian health care personnel: a cross-sectional study

“…Such policies were introduced in British Columbia and 1 of New Brunswick's 2 regional health networks (Horizon Health Network) in 2012-13, Saskatchewan in 2014-15 and selected hospitals across Ontario from 2012-13 to 2014-15. 20,21 Our objectives for this study were to examine influenza immunization and the reasons for not being immunized, by health care occupation group and specific occupation. Additionally, we aimed to determine the impact of the introduction of vaccinate-or-mask influenza prevention policies on health care personnel influenza immunization coverage.…”