A new study reveals a significant increase in hospitals requiring flu vaccinations or exemptions for staff, with 74% of public hospitals and 96% of VA hospitals now enforcing mandates.

RT’s Three Key Takeaways:

  1. Increased Flu Vaccination Mandates: The study reveals that 74% of non-VA hospitals and 96% of VA hospitals now require employees to get flu vaccines, reflecting a significant rise in mandates aimed at enhancing patient and staff safety.
  2. Mask Requirements for Unvaccinated Staff: 81% of non-VA hospitals require unvaccinated employees to wear masks around patients during flu season.
  3. Impact of VA Directive and COVID-19: The 2020 Veterans Health Administration directive mandating flu vaccinations or waivers has had a massive impact, according to researchers, with a notable increase in compliance among VA hospitals. Additionally, the COVID-19 pandemic has influenced non-VA hospitals to adopt stricter flu vaccination policies.

A new study suggests that more hospitals than ever will require employees to get vaccinated against the flu, or seek an exemption.

The new study shows that 74% of hospitals serving the general public—and 96% of US hospitals that serve veterans—now require staff to get vaccinated.

Another 23% of non-Veterans Administration (VA) hospitals strongly encourage but don’t require flu vaccination. Whether or not they have a mandate, 81% of non-VA hospitals require unvaccinated workers to wear a mask around patients during flu season.

Published in JAMA Network Open, the study was done by a team from the University of Michigan and VA Ann Arbor Healthcare System that has surveyed hospitals on this topic since 2013.

Impact of VA Directive and COVID-19

Their latest survey reveals the “massive” impact of a 2020 Veterans Health Administration directive to require flu vaccination or waivers for the first time.

In 2013, only 1% of VA hospitals had such a mandate; the percentage rose slightly to 4% by 2017. Meanwhile, flu vaccination or a waiver was required by 43% of non-VA hospitals in 2013, rising to nearly 70% in 2017.

“Our findings show the impact of one of the largest health care systems in the United States taking a stand and putting a policy in place that is based in a bedrock ethical principle of medicine: Do no harm,” says Todd Greene, PhD, MPH, lead author of the new study and a patient safety researcher at VAAAHS and Michigan Medicine, U-M’s academic medical center. “In addition to the VA national directive, it is interesting to see how the COVID-19 era influenced flu vaccine requirements at non-VA hospitals.”

He and his colleagues, including senior author Sanjay Saint, MD, MPH, sent surveys to a national sample of hospitals starting in April 2021 and received replies from 405 non-VA hospitals providing general medical and surgical care, and 66 VA hospitals.

Exemptions and Penalties

In addition to asking about mandates and mask requirements, they asked hospitals that have a mandate to share what types of exemptions are permitted. Virtually all VA and non-VA hospitals allowed for medical exemptions, while there was a difference for religious exemptions, with 82% of non-VA and 95% of VA hospitals allowing these. A very small minority of hospitals (6% of non-VA hospitals and 2% of VA hospitals) allowed waivers to be granted without a specific reason.

At the time of the survey, which began at the end of the first flu season after the VHA directive, only 33% of VA hospitals with a mandate said they had penalties in place for staff who did not get vaccinated or pursue a waiver. By comparison, 74% of the non-VA hospitals with mandates had such penalties in place.

Declining Vaccination Rates

Greene notes that surveys of American health care workers show that flu vaccination percentages have dropped over time, from 91% during the 2019-2020 season to 81% by the 2022-2023 season. These percentages include health care workers who work in any setting, not just hospitals and health systems such as those surveyed for the new study.

“There will always be vaccine hesitancy and concerns about bodily autonomy among health care workers, and seasonal flu vaccine effectiveness is variable,” Greene says in a release. “But for people working in the care environment, the benefits of getting vaccinated will generally outweigh any potential risks.”

Photo 81406025 © Scyther5 | Dreamstime.com