Health Care Worker Vaccination 2011 Texas

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1 Health Care Worker Vaccination 2011 Texas Erica Swegler, MD Texas Medical Association Chair, Committee on Infectious Diseases TMA s Be Wise --Immunize Physician s Advisory Panel

2 Disclosure statement

3 HCW law (Article 8 of Senate Bill 7, 82 nd Texas Legislature) Chapter 224 of Health & Safety Code Partnership between TMA, TPS, TAFP, THA, TNA

4 Why vaccinate HCWs? Patient safety - reduce transmission of preventable diseases Reduce costs Maintain HCW workforce British hospitals. Lancet. 2000; 355: LTAC hospitals. J Infect Dis. 1997; 175:1-6.

5 Why vaccinate HCWs? Professional guidelines Advisory Committee on Immunization Practices Association for Professionals in Infection Control & Epidemiology, National Foundation for Infectious Diseases, Society for Healthcare Epidemiology, Infectious Disease Society of America, National Patient Safety Foundation, Joint Commission, AAP, AMA Texas requirements (pre-september 2012) Texas Health & Safety Code: nursing homes must offer influenza vaccinations to residents & employees, and pneumococcal vaccine to elderly residents End stage renal disease facilities must inform elderly patients about pneumococcal and influenza vaccines Students enrolled in health-related course must be vaccinated for Td, MMR, and hepatitis b, and varicella vaccine Students enrolled in schools of veterinary medicine must receive rabies and hepatitis b vaccine

6 Why vaccinate HCWs? 64 percent of HCWs received flu vaccination in % were immunized in facilities with mandatory flu vaccination Acceptance & non-acceptance of vaccination Doctors, medical students, nurses, most likely to be vaccinated other hospital personnel less likely Photo courtesy of CDC

7 % Vaccinated Vaccination coverage Estimated influenza vaccination coverage, health care personnel HP 2020 target is 90 percent NHIS Internet panel

8 Health Care Workers A range of health care personnel who come into contact with patients U.S. Health & Human Services More than 17 million people in U.S. (2004) 51,217 physicians in active practice of direct patient care in Texas 257,388 nurses, advanced practice nurses, or licensed vocational nurses employed in direct patient care in Texas

9 Key components Covered Facilities Hospitals Nursing homes Ambulatory surgical centers Birthing centers Abortion facility Special care facility End stage renal disease facility Freestanding emergency medical care facility Hospitals maintained or operated by the state

10 Who is covered? an employee of the health care facility individual providing direct care under contract; or individual granted privileges to provide direct care Photo courtesy of CDC

11 Covered vaccines Annually determined by the health care facility Vaccines identified in the current recommendations of ACIP

12 Written policy must: Specify each vaccine a covered individual is required to have Identify procedures for verifying individual compliance Identify exemptions for medical conditions (per CDC) Have procedures for an exempt individual to follow Prohibit discrimination or retaliatory action against exempt individuals

13 A facility: Must - Maintain a record of each covered individual s compliance or exemption from policy Identify authorized disciplinary actions that can be taken against someone that does not comply May - Include procedures for an exemption from the required vaccines based on a covered individual s conscientious objection, including a religious belief Prohibit an exempt individual from having contact with patients during a public health disaster

14 Exceptions Facility does not have to provide or pay for vaccines Exemptions allowed for medical reasons (CDC) State law does not harm current facilities with mandated vaccination policies

15 Future activities Develop resources for physicians and their practices Review requirements for other employees at high risk of transmitting preventable diseases to vulnerable populations

16

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