Infection Control & Hospital Epidemiology Only 23% of respondents indicated MCIR use, which allows
LTCF to access and record HCP immunity status. Moreover, increased use of health level 7 (HL7) messaging for vaccine reporting (starting in 2012) has increased the timeliness, quality, and quantity of vaccine histories available through the MCIR.
HCP Immunization Barriers
Whilemandatory policy implementation can increase immunization rates, additional vaccination barriers exist. The primary barriers in our survey were HCP misconceptions and lack of knowledge. Education paired with on-site, low-cost, and promoted vaccination have been cited as methods to overcome low HCP vaccination.3,4,10 Strengthened and multicomponent educational programs among LTCFs in Michigan could result in more immunized HCP.2
Limitations
This study has several limitations. First, LTCFs with an existing HCP vaccination policy may have been more apt to complete the survey. Also, self-report may have inflated the number of HCP, residents, and immunization coverage calculations. The survey was sent to administrators expected to be knowledgeable of site- level policies, but they may not accurately understand their HCP vaccination barriers. Due to limited survey responses, coverage estimates are likely not representative of all Michigan LTCFs and survey results cannot be generalized to other states. Work settings put HCP at increased risk of acquiring and transmitting disease and vaccination can reduce disease and absenteeism among HCP.1,2,10 Our survey results suggest that opportunities exist for improving HCP coverage through increasing attention to noninfluenza vaccines, strengthening LTCF immuni- zation polices, encouraging electronic tracking of HCP immunity status, and pairing HCP education with barrier removal within licensed LTCFs in Michigan.
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Acknowledgments. We acknowledge the valuable contributions of Bob Swanson and Rachel Potter for their manuscript revisions.
Financial support. No financial support was provided relevant to this article.
Potential Conflicts of interest. All authors report no conflicts of interest relevant to this article.
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3. Lu PJ, Euler GL. Influenza, hepatitis B, and tetanus vaccination coverage among health care personnel in the United States. Am J Infect Control 2011;39:488–494.
4. Byrd KK, Lu PJ, Murphy TV. Hepatitis B vaccination coverage among health-care personnel in the United States. Public Health Rep 2013; 128:498–509.
5. Black CL, Yue X, Ball SW, et al. Influenza vaccination coverage among health care personnel—United States, 2016–17 influenza season. MMWR Morb Mortal Wkly Rep 2017;66:1009–1015.
6. Wang TL, Jing L, Bocchini JA Jr. Mandatory influenza vaccination for all healthcare personnel: a review on justification, implementation and effectiveness. Curr Opin Pediatr 2017;29:606–615.
7. National Foundation for Infectious Diseases Society of America. Call to action: improving healthcare personnel immunization rates. November 2017 NFID Healthcare Personnel Immunization Summit; 2018.
8. Williams WW, Lu PJ, O’Halloran A, et al. Surveillance of vaccination coverage among adult populations—United States, 2015. MMWR Surveill Summ 2017;66:1–28.
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