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Hospitals Increasingly Require Employees to Get Flu Vaccine

  • Case manager Brooks Chapin, of Chelsea, speaks with Adeline Ostrosky, 97, of Bethel, at Gifford Medical Center in Randolph. Gifford employees who have not received flu vaccinations are required to wear masks while interacting with patients. “I’m waiting to get the shot with my kids,” Chapin said. “I just wanted to show them that it doesn’t hurt.” (Valley News - Ryan Dorgan)

    Case manager Brooks Chapin, of Chelsea, speaks with Adeline Ostrosky, 97, of Bethel, at Gifford Medical Center in Randolph. Gifford employees who have not received flu vaccinations are required to wear masks while interacting with patients. “I’m waiting to get the shot with my kids,” Chapin said. “I just wanted to show them that it doesn’t hurt.” (Valley News - Ryan Dorgan) Purchase photo reprints »

  • Melissa Herring displays a sticker on her ID badge that shows she has had her flu vaccination at Gifford Medical Center in Randolph.(Valley News - Ryan Dorgan)

    Melissa Herring displays a sticker on her ID badge that shows she has had her flu vaccination at Gifford Medical Center in Randolph.(Valley News - Ryan Dorgan) Purchase photo reprints »

  • Case manager Brooks Chapin, of Chelsea, speaks with Adeline Ostrosky, 97, of Bethel, at Gifford Medical Center in Randolph. Gifford employees who have not received flu vaccinations are required to wear masks while interacting with patients. “I’m waiting to get the shot with my kids,” Chapin said. “I just wanted to show them that it doesn’t hurt.” (Valley News - Ryan Dorgan)
  • Melissa Herring displays a sticker on her ID badge that shows she has had her flu vaccination at Gifford Medical Center in Randolph.(Valley News - Ryan Dorgan)

Lebanon — Flu season has arrived in the Twin States and hospitals everywhere have been ramping up efforts to vaccinate their workers.

Upper Valley hospitals have reported rising rates of vaccination among staff this year as many have stepped up efforts to guard doctors, nurses and anyone else who has contact with patients against the flu.

Hospitals have taken all sorts of approaches to convincing their workers to get immunized, from passing out apples at vaccine clinics to requiring it as a condition of employment.

The increased attention to the issue seems to be working, however, as hospitals join a nationwide push to vaccinate health care workers.

“This first and foremost is a patient safety effort,” said Bob McLellan, section chief of occupational and environmental medicine at Dartmouth-Hitchcock.

Hospital officials around the Upper Valley are reporting rates that hovered around 90 percent. Some institutions were higher than that, and all said they had boosted efforts this year to convince employees to get vaccinated.

Upper Valley hospitals are on par with peers around the Granite State. In New Hampshire, 89 percent of hospital staff received a flu vaccination last year, according to the New Hampshire Department of Health and Human Services. Statewide figures for Vermont were not available.

Area hospitals are also faring better than national averages, even as those rates continue to rise, according to a recent survey from the Centers for Disease Control and Prevention. Hospitals last month reported vaccination rates at around 83.4 percent of workers. That’s up from 77.8 percent the year before.

The findings suggest that mandatory vaccines and other steps designed to boost compliance are working. The U.S. Department of Health and Human Services has a goal to have 90 percent of health care workers receiving the flu vaccine by 2020.

Last year, Dartmouth-Hitchcock became the first hospital in the Upper Valley to mandate vaccines for its workers, a policy it will continue this year. Dartmouth-Hitchcock had nearly perfect compliance last year, with only 100 or so workers out of 8,000 choosing to opt out of getting a flu vaccine. Workers are excused from getting a flu shot if they have a religious objection or medical condition that would be exacerbated by a vaccination.

This year, Dartmouth-Hithcock has expanded the policy to include its clinic in Keene, which did not have the mandate last year because of its affiliation with Cheshire Medical Center. At the time, Cheshire didn’t require flu vaccines for its employees. This year, it will.

The mandatory vaccine policy also is being extended to employees of Dartmouth College’s Geisel School of Medicine who work at Dartmouth-Hitchcock.

Dartmouth-Hitchcock employees have until today to comply, after which they face a two-week suspension and possibly the loss of their jobs if they have not otherwise been excused from getting vaccinated.

So far, 10,405 people have gotten vaccinated and around 100 people have been exempted, McLellan said.

Other hospital officials said they have found ways of boosting immunization rates without mandates.

Cottage Hospital in Woodsville came close to Dartmouth-Hitchcock’s rate of compliance last year with 97 percent of staff vaccinated. This year, Gifford Medical Center in Randolph raised its flu vaccination rate to 92 percent from 80 percent in years past. Meanwhile, Valley Regional Hospital in Claremont and Alice Peck Day in Lebanon are 88 percent and 89 percent compliance, respectively. Mt. Ascutney Hospital in Windsor is hovering around 70 percent, below other area hospitals but still an improvement from previous years.

Most hospitals require employees who don’t get vaccinated to wear a mask when working near patients. In some cases, that was incentive enough.

“This year, I think we got an additional 10 percent because they didn’t want to wear a mask,” said Teresa Voci, vice president of medicine at Gifford.

Gifford did several things this year to improve immunization rates, including running multiple flu shot clinics to make it easy for people to comply, Voci said. Workers who were immunized were given a sticker for their name badge, providing an easy way to “police” staff and make sure everyone was taking the proper safety precautions. Anyone spotted without a sticker needed to be wearing a mask when near patients.

Gifford allowed workers to opt out for philosophical reasons, as well as medical or religious, Voci said. She suspected Dartmouth-Hitchcock’s vaccine mandate served as a wake-up call for Gifford staff, who may have come to see their employer as being comparatively forgiving.

“I think it was a mutual respect,” she said.

Valley Regional and APD have relied on accessibility and employee education to boost rates rather than with mandates.

“The medical staff have not felt we needed to do that,” said Jean Strawbridge, physician assistant and occupational medicine manager at Valley Regional, of mandatory vaccines. “We’ve had great numbers without it.”

Mt. Ascutney has never required flu vaccines, either. But this year, it pushed the issue more aggressively by requiring employees to either get vaccinated or sign a declaration explaining why they did not want it, said Alonzo Tapley, infection prevention nurse at the Windsor hospital. Of the 500 employees, 24 people have yet to do one or the other, he said.

Alice Peck Day’s vaccination rate hovered at around 50 percent for many years. It started to climb upward in 2010, and this year jumped 13 percentage points from the previous year, according to Suzanne Bissonnette, director of occupational health services at APD.

The hospital organized an “apple festival” in late September, when employees would stop in to get vaccinated and leave with a bag of apples. (“An apple a day keeps the doctor away,” Bissonnette said.) APD also appointed department “champions,” essentially cheerleaders who encouraged co-workers to get flu shots.

Nothing was mandatory, however, Bissonnette said.

“That’s not a value we have at APD,” she said. “Our staff really feels strongly about caring for our patients and we wanted to use positive reinforcement.”

At Dartmouth-Hitchcock, McLellan said he was aware of the objections some employees have about vaccines. Concerns have been raised about side effects from the vaccine, and critics often say it is not as effective at guarding against the flu as proponents make it seem. Nevertheless, the need to protect patients justified the mandate, McLellan said.

“There are many things that employers ask of employees,” he said, adding that in health care, one of those is “that they are immunized.”

Chris Fleisher can be reached at 603-727-3229 or cfleisher@vnews.com.