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Influence of critically appraising exemption requests from healthcare personnel along a spectrum of influenza vaccine hesitancy

Published online by Cambridge University Press:  18 February 2022

Joshua C. Eby Open the ORCID record for Joshua C. Eby [Opens in a new window] ,
Morgan M. Richey Open the ORCID record for Morgan M. Richey [Opens in a new window] ,
Costi D. Sifri Open the ORCID record for Costi D. Sifri [Opens in a new window]  and
Jonathon Z. Schuch
Joshua C. Eby*
Affiliation:
Employee Health, UVA Health, Charlottesville, Virginia Infectious Diseases and International Health, UVA Health, Charlottesville, Virginia
Morgan M. Richey
Affiliation:
Duke Department of Population Health Sciences, Duke University, Durham, North Carolina
Costi D. Sifri
Affiliation:
Infectious Diseases and International Health, UVA Health, Charlottesville, Virginia Office of Hospital Epidemiology/Infection Prevention and Control, UVA Health, Charlottesville, Virginia
Jonathon Z. Schuch
Affiliation:
Employee Health, UVA Health, Charlottesville, Virginia
*
Corresponding author: Joshua C Eby, E-mail: jce4u@virginia.edu
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Abstract

Objectives:

This study was performed to assess whether an intervention for critically appraising influenza vaccine exemption requests from healthcare personnel (HCP) affected (1) the overall rate of influenza vaccine exemption within a healthcare institution and/or (2) the rates of postintervention vaccine acceptance among those who inconsistently request exemption from annual vaccination and those who consistently request exemption from vaccination.

Design:

Retrospective, before-and-after intervention study.

Setting:

We conducted the study at a single academic medical center.

Participants:

This study included 29,663 HCP.

Methods:

Between 2010 and 2019, HCP were permitted to request an exemption from influenza vaccination without critical appraisal of exemption requests. After January 2019, medical center policy required critical appraisal of exemption requests. Of those employed 3 or more years who requested an exemption at least once during the preintervention period (n = 1,177), those with unchanging exemption reasons annually were termed “consistent exempters.” Those who changed reasons or accepted vaccination n ≥ 1 times were termed “inconsistent exempters.”

Results:

The overall exemption rate from influenza vaccine decreased from 3.8% to 1.2% (P < .001; N = 29,663) after the intervention. Of those requesting exemption at least once before the intervention, 329 (28.0%) of 1,177 were consistent exempters and 878 (72.0%) were inconsistent exempters. Of inconsistent exempters employed after the intervention, 442 (88.9%) of 497 accepted vaccine postintervention compared with 118 (59.6%) of 198 consistent exempters (P < .001). Of all exempters who changed from exemption to acceptance after the intervention, 442 (78.9%) of 560 were inconsistent exempters.

Conclusions:

Critical appraisal of HCP exemption requests promotes influenza vaccine acceptance, and acceptance by inconsistent exempters drives the effect of the intervention. Analysis of changes in annual exemption requests represents a novel objective method for describing those on the spectrum of vaccine hesitancy.

Keywords

Influenzavaccinehesitancyexemptionhealthcare personnel
Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 11 , November 2022 , pp. 1672 - 1678
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Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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Footnotes

a

Authors of equal contribution.

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