Abstract
OBJECTIVE: The Influenza Prevention Policy (“the Policy”) aims to increase seasonal influenza vaccination coverage among British Columbia (BC) health care workers (HCWs).
PARTICIPANTS: HCWs who work in publicly funded facilities and attend patient care areas.
SETTING: The Policy was announced in August 2012 and took effect province-wide during the 2012/13 flu season.
INTERVENTION: BC HCWs are required to receive seasonal influenza vaccination by the start of the flu season (December 1) or wear a mask while at work until the flu season ends (March 30). Vaccinated HCWs need to wear a green dot on their identification tag. HCWs are expected to report noncompliant coworkers. As initially proposed, continued noncompliance with the Policy could result in termination of employment (ultimately this component was put in abeyance).
OUTCOME: For the 2012/13 flu season, 74% of HCWs (35,889/48,818) at acute care facilities received influenza vaccination compared with 40% (23,375/58,212) in 2011/12 (difference in proportion=0.33, 95% confidence interval [CI]: 0.33-0.34, p<0.001). Similarly, staff vaccination rates at residential care facilities increased from 57% (21,535/37,700) for the 2011/12 flu season to 75% (27,617/36,620) in 2012/13 (difference in proportion=0.18, 95% CI: 0.18-0.19, p<0.001). Health care unions claimed that the Policy was coercive, and they launched an unsuccessful grievance with the BC Labour Relations Board.
CONCLUSION: Implementation of the Policy was associated with increased HCW vaccination; the Policy was upheld by an independent arbitrator. Further research is required to correlate HCW vaccination coverage rates with changes in influenza incidence and its complications. Continued stakeholder engagement is vital to achieve a collaborative decision-making process.
Résumé
OBJECTIF : Une politique de prévention de l’influenza (« la Politique ») vise à accroître la couverture vaccinale contre l’influenza saisonnière chez les travailleurs de la santé (TS) de la Colombie-Britannique.
PARTICIPANTS : Les TS qui travaillent dans des établissements subventionnés par l’État et qui sont présents dans les zones de soins aux patients.
LIEU : La Politique a été annoncée en août 2012; elle est entrée en vigueur à l’échelle de la province durant la saison grippale 2012–2013.
INTERVENTION : Les TS de la Colombie-Britannique sont tenus de recevoir le vaccin contre l’influenza saisonnière avant le début de la saison grippale (le 1er décembre) ou de porter un masque au travail jusqu’à la fin de la saison (le 30 mars). Les TS vaccinés portent une pastille verte sur leur étiquette d’identité. Les TS sont censés dénoncer leurs collègues contrevenants. Selon ce qui était proposé au départ, le non-respect continu de la Politique pouvait entraîner un congédiement (mais cet élément a été mis en suspens).
RÉSULTAT : Pour la saison grippale 2012–2013, 74 % des TS (35 889 sur 48 818) des établissements de soins actifs ont reçu le vaccin contre l’influenza, contre 40 % (23 375 sur 58 212) en 2011–2012 (écart proportionnel=0,33, intervalle de confiance de 95 % [IC]: 0,33-0,34, p<0,001). Les taux de vaccination du personnel des établissements de soins résidentiels ont aussi augmenté, passant de 57 % (21 535 sur 37 700) pendant la saison grippale 2011–2012 à 75 % (27 617 sur 36 620) en 2012–2013 (écart proportionnel=0,18, IC de 95 %: 0,18-0,19, p<0,001). Les syndicats de travailleurs de la santé ont prétendu que la Politique était coercitive et ont logé un grief auprès de la Commission des relations de travail de la province, qui l’a rejeté.
CONCLUSION : La mise en oeuvre de la Politique a été associée à une vaccination accrue des TS; la Politique a été défendue par un arbitre indépendant. Il faudrait pousser la recherche pour corréler les taux de couverture vaccinale des TS avec l’évolution de l’incidence de l’influenza et de ses complications. Il est vital de continuer à mobiliser les acteurs pour en arriver à un processus décisionnel concerté.
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Acknowledgements: This work was conducted as a Culminating Project as part of the MPH degree requirements for the School of Public Health and Social Policy (PHSP), University of Victoria, under the supervision of Dr. Dee Hoyano at the Office of Public Health for the Vancouver Island Health Authority and Dr. Catherine Worthington, PHSP, University of Victoria. Dr. Worthington and Dr. Trevor Hancock are thanked for reviewing the manuscript.
Conflict of Interest: None to declare.
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Ksienski, D.S. Mandatory seasonal influenza vaccination or masking of British Columbia health care workers: Year 1. Can J Public Health 105, e312–e316 (2014). https://doi.org/10.17269/cjph.105.4346
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DOI: https://doi.org/10.17269/cjph.105.4346