Published in JAMA Network Open, results of a national survey describe an increase in vaccination coverage among healthcare professionals from 2013 to 2017, although many hospitals still do not mandate influenza vaccinations specifically.

This national survey study included responses from 1062 infection preventionists at both Veterans Affairs (VA) and non-VA hospitals between the 2013 and 2017 calendar years. In addition to VA status, hospitals were stratified by location, profit and teaching status, and number of hospital beds in subsequent statistical analyses. The overall survey response rate for 2013 was 69.3%, with 70.6% of non-VA hospitals and 63.5% of VA hospitals participating. In 2017, the overall response rate declined to 59.1% (non-VA, 59.1%; VA, 58.9%).

Among all responding hospitals, mandatory influenza vaccination requirements for healthcare professionals increased from 37.1% in 2013 to 61.4% in 2017 (P <.001). This change was primarily a result of the participation of non-VA hospitals, with the proportion of facilities mandating vaccinations increasing from 44.3% in 2013 to 69.4% in 2017 (P <.001). For VA hospitals, however, no significant change in requirement policy rates was observed during the study period (P =.29).

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As influenza infection rate data were not collected for the surveyed hospitals, researchers were not able to demonstrate whether influenza rates were influenced by vaccination mandates. However, these results still indicate a trajectory toward stricter infection prevention at hospitals in general, and highlight a possible need for increased vaccine mandates at VA hospitals specifically.


  1. Greene MT, Fowler KE, Ratz D, Krein SL, Bradley SF, Saint S. Changes in influenza vaccination requirements for health care personnel in US hospitals. JAMA Network Open. 2018;1(2):e180143.
  2. Babcock, HM. Continuing to move the needle on health care personnel influenza vaccination rates. JAMA Network Open. 2018;1(2):e108144.