Discussion
Overall influenza vaccination coverage among HCPs during the 2021-22 season was similar to the previous season. As observed during previous influenza seasons, nonclinical staff, assistants and aides, HCPs working in LTC settings, HCPs with less than a college degree, and HCPs who reported that the their employer did not require or recommend the flu vaccine had the lowest vaccination coverage (5). Similar patterns were observed for COVID-19 vaccination coverage, although coverage with the primary COVID-19 vaccination series was ≥80% in all work settings, including LTC settings, possibly in part due to the prioritization of HCP when the US vaccination program began in December 2020 and a relatively high prevalence of employers requiring COVID-19 vaccination among HCPs. Although the prevalence of reported requirements for influenza vaccination during the 2021-22 season increased by approximately 10 percentage points compared to those during the 2020-21 season, requirements for influenza vaccination were lower those of vaccination against COVID-19 in most work settings. See the article : News Release: Minnesota joins other states to roll out July 16, 988 mental health crisis Lifeline. especially the LTC setup. Requirements for a COVID-19 booster vaccination were infrequently reported in all work settings by HCP who had completed the primary COVID-19 vaccination series, even among hospitals, a a large percentage of which had requirements for primary vaccination against influenza and COVID-19. Thus, compared with primary COVID-19 vaccination coverage, influenza vaccination coverage was lower in non-hospital settings and COVID-19 booster vaccination coverage was lower in all environments Given that the vaccine-induced immunity declines over time after vaccination, keeping up with all recommended vaccinations against COVID-19 is important for all eligible individuals to prevent hospitalization and serious outcomes related to COVID-19, and for the HCP to protect their patients (3). ,8). In September 2022, the CDC recommended an updated bivalent COVID-19 booster vaccine to provide improved protection against circulating strains of COVID-19 (9).
The findings of this report are subject to at least four limitations. First, the study used a non-probability sample of volunteer members of Medscape and Dynata internet panels. Responses were weighted to be representative of the US HCP population; however, some bias in coverage estimates could remain. Second, self-selection of panel and survey respondents could introduce selection bias if participation in the panel or survey is related to the likelihood of being vaccinated. Third, vaccination status was self-reported and could be subject to recall or social desirability bias. Finally, insufficient sample size resulted in coverage estimates in some subgroups not meeting National Center for Health Statistics reliability criteria for reporting proportions.
HCP coverage with influenza vaccine, the primary COVID-19 vaccination series, and a COVID-19 booster dose was highest among those who reported employer vaccination requirements for the respective vaccines. Workplaces that successfully implemented requirements for primary vaccination against COVID-19 could consider the same requirements for booster doses of COVID-19 to restore protection among HCPs that has declined since your previous vaccination. In addition, many LTC settings now have experience implementing COVID-19 vaccine requirements and could consider these requirements for influenza vaccination to improve influenza vaccination coverage. The Centers for Medicare & Medicaid services require many healthcare settings to report both influenza§§§ and COVID-19¶¶¶ HCP vaccination data to CDC’s National Health Security Network; the interim final rule published by the Centers for Medicare & Medicaid services also require LTC settings to offer the COVID-19 vaccine to staff members and residents and educate them about the benefits and potential side effects, which could increase vaccination coverage in these settings.* *** Additionally, useful resources that can help increase vaccination coverage among HCPs include the CDC’s Long-Term Care Web-based Toolkit,††††, which provides access to resources, strategies and educational materials and interventions recommended by the Community Preventive Services Task Force and CDC (4,10). Annual influenza vaccination and keeping up to date with recommended COVID-19 vaccines are critical to preventing serious illness as well as reducing influenza and related morbidity and mortality with COVID-19 among health professionals and their patients.
1 Division of Immunization Services, National Center for Immunization and Respiratory Diseases, CDC; 2Leidos, Inc., Atlanta, GA; 3Office of the Director, National Institute of Occupational Safety and Health, CDC; 4Division of Respiratory Health, National Institute of Occupational Safety and Health, CDC.
References
TABLE 1. Receipt of influenza vaccination during 2020–21 and 2021–22 influenza seasons among health care personnel, by selected characteristics — Internet panel surveys,* United States, April 2021 and April 2022
Abbreviation: Ref = reference group. * Respondents were recruited from two pre-existing national Internet sources: Medscape, a medical website operated by WebMD Health Professional Network, and general population Internet panels operated by Dynata.† Korn-Graubard 95% CI. § The estimate does not meet national CDC regulations. Center for Health Statistics Reliability Standards (https://www.cdc.gov/nchs/data/series/sr_02/sr02_175.pdf). These estimates are presented in this report for comparison purposes and should be interpreted with caution.¶ Statistically significant (p<0.05) when compared between seasons. The difference between percentages is based on unrounded percentages from each season. ** Race and ethnicity were self-reported. Respondents who identify as Hispanic or Latino can be of any race. The “Other” race category included people who identified as Asian, American Indian or Alaska Native, Native Hawaiian, or other Pacific Islander, and people who selected “Other” or “multiple races.”†† Statistically significant (p<0.05) in comparison. with Ref in the same season. The difference between percentages is based on unrounded percentages from each season.§§ Excludes students (34).¶¶ Includes dentists, health professionals, technicians and technologists, emergency technicians, emergency medical technicians and paramedics. *** Includes administrative support staff members and managers and non-clinical support staff members.††† Respondents could select more than one work setting. Each work environment is represented by a separate variable with two values (yes and no, where the reference value is no).§§§ Nursing home, assisted living facility, other long-term care facility, agency home health or home medical care. ¶¶¶ Includes the dentist’s office sta or the dental clinic, pharmacy, emergency medical services and other settings where clinical care or related services were provided to patients. **** Rurality was defined by postal codes in which > ; 50% of the population resides in a nonmetropolitan county, a US Census Bureau rural sector, or both, as defined by the Health Resources and Services Administration’s rural population. https://www.hrsa.gov/rural-health/about-us/what-is-rural††††https://www2.census.gov/geo/pdfs/maps-data/maps/reference/us_regdiv .pdf
TABLE 2. Receipt of ≥1 COVID-19 vaccine dose, completion of primary series,* and receipt of 1 COVID-19 booster dose† among health care personnel, by selected characteristics — Internet panel surveys,§ United States, April 2022
Abbreviations: HCP = healthcare personnel; NA = not applicable; Ref = reference group. * Completion of the primary COVID-19 vaccine series was defined as receipt of a 2-dose primary mRNA COVID-19 vaccine series for respondents who did not report being immunocompromised, or an additional dose after completing a dose of COVID-19 mRNA. 19 vaccine series for respondents who reported being immunocompromised. For respondents whose initial vaccine was Janssen (Johnson & Johnson), completion of the primary COVID-19 vaccination series was defined as receiving one dose for those who were not immunocompromised or a second COVID-19 vaccine (Jassen or mRNA) for those who were immunocompromised.† A COVID-19 booster was defined as receiving a third dose of the COVID-19 vaccine after completing a 2-dose primary mRNA vaccine series for COVID-19 for respondents who did not report being immunocompromised, or a fourth dose of COVID-19 vaccine after completing a 3-dose vaccine series mRNA for COVID-19 for respondents who reported being immunocompromised. For respondents whose initial vaccine was Janssen, booster vaccination was defined as receiving a second dose of COVID-19 vaccine (either Janssen or mRNA) for respondents who were not immunocompromised or 3 doses totals for respondents who were immunocompromised.§ Respondents were recruited from two preexisting national Internet sources: Medscape, a medical website operated by WebMD Health Professional Network, and general population Internet panels operated by Dynata.¶ Korn -Graubard 95% CI. ** Statistically significant (p<0.05) compared to Ref.†† Race and ethnicity were self-reported. Respondents who identify as Hispanic or Latino s can be of any race. The “Other” race category included people who identify as Asian, American Indian or Alaska Native, Native Hawaiian, or other Pacific Islander, and people who selected “Other” or “multiple races.”§§ Excludes students (34).¶¶ Includes dentists, health professionals, technicians and technologists, emergency technicians, emergency medical technicians and paramedics. *** Includes administrative support staff members and managers and non-clinical support staff members.††† Respondents could select more than one work setting. Each work environment is represented by a separate variable with two values (yes and no, where the reference value is no).§§§ Nursing home, assisted living facility, other long-term care facility, agency home health or home medical care. ¶¶¶ Includes the dentist’s office or dental clinic, pharmacy, emergency medical services, and other settings where clinical care or related services were provided to patients. **** Rurality was defined by zip codes in which >50% of the population resides in a nonmetropolitan county, a US Census Bureau rural sector, or both, as defined by the rural population of the Administration of Health Resources and Services. https://www.hrsa.gov/rural-health/about-us/what-is-rural†††† https://www2.census.gov/geo/pdfs/maps-data/maps/reference/us_regdiv .pdf§§§§ “Other” place of first or only vaccination against COVID-19 includes other places related to medicine or not, such as a pharmacy, supermarket and pharmacy.
FIGURE. Prevalence of employer requirement or recommendation for influenza and COVID-19* vaccination (A) and vaccination coverage,† by employer requirement status (B) among health care personnel, by work setting§ — Internet panel surveys,¶ United States, April 2022
*Covid-19 booster vaccination coverage was limited to healthcare workers who completed the primary series of COVID-19 vaccines. On the same subject : Google’s disruption to Employee Travel is yet another setback for the Transportation recovery. Specific analysis of employer requirements for COVID-19 booster vaccines was limited to 2,256 health care workers who completed the primary series of COVID-19 vaccines and excluded 1,044 health care providers who found an erroneous jump pattern that was corrected on the second day of the survey. .
† Completion of the primary COVID-19 vaccine series was defined as receipt of a 2-dose primary mRNA COVID-19 vaccine series for respondents who did not report being immunocompromised, or an additional dose after completing a 2-dose COVID-19 mRNA. 19 vaccine series for respondents who reported being immunocompromised. For respondents whose initial vaccine was Janssen (Johnson & Johnson), completion of the primary COVID-19 vaccination series was defined as receiving one dose for those who were not immunocompromised or a second COVID-19 vaccine (Jassen or mRNA) for those who were immunocompromised.
§ Includes dentist’s office or dental clinic, pharmacy, emergency medical services, and other settings where clinical care or related services are provided to patients.
¶ Respondents were recruited from two preexisting national Internet sources: Medscape, a medical website operated by WebMD Health Professional Network, and general population Internet panels operated by Dynata.
Suggested citation for this article: Razzaghi H, Srivastav A, de Perio MA, Laney AS, Black CL. Influenza and COVID-19 vaccination coverage among healthcare workers — United States, 2021–22. MMWR Morb Mortal Wkly Rep 2022;71:1319–1326. DOI: http://dx.doi.org/10.15585/mmwr.mm7142a2.
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