Study suggests increased flu vaccination among US home healthcare workers could reduce patient illness, hospitalization

Results from a new study suggest that increasing influenza vaccination rates among home healthcare (HHC) workers may reduce serious respiratory infection-related hospitalizations among patients in home healthcare settings. Published today in the American Journal of Infection Control (AJIC), the findings are among the first to highlight the association between HHC staff flu-vaccination rates and patient illness at a national level.

"Millions of older Americans receive HHC services on an annual basis, yet little is known about the influenza vaccination rate among HHC workers and its impact on these patients," said Jingjing Shang, Ph.D., RN, Center for Health Policy, Columbia University School of Nursing, and first author on the published study. "Our study provides valuable new insights that could help inform HHC vaccination policies to reduce flu-related illness and hospitalizations among this population and could also have implications for HHC vaccination policies relative to COVID-19."

During the 2019-2020 influenza season, adults aged 65 and over accounted for 57% of influenza-associated infections and 75% of influenza-associated deaths in the United States. Previous research has shown that healthcare workers are one of the main sources of influenza transmission to geriatric patients during the flu season. In 2018, 3.4 million Medicare beneficiaries received HHC services.

The study conducted by Dr. Shang and colleagues evaluated the association between hospital transfers due to respiratory infection among HHC patients and corresponding HHC agencies' staff vaccination policies. The researchers conducted a national survey of HHC agencies and then obtained assessment data for all Medicare beneficiaries who received services from these agencies during a 60-day period. The average age of patients in the study was 80.3 years.

Key findings from the study include:

• Of the 460 HHC agencies surveyed, 26.2% required staff influenza vaccinations and 71.2% reported staff vaccination rates of 75% or higher during the 2017-2018 season.
• Agencies requiring staff influenza vaccinations were more likely to be non-profit and hospital based. They had substantially higher staff vaccination rates as compared to agencies without the requirement (95.5% vs. 61.2%).
• Assuming all HHC agencies adopted policies requiring staff influenza vaccinations, the researchers predicted an 11.25% reduction in the rate of hospital transfers due to respiratory infections as compared to if vaccination rates remained at the status quo (from 1.44% to 1.27%). This reduction would translate into approximately 6,752 avoided hospitalizations for Medicare beneficiaries annually.

"This study provides the first quantifiable evidence that requiring flu vaccination for HHC workers could substantially reduce the burden and cost of seasonal flu for older Americans in the HHC setting, as well as their family members and the U.S. healthcare system," said Linda Dickey, RN, MPH, CIC, FAPIC, and 2022 APIC president.