Healthcare worker influenza declination form program

Sherri L. Lavela*, Jennifer N. Hill, Bridget M. Smith, Charlesnika T. Evans, Barry Goldstein, Richard Martinello

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Background Health care worker (HCW) vaccination rates have been low for many years (approximately 50%). Our goal was to implement an influenza declination form program (DFP) to assess feasibility, participation, HCW vaccination, and costs. Methods This was a prospective interventional pilot study using mixed methods to evaluate the DFP implementation processes and outcomes. We conducted a formative evaluation and interviews; data were transcribed and coded into themes. Secondary outcomes included self-reported HCW influenza vaccine uptake (pre-/postsurvey) and program costs; data were evaluated using descriptive and bivariate analyses. Results The DFP was compatible with ongoing strategies and unit culture. Barriers included multiple hospital shifts and competing demands. Facilitators included complementary ongoing strategies and leadership engagement. HCW vaccination rates were higher post- versus preimplementation (77.4% vs 53.5%, P =.01). To implement the DFP at site 1, using a mobile flu cart, 100% of declination forms were completed in 42.5 staff hours over <2 months. At site 2, using a vaccination table on all staff meeting days, 49% of forms were completed in 26.5 staff hours over 4.5 months. Average cost of staff time was $2,093 per site. Conclusion DFP implementation required limited resources and resulted in increased HCW influenza vaccine rates; this may have positive clinical implications for influenza infection control/prevention.

Original languageEnglish (US)
Pages (from-to)624-628
Number of pages5
JournalAmerican Journal of Infection Control
Issue number6
StatePublished - Jun 1 2015


  • Declination forms
  • Health care workers
  • Implementation science
  • Influenza vaccination

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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