Frequently Asked Questions
Background on Influenza Vaccine:
Each year Influenza virus causes significant illness and death to people across the world. In the United States, Influenza is estimated to cause over 226,000 hospitalizations, and 36,000 deaths every year. Influenza is most deadly to the sickest and most vulnerable populations: the elderly, the very young, and the very ill. In addition, the H1N1 influenza was particularly dangerous for pregnant women.
There is a way to help stop the virus and protect our patients, our families, and ourselves. GET VACCINATED. Vaccination is the most effective method for preventing influenza infection and its complications. The Centers for Disease Control and Prevention (CDC) recommends that all health care personnel be vaccinated against influenza every year. However, data shows that in previous years, only about 40% of health care workers were vaccinated (DMC 2009 vaccination rate 41%).
1. Why is the DMC requiring vaccination against seasonal Influenza?
Every year, a new strain of Influenza (flu) affects us. To improve the safety of our patients, our staff, and their families, all employees should be vaccinated to reduce the risk of disease, and the risk of transmitting Flu to our patients.
A recent CDC report on 2009 H1N1 vaccination found that the existence of an employer requirement for vaccination was associated with an 8-fold greater likelihood of vaccination. Patients cared for in hospitals and clinics are safer when cared for by vaccinated staff.
2. Is there a Flu Vaccination policy?
Yes. It is a Tier 1 System Administrative Clinical policy – 1 CLN 058 “Employee Influenza Vaccine”. It can be found on the DMC intraweb under the Policies section.
3. Are other hospitals requiring flu vaccination?
Yes. Henry Ford Health System and Karmanos have a similar policy. In this area, St. John, Oakwood and the University of Michigan are all working on similar policies. Other systems in Michigan and across the United States have mandatory flu vaccine policies. The Michigan Department of Community Health is urging hospitals to make influenza vaccination mandatory for employees and staff. Finally, Vanguard’s corporate policy includes mandatory flu vaccination. We expect, with time, that all healthcare systems will require flu vaccination as a safety strategy for patients and staff.
4. Who is included in this policy?
All DMC employees, which includes nurses, patient care associates, technicians, therapists, social workers, pharmacists, students, transporters, housekeepers, phlebotomists, physicians/residents, and all others who provide direct care. Vendors are included if they provide direct patient care. Visitors are not included in this policy.
5. Are physicians included?
Yes. Physicians, residents and medical students are all included in this policy.
6. Do I have a choice?
Yes, employee can decline vaccination on basis of valid evidence-based medical contradiction or religious restriction. In such cases, individual must present a verified exemption letter from registered physician or verified religion's representative.
7. Is the vaccine safe?
Yes. The vaccine has been tested and used extensively and is considered to be very safe. Side effects are generally mild and include temporary arm soreness and muscle aches.
8. What does the vaccine cost?
The vaccination is free of charge for DMC employees, medical staff, students and volunteers.
9. What happens if I do not get vaccinated?
If you choose NOT to receive the flu vaccine (or cannot receive the vaccine), AND you provide direct patient care in a high risk area, then you must wear a mask while providing that direct patient care.
10. Where can I get vaccinated?
As in prior years, vaccine will be available from Occupational Health, as well as through their Mass Vaccination Clinics, and roving unit vaccinators.
11. What if I get my vaccine elsewhere?
Vaccines given elsewhere (such as private physician office, county clinic, or local store) are all valid and acceptable. However, please obtain WRITTEN PROOF of vaccination including date and signature.
12. When will this policy start?
Vaccine should be available by end of September. The policy will go into effect when Infection Control, in conjunction with the State of Michigan, declare “flu season” for our area. Generally this is from November thru March, but months may vary depending on flu strain.
13. How long will I have to wear a mask?
Masks will need to be worn as long as direct patient care in the high risk area is being provided, during the “flu season” (generally November thru March but months may vary).
14. Will masks be provided?
Yes. Masks will be provided by your department. Regular surgical masks are sufficient. There is no need for “respirators”, unless you are performing certain “aerosol-generating procedures” such as sputum induction, bronchoscopy, suctioning and intubation/extubation. For these procedures a fit-tested N95 respirator is required. If a mask shortage occurs, mask conservation policy will be followed (2 IC 006 Appendix A).
15. How do I know if an employee has been vaccinated?
Employees will be given a badge identification sticker to visually identify those who have been vaccinated. These will be available through OHS. If you have received a vaccine elsewhere, just bring your proof of vaccination to OHS. Unit based vaccinators will have stickers for those employees they vaccinate.
16. Isn’t this a violation of HIPPA or patient privacy to wear a badge identifying vaccination?
HIPPA is a regulation which pertains to confidentiality of patient medical records and does not extend to employees. However, all employees have a right to privacy. Those employees who wish not to wear a badge identifying that they have been vaccinated, can instead wear a mask while providing direct patient care in a high risk area.
17. What happens if I observe a violation of this policy?
If you see somebody providing direct patient care in a high risk area without proof of vaccination, and not wearing a mask, please feel free to remind them of the importance of vaccination and offer them a mask. If this is not successful, report the incident to your supervisor.
18. What happens if I decline vaccination and also fail to wear a mask, and I provide direct patient care in a high risk area?
This policy is to protect patients, staff and families and is a patient safety issue. As such failure to follow this vaccination policy is a major disciplinary action. Employees who decline vaccination and refuse to wear a mask while providing direct patient care in a high risk area will be suspended pending further Human Resources investigation. Medical staff will also be subject to suspension if they both decline vaccination and fail to wear a mask while providing direct patient care in a high risk area.
SPECIFIC SCENARIOS
- A nurse reports to work on her unit and does not have proof of vaccination. When approached by her supervisor, she says that she has had the vaccine but left her paperwork at home. What should the supervisor do?
Working in a high risk patient care area requires employees to be vaccinated or wear a mask while providing direct patient care. The nurse will be required to wear a mask until she can display proof of vaccination.
- A physician declines a mask and does not have proof of vaccination. Who should be notified?
Notify the supervisor of the unit who will call the Vice President of Medical Affairs for the site. Physician leadership unanimously supported this vaccine policy. The VPMA, Chief of Staff, and Department Chief/Specialist in Charge, are all responsible for enforcing this policy. If there is no response, the supervisor may also contact the Corporate Chief of Infection Control, the Chief Quality Officer or the Chief Medical Officer of the DMC.
- A transporter comes on a unit without a displayed vaccination sticker and declines a mask. What should the clinical leader do?
Remind the transporter of the importance of complying with the policy. If the transporter refuses a mask, contact the supervisor of transport. Do not release the patient for transport unless the employee wears a mask.
- A non-vaccinated housekeeper refuses to wear a mask because he/she feels there will be more than six feet between him/her and the patient, and the duration will be less than 5 minutes.
If this is correct, that no DIRECT patient care is being provided, and the timeframe is less than 5 minutes, then no mask is needed. However, the employee is taking a gamble on whether he/she can remain within this expected interaction time and location. Too often, unexpected events impact our tasks. In this case, the housekeeper would be wise to wear the mask.
- A nurse is providing care in the ICU outside of the patient room. Does a mask need to be worn?
A mask needs to be worn when an unvaccinated employee is providing DIRECT patient care, within 6 feet of the patient, in the patient room (assuming the patient is in the room), for more than 5 minutes. So if an employee is sitting at the desk, or sitting outside the room, or in the hallway, he/she does not need to wear a mask at that time, even while inside a high risk unit.