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The Guide to Clinical Preventive Services

Together, the Community Guide and the Clinical Guide provide evidence-based recommendations across the prevention spectrum.


Interventions to Promote Seasonal Influenza Vaccinations among Non-Healthcare Workers

Interventions to promote influenza vaccination among workers can include making vaccines available to workers and announcing this availability in work settings, using things such as newsletters, e-mails, or paycheck inserts. These interventions attempt to correct myths, to reduce the financial cost, or to change worksite norms regarding vaccination.

Vaccines may be offered:

  • On-site or off-site
  • At cost, reduced cost, or no cost
  • With health education and mobile units
  • In clinics
  • At multiple locations

Summary of Task Force Recommendations and Findings

The Community Preventive Services Task Force recommends interventions with on-site, reduced cost, and actively promoted influenza vaccinations, when implemented alone or as part of a multicomponent intervention, based on sufficient evidence of their effectiveness in increasing influenza vaccination coverage among workers in worksites.

The Task Force finds insufficient evidence to determine the effectiveness of interventions with actively promoted, off-site influenza vaccinations to increase influenza vaccination coverage among workers in worksites because only one study qualified for review and it had a small effect size.

Read the full Task Force Finding and Rationale Statement for details including implementation issues, possible added benefits, potential harms, and evidence gaps.

Interventions with On-Site, Free, Actively Promoted Influenza Vaccinations

On-site vaccination interventions principally attempt to enhance access to the vaccine for workers and attempt to address many of the identified barriers to vaccine uptake. They announce vaccination availability through formal worksite announcements, such as in newsletters, e-mails, or paycheck inserts. By providing the vaccination at the worksite, employers reduce the temporal, geographic, and financial barriers that can prevent a worker from getting vaccinated.

Results from the Systematic Review

Five studies with six total study arms (intervention comparisons) qualified for the review and examined changes in vaccination coverage or worker productivity.

  • Evaluated interventions showed median increases in vaccination coverage of:
    • 21 percentage points (2 study arms with comparison groups)
    • 38 percentage points (4 studies with no comparison group)
  • Studies evaluated interventions with reduced cost, on-site, actively promoted influenza vaccinations alone and when combined with additional interventions, including provision of information, efforts to enhance access, activities to change attitudes and norms, and policy changes.
  • Studies evaluated interventions conducted in large worksites (more than 500 workers).
  • Most studies were conducted in the United States, and one study was conducted in the Philippines.

Interventions with Actively Promoted, Off-Site Seasonal Influenza Vaccinations

Off-site, actively promoted influenza vaccination interventions encourage workers to obtain influenza vaccinations in a location other than that in which they normally work using any of a variety of approaches. These include providing vouchers or leave time, conducting health education sessions, and sending reminders about the vaccination. The intervention must be promoted through formal worksite announcements, such as newsletters, e-mails, paycheck inserts, or posters in the worksite and may include additional components.

Results of the Systematic Reviews

We identified one study in this review. This study examined the effect of providing one group of high-risk workers with a second postcard reminder as compared to a group of high-risk workers who received only one postcard reminder. Workers were encouraged to vaccinate at an off-site benefits provider clinic. The coverage effect estimate for the second postcard was 0.8 percentage points favoring the intervention.

These results are based on a systematic review of all available studies, conducted on behalf of the Task Force by a team of specialists in systematic reviews, other research, and public health practice and policy related to worksite health promotion and influenza vaccination.

Supporting Materials

Publication Status

Full peer-reviewed articles of this systematic review will be posted on the Community Guide website when published. Subscribe External Web Site Icon to be notified when we post these publications or other materials. See our library for previous Community Guide publications on this and other topics.


The findings and conclusions on this page are those of the Community Preventive Services Task Force and do not necessarily represent those of CDC. Task Force evidence-based recommendations are not mandates for compliance or spending. Instead, they provide information and options for decision makers and stakeholders to consider when determining which programs, services, and policies best meet the needs, preferences, available resources, and constraints of their constituents.

Sample Citation

The content of publications of the Guide to Community Preventive Services is in the public domain. Citation as to source, however, is appreciated. Sample citation: Guide to Community Preventive Services. Interventions to promote seasonal influenza vaccinations among non-healthcare workers. Last updated: MM/DD/YYYY.

Review completed: June 2008