Worksite: Seasonal Influenza Vaccinations Using Interventions with On-Site, Reduced Cost, Actively Promoted Vaccinations non-Healthcare Workers

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Findings and Recommendations

The Community Preventive Services Task Force (CPSTF) 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 CPSTF has related findings for the following:

The full CPSTF Finding and Rationale Statement and supporting documents for Worksite: Seasonal Influenza Vaccinations Using Interventions with On-Site, Reduced Cost, Actively Promoted Vaccinations non-Healthcare Workers are available in The Community Guide Collection on CDC Stacks.

Intervention

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 offered on-site may be provided:

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

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. By providing the vaccination at the worksite, employers reduce the temporal, geographic, and financial barriers that can prevent a worker from getting vaccinated.

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review of 5 studies (search period through March 2008).

Study Characteristics

  • 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 conducted in United States; one study conducted in Philippines

Summary of Results

Five studies with six total study arms (intervention comparisons) qualified 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)

Summary of Economic Evidence

One study from the U.S. provided economic information for influenza vaccination programs in non-healthcare worksites. Conclusions cannot be made from this small and incomplete body of evidence. Monetary values in 2007 U.S dollars.

  • Cost of vaccination program: $31.95 per person, and did not include promotional campaign cost
  • Economic net benefit per person: $129 — $53 in averted productivity losses due to work absences, and $76 in averted healthcare cost due to influenza

Applicability

Results applicable to workers in medium and large worksites.

Evidence Gaps

The primary questions that remain unanswered from this review relate to cost savings and the overall effectiveness of interventions with additional components like mobile carts or incentives. To address these issues and further the knowledge of the field of worksite influenza vaccination interventions, researchers must conduct rigorous, multi-year studies with concurrent comparison worksites that evaluate on-site, off-site, and other intervention approaches. Additionally, researchers should investigate the following:

  • How might the successes in increasing influenza vaccination coverage in the body of evidence for healthcare workers inform efforts in non-healthcare worksites?
  • What specific barriers, besides access, should implementers address with their interventions?
  • What might be the cost of presenteeism associated with influenza in the worksite, including, for example, the cost of injuries due to reduced alertness, the cost of reduced morale, and the cost of spreading infection to other workers?

Implementation Considerations and Resources

Implementation barriers identified in broader literature include:

  • Language differences
  • Lack of adequate knowledge about vaccine or influenza
  • Distrust of the vaccine/medical industry

Barriers suggested by review team include:

  • Less flexible schedules for lower-income workers
  • Upfront costs of buying a vaccine for employer
  • Employers’ perceived or actual liability

Crosswalks

Healthy People 2030 icon Healthy People 2030 includes the following objectives related to this CPSTF recommendation.