Increased Flu Vaccinations Among Home Health Workers Could Reduce Patient Illness, Hospitalization


If 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.

Results from a new study published in the American Journal of Infection Control suggest that increased vaccination rates among home health care (HHC) workers could reduce respiratory infection-related hospitalizations among patients in HHC settings. According to the investigators, the findings are among the first to highlight the links between HHC staff flu vaccination rates and patient illnesses at a national level.

During the 2019-2020 influenza season, adults 65 years of age and older accounted for 57% of influenza-related infections and 75% of influenza-related deaths in the United States. Earlier studies have shown that health care workers are one of the major sources of influenza transmission to geriatric patients during the flu season. In 2018, 3.4 million Medicare beneficiaries received HHC services, underlining the importance of HHC worker vaccinations.

“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 first author Jingjing Shang, PhD, RN, in a press release. “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.”

The study evaluated the association between hospital transfers due to respiratory infection among HHC patients and corresponding HHC agencies’ staff vaccination policies. Investigators 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 analysis was 80.3 years, according to the study.

Of the 460 HHC agencies surveyed, the researchers found that 26.2% required staff to be vaccinated against influenza and 71.2% reported staff vaccination rates of 75% or higher during the 2017-2018 season. Notably, agencies requiring staff influenza vaccinations were more likely to be non-profit and hospital-based. They also had substantially higher staff vaccination rates compared to agencies without the requirement (95.5% versus 61.2%).

If 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 compared to the rates if vaccinations remained at the status quo. This reduction would translate into approximately 6752 hospitalizations avoided annually for Medicare beneficiaries, according to the study.

“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 US health care system,” said Linda Dickey, RN, MPH, CIC, FAPIC, 2022 president of the Association for Professionals in Infection Control and Epidemiology.


New study suggests increased flu vaccination among US home healthcare workers could reduce patient illness and hospitalization. News release. March 31, 2022; EurekAlert. Accessed April 5, 2022.

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