New approaches for influenza vaccination of healthcare workers.

PURPOSE OF REVIEW Vaccination of healthcare workers (HCWs) against influenza is an important component of infection control in healthcare settings but HCW vaccination rates remain low. Here we review current and emerging strategies for influenza vaccination of HCWs. RECENT FINDINGS Professional organizations have recommended annual influenza vaccination for HCWs since 1984, but HCW vaccination rates have improved minimally. Recent studies indicate that comprehensive influenza vaccination programs have failed to achieve adequate influenza vaccination rates for HCWs in spite of allocating substantial resources to HCW vaccination programs. Mandatory HCW influenza vaccination programs have been introduced and clearly outperform traditional comprehensive vaccination programs. Some argue that mandatory vaccination programs infringe on HCW autonomy, and introduction of mandatory vaccination programs can be controversial. Public reporting of institutional HCW influenza vaccination rates is another strategy to achieve high vaccination rates, as HCW influenza vaccination may be used in the future as a quality and safety metric. SUMMARY HCW influenza vaccination in the setting of a comprehensive infection control program is a core patient-safety practice. Mandatory HCW influenza vaccination and public reporting of HCW vaccination rates will complement one another in achieving substantial gains for HCW influenza vaccination programs.