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Worksite Health: Seasonal Influenza Vaccinations Using Interventions with Actively Promoted, Off-Site Vaccinations – non-Healthcare Workers


What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review of 1 study (search period through March 2008). The review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to worksite health promotion.


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.

Summary of Results

Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement pdf icon [PDF - 128 KB].

One study was included in the review.

  • The 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.

Summary of Economic Evidence

An economic review of this intervention was not conducted because the CPSTF did not have enough information to determine if the intervention works.


Applicability of this intervention across different settings and populations was not assessed because the CPSTF did not have enough information to determine if the intervention works.

Evidence Gaps

The CPSTF identified several areas that have limited information. Additional research and evaluation could help fill remaining gaps in the evidence base. (What are evidence gaps?)

The following outlines evidence gaps for these interventions to promote seasonal influenza vaccinations among non-healthcare workers: on-site, reduced cost, actively promoted vaccinations; and actively promoted off-site vaccinations.

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?

Study Characteristics

The one included study was conducted in the U.S. and targeted people aged 18 to 64 years with high-risk conditions.