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

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Findings and Recommendations

The Community Preventive Services Task Force (CPSTF) 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.

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 Actively Promoted, Off-Site 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 off-site may be provided:

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

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.

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review of 1 study (search period through March 2008).

Study Characteristics

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

Summary of Results

One study was included.

  • 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 was not conducted because CPSTF did not have enough information to determine if the intervention works.

Applicability

Applicability was not assessed because CPSTF did not have enough information to determine if the intervention works.

Evidence Gaps

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

Although the body of evidence is strong, the field would benefit from research into the following questions:

  • How do the observed successes in large hospitals and long-term care facilities translate to coalitions of smaller healthcare facilities that may share health promotion resources or family practice clinics that operate on their own?
  • In what ways do current interventions with on-site, no-cost, actively promoted influenza vaccinations create, add to, reduce, or eliminate disparities among sub-groups of HCP?
  • What additional barriers should implementers address to achieve influenza vaccination coverage of greater than 90% among HCP?

Finally, as was shown in the review for general worksites, the overall body of knowledge for off-site, promoted interventions is weak. With only one study with small and non-significant effect measure, in spite of the study’s use of rigorous methods, in the body of literature that analyzed this approach, we were unable to conclude on its effectiveness.

Implementation Considerations and Resources

CPSTF did not have enough evidence to determine whether the intervention is or is not effective. This does not mean that the intervention does not work, but rather that additional research is needed to determine whether or not the intervention is effective.