Carrots and Sticks: Achieving High Healthcare Personnel Influenza Vaccination Rates without a Mandate

In Infection Control and Hospital Epidemiology, Marci Drees and colleagues, including J. Sanford Schwartz, evaluate the efficacy of implementing a multimodal campaign to increase influenza vaccination among healthcare personnel (HCP) without a mandate. The authors implemented an integrated multimodal approach incorporating peer pressure, accountability, and financial incentives to improve the HCP influenza vaccination rate. Employee compliance, vaccination, exemption and declination rates were compared with those of the seasons prior to the intervention. The authors find that employee influenza vaccination increased to 93% in the second through fourth year of the intervention compared to 56-62% in the three years preceding it. The authors suggest that an integrated multimodal approach, such as the one they created and tested, can serve as a model for behavior change within healthcare organizations.