From the National Business Coalition on Health: A study presented on
October 29, 2012 at the American Public Health Association annual meeting in
San Francisco and recently published in the Journal of Occupational and
Environmental Medicine found that influenza-like illness took a significant
toll on employee health and productivity during a recent influenza season.
new employer-sponsored influenza immunization program that was developed for
this study was effective at engaging both employees and families.
The prospective, multi-site study was designed
by Ofstead & Associates, Inc. and conducted in collaboration with a major
U.S. manufacturer that is an active member of the Employers Health Coalition
in Ohio. Study sites included factories in three Midwestern towns, with a study
population of 13,520 covered employees and dependents.
During the 2010-2011 influenza season, only 35% of working-age adults were
vaccinated against influenza even though the annual vaccine is recommended for
everyone in the United States and vaccination is a covered health benefit for
many workers. This is far short of the Healthy People 2020 objective of 80
percent coverage and indicates the need for innovative approaches to achieving
higher immunization rates.
A baseline survey found that 45% of employees experienced influenza-like
illness, with high rates of associated absenteeism (>25%), presenteeism
(>80%), and healthcare utilization (30%). The economic toll on employees
totaled more than $600,000 in lost wages and out-of-pocket costs at each
factory. Many employees had concerns and misconceptions about influenza and
vaccination, and multiple barriers to receiving vaccine were identified.
Employees commonly perceived that immunization was expensive, inconvenient, and
unnecessary for healthy adults. The survey findings were used to design
multifaceted interventions that provided educational information and addressed
barriers to vaccination during the 2010-2011 influenza season.
According to the co-principal investigators, Cori L. Ofstead, MSPH and Bruce W.
Sherman, MD, vaccine uptake significantly increased at the two intervention
sites, whereas it decreased at the control site, reflecting a national trend
toward lower vaccination rates among working adults. A follow-up survey and
claims data analysis revealed that convenient access to free vaccine was the
primary driver of immunization. One half of vaccinated employees indicated they
would not have received vaccine were it not offered free through the
A strong association was found between employee and family vaccination status.
When the employee was vaccinated, nearly all spouses (94%) were vaccinated;
when the employee was unvaccinated, few spouses (10%) were vaccinated. In
addition, households with vaccinated employees were significantly more likely
to have vaccinated all of their children than households with unvaccinated
Evidence showed that customized, evidence-based education successfully served
as an important cue to action, but did not result in significant changes in
employee knowledge or beliefs. Employees were motivated to receive vaccine
primarily due to economic reasons, including convenient access to free vaccine
and a desire to avoid missing work due to illness, rather than fear of catching
influenza or transmitting it to others.