SYSTEM POLICY. Section: Human Resources Page: 1 of 6 Employee Health Services. Influenza Vaccination Program

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1 Section: Human Resources Page: 1 of 6 Program Executive Owner: Chief Human Resources Officer Approval Date: 10/1/2012 Effective Date: 10/1/2012 Last Review Date: New Policy Revised Date: N/A Supersedes: N/A I. POLICY STATEMENT Presence Health (PH) is committed to ensuring the health, wellness, and safety of its employee s patients/residents and that vaccination is the best way to prevent influenza infection and its complications. All Presence Health employees are therefore required, as a condition of employment, to be immunized against influenza annually or as otherwise recommended by the Centers for Disease Control (CDC) and as approved by Presence Health Infection Control. Flu vaccines are free of charge to Presence Health employees. The vaccination program is coordinated by the Presence Health (EHS). II. PURPOSE This policy describes the Influenza Immunization Program directed toward the prevention and decreased transmission of influenza by employees, volunteers, contract workers and students. III. MISSION / VALUES RATIONALE This policy is aligned with the Mission and Values for Presence Health. Our mission calls us to provide compassionate, holistic care with a spirit of healing and hope for all persons in the communities we serve. Our ministry is an enduring sign of our Core Values of HOPE, to instill us with integrity, inspire us to interconnect with each other, encourage us to honor diversity and dignity of each individual and empower us to always strive for exceptional performance to our patients/residents and to best serve those in need. IV. SPECIAL INSTRUCTIONS A. The CDC s Influenza Vaccine Information Sheet (VIS) will be made available to all employees prior to vaccination. B. Post-vaccination Adverse Reactions. Any post-vaccination adverse reactions must be reported directly to EHS, informing the EHS nurse either by phone or in person.

2 Section: Human Resources Page: 2 of 6 C. Vaccination Exempted Employees Prescribed Protective Measures. The employee shall be required to wear a surgical or procedure mask in all patient care areas, and/or in departments where patient contact occurs frequently while at work during the influenza season. D. Vaccination Exempted Independent/Affiliated Physicians Prescribed Protective Measures. The independent/affiliated physicians who have not been vaccinated are also required to wear a surgical or procedure mask while in patient care areas and/or departments with regular patient contact. V. DEFINITIONS A. Non Employees. Private practice physicians, rotating residents, contracted workers and any students affiliated with Presence Health. B. Volunteers/Ministers of Care. Reference Ministry Volunteer Policy. C. Patient Care Areas. The Patient Care Areas include all in-patient units, ancillary departments, ambulatory care clinics, and all other procedural sites. D. Prescribed Protective Measures Reference definitions under Special Instructions. VI. PROCEDURES A. Mandatory Vaccinations for All Presence Health Employees 1. Required s. Influenza vaccination is required for all PH employees, regardless of job function. Vaccinations are also required for medical residents, students, faculty, contract workers and volunteers. Independent/Affiliated Physicians are strongly encouraged to comply with the vaccination requirements. 2. Flu Vaccination Mandate. Mandating flu vaccinations is dependant both upon an appropriate supply of available vaccine. The PH Infectious Disease Medical Advisor will recommend to PH Senior Management a commencement date and a deadline for the mandated annual vaccine. The Infectious Disease Medical Advisor or designee will then communicate with the PH with each ministry management team. If it is determine that an appropriate supply is not available, PH management shall prioritize vaccination areas and occupations, based on job functions and risk exposure to influenza.

3 Section: Human Resources Page: 3 of 6 3. Once a readily available supply of vaccine has been determined, all employees who are awaiting vaccination, who have been granted an exemption as described in Section VI. Procedures, Letter B. below, or who have filled a request for an exemption shall be required to wear a surgical or procedure mask in all patient care areas, or in departments where patient contact occurs frequently while at work during the influenza season. Independent/Affiliated Physicians who have not been vaccinated are also required to wear a surgical or procedure mask while in patient care areas and departments with regular patient contact. Patient care areas include all in-patient units, ancillary departments, ambulatory care clinics, and all other procedural sites. 4. Vaccination Refusal. If an employee refuses to be vaccinated and does not qualify for an exemption, or if the employee refuses to comply with the required protective measures, progressive disciplinary actions will be taken, up to and including termination. The employee will not be permitted to work until vaccinated or until qualifying for an exemption. (Reference Presence Health Corrective Action Policy). 5. Obtaining Vaccination Sites. Employees shall normally receive the influenza vaccines through their ministry specific site EHS office. Employees can obtain the vaccines outside Presence Health; however, will be required to present EHS with proof of immunization. B. Exemptions from the Mandatory Vaccination Requirements 1. Request for Medical Exemptions. An employee may be granted a medical exemption to the mandatory flu vaccination requirement if they have a medical contraindication to the influenza vaccine. Any request for a medical exemption must be confirmed and attested to by the employee s physician on the Medical Exemption Form. The signed form must include the physician s contact information. Acceptable medical contraindications include: a. A severe allergy or hypersensitivity to chicken eggs. b. Previous experienced several medical contraindications or a prior hypersensitivity reaction to the vaccine. c. The employee has a history of Guillian-Barre Syndrome. d. Other reasons will be reviewed on a case-by-case basis. The employee will be notified within five (5) days whether their request has been granted. Any denial will include an explanation of the reason for denial. During the period of time a request for an exemption is being considered, the employee must follow the prescribed protective measures for preventing the disease. (Reference the Special Instructions).

4 Section: Human Resources Page: 4 of 6 2. Request for Exemptions for Reasons of Religion or Conscience. An employee may be granted exemption if receiving the flu vaccination would violate the employee s sincerely held religious beliefs and/or conscience. In order to be exempt from the vaccination requirements for reasons of religion or conscience, the following is required: a. A letter must be submitted by the employee, or on behalf of the employee, to the ministry specific site s Human Resources Director requesting religious accommodation. b. The letter must state sincerely held a religious and/or conscience conviction that is in opposition to the vaccination, and the employee must be able to demonstrate a strict adherence to the conviction in question. All such requests will be reviewed by the Ethics Department on a case-by-case basis. c. Employees will be notified, in writing, by the Clinical Ethics Department, within five (5) days whether or not their request has been granted. d. Any denial will include an explanation of the reason for the denial. During the period of time a request for an exemption is being considered, employees must follow the prescribed protective measures for preventing disease transmission. (See Special Instruction for information). C. Refusal of the Mandatory Flu Vaccine 1. Once the annual influenza vaccination period has commenced, and an employee is directed to be vaccinated by refuses, the employee will be given a thirty (30) day grace period to receive the vaccine or to seek an exemption from the mandatory vaccination requirement. a. During the 30-day grace period, the employee must follow the prescribed precautionary measures for preventing disease transmission. b. In addition, the employee s manager shall ascertain the reason for noncompliance and shall provide coaching about influenza, the vaccine, and the consequences for non-compliance. 2. Following conclusion of the 30-day grace period, if the employee still refuses the vaccination and has not qualified for one of the medical or religious exemptions listed above, the employee will then be suspended without pay until vaccinated or receiving an exemption, up to an additional thirty (30) days.

5 Section: Human Resources Page: 5 of 6 D. Absences 3. Following the sixty (60) day period, from the date of the original directive to be vaccinated, if the employee continues to refuse the vaccine and has not qualified for a medical or religious exemption, the employee will be terminated for failing to meet the terms and conditions of employment. Absences related to non-compliance with the mandatory flu vaccination program will be treated as an occurrence under the Presence Health Attendance Policy. E. Vaccine Adverse Reactions. Upon receipt of an adverse reaction, the EHS staff will do all of the following: 1. Interview employee for pertinent information. 2. Direction regarding medical care will be assessed on case-by-case basis. 3. Document in the employee file. 4. Inform Pharmacy. a. Pharmacy will be responsible for all adverse drug reaction paperwork. F. Documentation of Immune Status for Those with Affiliated Organizations Departments affiliated with external organizations who deploy individuals to Presence Health Ministries will communicate that documentation of immune status must be made available, prior to the individuals start date, to the departments responsible for the program. This information will be made available to EHS upon request and should be retained for the duration of affiliation at the Presence Health Ministry. G. Policy Modification Presence Health management reserves the right to modify any portion of the Mandatory Policy whenever guidelines from the Centers of Disease Control (CDC), Illinois Department of Public Health (IDPH), and/or the Chicago Department of Public Health (CDPH) may advise or dictate. VII. FORMS AND OTHER DOCUMENTS Medical Exemption Form VIII. REFERENCES Presence Health Corrective Action Policy CDC-Immunization of Health Care Personnel: Recommendations of the Advisory Committee on Immunization Practices. (ACIP) MMWR, 2011:60(RR-7) Summary Healthcare Personnel Vaccination Recommendations, Item #P2017, Immunization Action Coalition, 10/09. Retrieved from

6 Section: Human Resources Page: 6 of 6 Healthcare Facilities Accreditation Program Requirements for Healthcare Facilities (HFAP) 2009, Infection Control Standard Employee Health Influenza Vaccine Advisory Committee on Immunization Practices (ACIP) updated recommendations for the Control and Elimination of Mumps, Morbidity and Mortality Weekly Report, Vol. 55, June 9, 2006 CDC (97) Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Hospital Infection Control Practices Advisory Committee (HICPAC). Morbidity and Mortality Weekly Report, Vol. 46 (RR-18) III. Admin. Code tit.77, relating to