• The declination form program was compatible, flexible, easy to use, and supported by leadership.
• Declination form program facilitators included complementary ongoing strategies and leadership engagement.
• One-on-one attention and education at the time of vaccination led to health care worker accountability.
• An influenza declination form program is of minimal cost, but it requires some dedicated staff and resources.
• Vaccination rate improved from 53.5% to 77.4% pre- to postdeclination form program implementation.
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Funding/Support: This work was supported by the Department of Veterans Affairs, Office of Research and Development , Health Services Research and Development Service , Quality Enhancement Research Initiative (QUERI) Rapid Response Project (no. 12-515).
Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.
Conflicts of interest: None to report.