Major Article| Volume 50, ISSUE 4, P369-374, April 2022

Influenza vaccination of home health care staff and the impact on patient hospitalizations


      • Older adults are at high risk for influenza and are more likely to develop serious complications.
      • Influenza vaccination of healthcare workers can help protect older patients from acute respiratory disease.
      • Influenza vaccination among home health care workers are suboptimal.
      • Home health care agencies with influenza vaccination requirements had higher influenza vaccination rates.
      • Home health care agency's influenza vaccination policies are associated with reduced respiratory infection-related hospitalization among older patients.



      Influenza is associated with significant morbidity and mortality for adults aged 65 years and older. Influenza vaccination of health care workers is recommended. There is limited evidence regarding influenza vaccinations among health care workers in the home health care (HHC) setting and their impact on HHC patient outcomes.


      A national survey of HHC agencies was conducted in 2018-2019 and linked with patient data from the Centers for Medicare and Medicaid Services. Adjusted logistic regression models were used to estimate the association between hospital transfers due to respiratory infection during a 60 day HHC episode and staff vaccination policies.


      Only 26.2% of HHC agencies had staff vaccination requirements and 71.2% agencies had staff vaccination rates higher than 75%. Agency policies for staff influenza vaccination were associated with reduced hospital transfers due to respiratory infection among HHC patients.


      Influenza vaccination rates among HHC staff were low during the 2017-2018 influenza season. Policymakers may consider vaccination mandates to improve health care worker vaccination rates and protect patient safety.


      This study sheds light on the potential impact of COVID-19 vaccination among HHC workers on patient outcomes. COVID-19 vaccination mandates could prove to be a vital tool in the fight against COVID-19 variants and infection outbreaks.

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