San Francisco Marin Medical Society Blog

SFDPH Memo: Influenza Vaccination or Masking for Health Care Workers



As in previous years, I am issuing a Health Officer order mandating that all hospitals, skilled nursing, and other long-term care facilities in the City and County of San Francisco require their health care workers (HCWs) to receive an annual influenza vaccination or, if they decline, to wear a mask in patient care areas during the influenza season. For other clinical facilities, we strongly recommend implementation of a similar policy.

Based on statewide influenza epidemiology and in accordance with the practice in many other California counties, this year we will again define the influenza season as spanning from November 1 through April 30 (11/l/2019-4/30/2020). Modifications may still be possible based on local epidemiology, but are unlikely to result in a shorter seasonal span.

As leaders in health care, I know we share common goals: to minimize the spread of communicable diseases, provide outstanding healthcare for our community, and keep our workers healthy. Influenza infection leads to millions of outpatient visits, hundreds of thousands of hospitalizations, and tens of thousands of deaths every year. HCWs are at risk for influenza illness and can transmit the virus to their patients and coworkers. Patients in our health care facilities, especially young children, pregnant women, the elderly, and those with chronic health conditions, are at greater risk for influenza-related hospitalization and death.

Vaccination of health care workers against influenza reduces infection and absenteeism, prevents patient morbidity and mortality, and results in financial savings to our communities and the health care system. Healthy People 2020 objectives target a 90 percent seasonal influenza vaccination rate for all health care personnel. Comprehensive mandatory vaccination programs that include masking for unvaccinated health care workers have been associated with health care worker vaccination rates above 95%.

State law provides that hospitals, skilled nursing facilities, long-term care facilities, and certain other health care facilities must offer influenza vaccination annually to employees, and for those employees that decline such vaccination, maintain a record of the signed declination form.5 This order enhances patient protection by requiring unvaccinated health care workers to wear a face mask in patient care areas during the influenza season.

Order

I, as the Health Officer of the City and County of San Francisco, am requiring that each and every hospital, skilled nursing, and long-term care facility in San Francisco implement a program requiring its health care workers to receive an annual influenza vaccination or, if they decline, to wear a mask for the duration of the influenza season while working in patient careareas.

Duration of Order

This order is ongoing and applies to each influenza season unless the order is rescinded. The influenza season is hereby defined as November 1 through April 30. In any given year, if influenza surveillance data demonstrate unusually early and/or late peaks, I may shift or extend the period during which the masking program shall apply for that season.

Facilities Subject to the Order

This order applies to hospitals, skilled nursing, and other long-term care facilities. For other clinical facilities, we strongly recommend implementation of a similar policy.

Definition of HCWs

For the purposes of this order, "health care workers" or "HCW" are persons, paid and unpaid, fulltime or part-time, employees or contractors, working in the licensed health care facility, who have direct patient contact or who work in patient care areas.

I appreciate your help and support in protecting the residents of the City and County of San Francisco. For any additional questions, please contact the SFDPH Immunization Program at 415- 554-2955.

cc: Grant Colfax, MD, Director of Health Anne Pearson, Deputy City Attorney

To read original Health Alert, please click on the following link:

SFDPH Memo: Mandatory Flu Vaccination or Masking of Health Care Workers


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