Influenza Vaccination Policy

NORTH KANSAS CITY HOSPITAL

Purpose To prevent the acquiring and transmission of the Influenza virus. According to the Centers for Disease Control and Prevention (CDC), vaccination is considered the single most important influenza control measure to reduce the chances that you will get the seasonal flu and lessen the chance that you will spread it to others. When more people get vaccinated against the flu, less flu can spread through the community.

Audience All employees, medical staff members, allied health personnel, ancillary personnel, contract/agency personnel, residents, medical students and other students, job shadows, vendors with patient contact and volunteers.

Policy As a condition of employment and/or affiliation, North Kansas City Hospital requires annual influenza vaccination for individuals that have job duties and/or physical presence inside any North Kansas City Hospital owned and/or leased facilities or properties. North Kansas City Hospital will offer the flu vaccination free of charge.

Procedure Step Action

1 The flu vaccine is administered by Employee Health each year when the vaccine becomes available. Notification of vaccine availability will be via hospital email and other notifications. 2 The vaccination start date for each year and the deadline by which individuals are required to have received the vaccination each year (the "Vaccination Deadline") will be set annually at the recommendation of the Infection Control Committee Chairperson. An authorization/consent form is signed prior to the administration of the vaccine. Managers will be notified yearly of the percentage rate of flu vaccine recipients within their departments to share with employees as an educational tool. Facility vaccination rates will be calculated and reported as required using the National Quality Forum (NQF) #0431: Influenza Vaccination Coverage Among Healthcare Personnel. 3 Individuals new to NKCH after March 31 of each year will be notified of the policy and will be expected to comply with the vaccination requirement for the next influenza season. Individuals new to NKCH during the flu season will be expected to comply with the vaccination requirement immediately.

4 1. Individuals may request a medical accommodation to be Medical exempt from the flu vaccine requirement if they have a medical contraindication that is: a) listed in the vaccine manufacturer's Accommo prescribing information; orb) listed by the Centers for Disease dations Control and Prevention (CDC).

2. Individuals requesting a medical accommodation must complete a Request for Accommodation form, signed by the individual's personal, treating physician. Request for Accommodation forms signed by an emergency medicine physician or a hospitalist will not be accepted unless documentation proves treatment by that physician. Request for Accommodation forms signed by chiropractors will not be accepted. Request for Accommodation forms must be completed and turned into the Employee Health Department by the date that is fourteen (14) days prior to the

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Procedure Step Action Vaccination Deadline.

3. If additional information regarding a medical accommodation request is necessary, the individual will be notified and will have fourteen (14) days from the date of the notification to submit to the Employee Health Department any additional information that the individual wishes to be considered in the evaluation of the request. An individual may be required to sign a release of information authorization form to be sent by the Employee Health Department to the individual's physician, requesting records and/or requesting the physician to contact the Infection Control Committee Chairperson to discuss the request for an accommodation. If the individual's physician does not provide the requested records or contact the Infection Control Committee Chairperson prior to the Vaccination Deadline, the request for accommodation may be denied.

4. All requests for accommodation due to medical contraindications will be subject to approval by the Infection Control Committee Chairperson.

5. If a request for an accommodation is not received by the Employee Health Department by the date that is fourteen (14) days prior to the Vaccination Deadline it will not be accepted and the individual will be expected to complete the vaccination before the Vaccination Deadline or face disciplinary action. (See policy, Mandatory Educational/Safety Requirements).

6. If the request for accommodation is denied, the individual will be expected to complete the vaccination before the Vaccination Deadline or face disciplinary action. (See policy, Mandatory Educational/Safety Requirements). 7. Individuals approved for accommodation for medical reasons will be required to wear a mask, during flu season, while inside any owned and/or leased facilities or properties in any patient care areas. If the individual does not work in a patient care area but is exhibiting symptoms that may be related to the flu, the individual will be required to wear a mask until he or she is symptom free for at least twenty four (24) hours. Individuals approved for accommodation must obtain a new identification badge from the Human Resources Department with a border color variation that will signify that the mask requirement applies to that individual. The mask requirement is also mandatory and will be enforced by the department manager.

5 1. Individuals may request a religious accommodation to be Religious exempt from the flu vaccine requirement if they have a sincerely held, bona fide religious belief that does not permit the individual Accommo to receive the influenza vaccine. Requests for accommodation dations will not be granted based on secular philosophical, political, scientific or sociological objections to the influenza vaccine.

2. Individuals requesting a religious accommodation must

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Procedure Step Action complete a Request for Accommodation form, and must submit documentation from the individual's religious leader (or other individual who can attest to the individual's religious belief) outlining the specific and current religious objection to the influenza vaccine. Request for Accommodation forms must be completed and turned into the Employee Health Department by the date that is fourteen (14) days prior to the Vaccination Deadline.

3. If additional information regarding a religious accommodation request is necessary, the individual will be notified and will have fourteen (14) days from the date of the notification to submit to the Employee Health Department any additional information that the individual wishes to be considered in the evaluation of the request. Additionally, individuals may be required to discuss, or their identified religious leader may be required to discuss, the request for accommodation with a NKCH Chaplain or other designated faith-based support service. If the individual or the individual's religious leader does not discuss the matter with the NKCH Chaplain or designee prior to the Vaccination Deadline, the request for accommodation may be denied.

4. All requests for accommodation due to religious reasons will be subject to approval by a committee consisting of the Infection Control Committee Chairperson, a NKCH Chaplain, a representative from the Human Resources Department, and a representative from the Employee Health Department.

7. Individuals approved for accommodation for religious reasons will be required to wear a mask, during flu season, while inside any owned and/or leased facilities or properties in any patient care areas. If the individual does not work in a patient care area but is exhibiting symptoms that may be related to the flu , the individual will be required to wear a mask until he or she is symptom free for at least twenty four (24) hours. Individuals approved for accommodation must obtain a new identification badge from the Human Resources Department with a border color variation that will signify that the mask requirement applies to that individual. The mask requirement is also mandatory and will be enforced by the department manager.

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Procedure Step Action Received at 6 Individuals who receive the influenza vaccination other than at NKCH other facilities will be required to submit proof of vaccination documentation to the Employee Health Department by the Vaccination Deadline. 7 Employees who do not comply with this policy by the Vaccination Deadline will be subject to disciplinary action up to and including termination. (See policy, Mandatory Educational/Safety Requirements). Non-employees who do not comply with this policy will be separated from affiliation with NKCH or the non-compliance will be referred to the appropriate medical staff committee for action.

References: MMWR, Immunization of Healthcare Personnel - Recommendations of the Advisory Committee on Immunization Practices (ACIP), November 25, 2011 , Volume 60, No. 7. Association of Professionals in Infection Control and Epidemiology (APIC) Position Paper: Influenza Immunization of Healthcare Personnel, 2008. Association of Professionals in Infection Control and Epidemiology (APIC) Position Paper: Influenza Vaccination Should Be A Condition Of Employment for Healthcare Personnel Unless Medically Contraindicated, 2011 .

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