Research article

Outcomes, Approaches, and Challenges to Developing and Passing a Countywide Mandatory Vaccination Policy: St. Louis County’s Experience with Hepatitis A Vaccine for Food Service Personnel

  • Received: 14 November 2015 Accepted: 11 March 2016 Published: 15 March 2016
  • In the early 1990s, St. Louis County had multiple foodservice worker-related hepatitis A outbreaks uncontrolled by standard outbreak interventions. Restaurant interest groups and the general public applied political pressure to local public health officials for more stringent interventions, including a mandatory vaccination policy. Local health departments can enact mandatory vaccination policies, but this has rarely been done. The study objectives were to describe the approach used to pass a mandatory vaccination policy at the local jurisdiction level and illustrate the outcome from this ordinance 15 years later. A case study design was used. In-depth, semi-structured interviews using guided questions were conducted in spring, 2015, with six key informants who had direct knowledge of the mandatory vaccination policy process. Meeting minutes and/or reports were also analyzed. A Poisson distribution analysis was used to calculate the rate of outbreaks before and after mandatory vaccination policy implementation. The policy appears to have reduced the number of hepatitis A outbreaks, lowering the morbidity and economic burden in St. Louis County. The lessons learned by local public health officials in passing a mandatory hepatitis A vaccination policy are important and relevant in today’s environment. The experience and lessons learned may assist other local health departments when faced with the potential need for mandatory policies for any vaccine preventable disease.

    Citation: Terri Rebmann, Kristin D. Wilson, Travis Loux, Ayesha Z. Iqbal, Eleanor B. Peters, Olivia Peavler. Outcomes, Approaches, and Challenges to Developing and Passing a Countywide Mandatory Vaccination Policy: St. Louis County’s Experience with Hepatitis A Vaccine for Food Service Personnel[J]. AIMS Public Health, 2016, 3(1): 116-130. doi: 10.3934/publichealth.2016.1.116

    Related Papers:

  • In the early 1990s, St. Louis County had multiple foodservice worker-related hepatitis A outbreaks uncontrolled by standard outbreak interventions. Restaurant interest groups and the general public applied political pressure to local public health officials for more stringent interventions, including a mandatory vaccination policy. Local health departments can enact mandatory vaccination policies, but this has rarely been done. The study objectives were to describe the approach used to pass a mandatory vaccination policy at the local jurisdiction level and illustrate the outcome from this ordinance 15 years later. A case study design was used. In-depth, semi-structured interviews using guided questions were conducted in spring, 2015, with six key informants who had direct knowledge of the mandatory vaccination policy process. Meeting minutes and/or reports were also analyzed. A Poisson distribution analysis was used to calculate the rate of outbreaks before and after mandatory vaccination policy implementation. The policy appears to have reduced the number of hepatitis A outbreaks, lowering the morbidity and economic burden in St. Louis County. The lessons learned by local public health officials in passing a mandatory hepatitis A vaccination policy are important and relevant in today’s environment. The experience and lessons learned may assist other local health departments when faced with the potential need for mandatory policies for any vaccine preventable disease.


    加载中
    [1] Roush SW, Murphy TV, Vaccine-Preventable Disease Table Working Group. (2007) Historical comparisons of morbidity and mortality for vaccine-preventable diseases in the United States. JAMA 298: 2155-2163. doi: 10.1001/jama.298.18.2155
    [2] Lindberg C, Lanzi M, Lindberg K. (2015) Measles: Still a significant health threat. MCN Am J Matern Child Nurs 40(5): 298-305.
    [3] Polgreen P M CY, Beekmann S E, Srinivasan A, Neill M A, Gay T, Cavanaugh J E. (2008) Elements of influenza vaccination programs that predict higher vaccination rates: Results of an emerging infections network survey. Clinical Infectious Diseases 46: 14-19. doi: 10.1086/523586
    [4] Zimmerman RK NM, Lin CJ, Raymund M, Fox DE, Harper JD, Tanis MD, Willis BC. (2009) Factorial design for improving influenza vaccination among employees of a large health system. Infect Control Hosp Epidemiol 30: 691-697. doi: 10.1086/598343
    [5] Ajenjo MC, Woeltje KF, Babcock HM, et al. (2010) Influenza vaccination among healthcare workers: ten-year experience of a large healthcare organization. Infect Control Hosp Epidemiol 31: 233-240. doi: 10.1086/650449
    [6] Centers for Disease Control & Prevention (2011) Influenza vaccination coverage among health-care personnel--United States, 2010-11 influenza season. Morbidity and Mortality Weekly Reports 60: 1073-1077.
    [7] Polgreen P M SEJ, Parry M F, Beekmann S E, Cavanaugh J E, Srinivasan A, et al. (2008) Relationship of influenza vaccination declination statements and influenza vaccination rates for healthcare workers in 22 U.S. hospitals. Infect Control Hosp Epidemiol 29: 675-677. doi: 10.1086/588590
    [8] Rebmann T, Wright KS, Anthony J, et al. (2012) Seasonal influenza vaccine compliance among hospital-based and nonhospital-based healthcare workers. Infect Control Hosp Epidemiol 33: 243-249. doi: 10.1086/664057
    [9] Rakita RM, Hagar BA, Crome P, et al. (2010) Mandatory influenza vaccination of healthcare workers: a 5-year study. Infect Control Hosp Epidemiol 31: 881-888. doi: 10.1086/656210
    [10] Ribner BS, Hall C, Steinberg JP, et al. (2008) Use of a mandatory declination form in a program for influenza vaccination of healthcare workers. Infect Control Hosp Epidemiol 29: 302-308. doi: 10.1086/529586
    [11] Cole JP, and Swendiman, K. S. (2014) Mandatory Vaccinations: Precedent and current laws. Congressional Research Service. Avaiilable at: http://www.fas.org/sgp/crs/misc/RS21414.pdf.
    [12] California state. (2015) Public health: vaccinations. Health and Safety Code. Senate Bill No. 277.
    [13] Babcock HM, Gemeinhart N, Jones M, et al. (2010) Mandatory influenza vaccination of health care workers: translating policy to practice. Clin Infect Dis 50: 459-464. doi: 10.1086/650752
    [14] McCarty KL, Nelson GD, Hodge J, Jr., et al. (2009) Major components and themes of local public health laws in select U.S. jurisdictions. Public Health Rep 124: 458-462.
    [15] Kingdon JW. (2010) Agendas, Alternatives, and Public Policies. London: Pearson.
    [16] Coffman J (2007) The Evaluation Exchange: Evaluation Based on Theories of the Policy Process. Available at: http://www.hfrp.org/evaluation/the-evaluation-exchange/issue-archive/advocacy-and-policy-change/evaluation-based-on-theories-of-the-policy-process.
    [17] St. Louis County Department of Health. (2013) Mandatory hepatitis A vaccine ordinance for food handlers and subsequent decline in case rate in St. Louis County. Available at: http://www.naccho.org/topics/modelpractices/.
    [18] U.S. Census Bureau. (2000) 2000 Census. United States Government.
    [19] Centers for Disease Control & Prevention (1999) Prevention of hepatitis A through active or passive immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 48: 1-37.
    [20] Craig AS, Watson B, Zink TK, et al. (2007) Hepatitis A outbreak activity in the United States: responding to a vaccine-preventable disease. Am J Med Sciences 334: 180-183. doi: 10.1097/MAJ.0b013e3181425411
    [21] Fiore AE. (2004) Hepatitis A transmitted by food. Clin Infect Dis 38: 705-715. doi: 10.1086/381671
    [22] Potter J, Stott DJ, Roberts MA, et al. (1997) Influenza vaccination of health care workers in long-term-care hospitals reduces the mortality of elderly patients. J Infect Dis 175: 1-6.
    [23] Centers for Disease Control & Prevention (2015) Surveillance for Viral Hepatitis – United States, 2013. Available at: http://www.cdc.gov/hepatitis/statistics/2013surveillance/commentary.htm - hepatitisA.
    [24] Bohm S, R., Berger, K. W., Hackert, P. B., et al. (2015) Hepatitis A outbreak among adults with developmental disabilities in group homes — Michigan, 2013. MMWR 64: 148-152.
    [25] Centers for Disease Control & Prevention. (2015) Pertussis epidemic-California, 2014. Ann Emerg Med 65: 568-570. doi: 10.1016/j.annemergmed.2015.02.009
    [26] Missouri Department of Health. (2014) 2014-2015 Missouri school immunization requirements. Available at: http://www.nvic.org/Vaccine-Laws/state-vaccine-requirements/missouri.aspx.
  • Reader Comments
  • © 2016 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)
通讯作者: 陈斌, bchen63@163.com
  • 1. 

    沈阳化工大学材料科学与工程学院 沈阳 110142

  1. 本站搜索
  2. 百度学术搜索
  3. 万方数据库搜索
  4. CNKI搜索

Metrics

Article views(5667) PDF downloads(1145) Cited by(1)

Article outline

Figures and Tables

Figures(2)  /  Tables(2)

/

DownLoad:  Full-Size Img  PowerPoint
Return
Return

Catalog