title: Implementation of mandatory immunisation of healthcare workers: observations from New South Wales, Australia.
abstract: OBJECTIVE
  To identify factors influencing implementation of a state-wide mandatory immunisation policy for healthcare workers (HCWs) in New South Wales (NSW), Australia, in 2007. Vaccines included were measles, mumps, rubella, varicella, hepatitis B, diphtheria, tetanus and pertussis, but not influenza.
  
  
  METHODS
  We evaluated the first 2 years of this policy directive in 2009. A qualitative study was conducted among 4 stakeholder groups (the central health department, hospitals, health professional associations, and universities). 58 participants were identified using maximum variation sampling and data were analysed using a hierarchical thematic framework. Quantitative data on policy compliance were reviewed at the regional level.
  
  
  RESULTS
  Success in policy implementation was associated with effective communication, including support of clinical leaders, provision of free vaccine, access to occupational health services which included immunisation, and appropriate data collection and reporting systems. Achieving high vaccine uptake was more challenging with existing employees and with smaller institutions.
  
  
  CONCLUSIONS
  These findings may apply to other jurisdictions in Australia or internationally considering mandatory approaches to HCW vaccination.
authors.affiliation: University of Sydney, Australia. charles-helms@uiowa.edu
authors.forename: Charles
authors.initials: C
authors.lastname: Helms
authors.forename: Julie
authors.initials: J
authors.lastname: Leask
authors.forename: Spring Cooper
authors.initials: SC
authors.lastname: Robbins
authors.forename: Maria Yui Kwan
authors.initials: MY
authors.lastname: Chow
authors.forename: Peter
authors.initials: P
authors.lastname: McIntyre
mesh_terms: D001428:Bacterial Vaccines / Q000008:administration & dosage; D003142:Communication; D019983:Guideline Adherence; D006282:Health Personnel; D006284:Health Plan Implementation; D006291:Health Policy; D006297:Health Services Accessibility; D006779:Hospitals, Public; D006801:Humans; D007407:Interviews as Topic; D037141:Mandatory Programs / Q000592:standards*; D009517:New South Wales; D014495:Universities; D014611:Vaccination / Q000592:standards*; D014765:Viral Vaccines / Q000008:administration & dosage
chemical_list: D001428:Bacterial Vaccines; D014765:Viral Vaccines