title: Association of increased influenza vaccination in health care workers with a reduction in nosocomial influenza infections in cancer patients.
abstract: Vaccination of health care workers (HCWs) remains a key strategy to reduce the burden of influenza infections in cancer patients.
  
  
  
  In this 8-year study, we evaluated the effect of a multifaceted approach, including a mandatory influenza vaccination program, on HCW vaccination rates and its effect on nosocomial influenza infections in cancer patients.
  
  
  
  The influenza vaccination rate of all employees significantly increased from 56% (8,762/15,693) in 2006-2007 to 94% (17,927/19,114) in 2013-2014 (P < .0001). The 2009 mandatory participation program increased HCW vaccination rates in the targeted groups (P < .0001), and the addition of an institutional policy in 2012 requiring influenza vaccination or surgical mask use with each patient contact further increased vaccination rates by 10%-18% for all groups in 1 year. The proportion of nosocomial influenza infections significantly decreased (P = .045) during the study period and was significantly associated with increased HCW vaccination rates in the nursing staff (P = .043) and in personnel working in high-risk areas (P = .0497).
  
  
  
  Multifaceted influenza vaccination programs supported by institutional policy effectively increased HCW vaccination rates. Increased HCW vaccination rates were associated with a reduction in the proportion of nosocomial influenza infections in immunocompromised cancer patients.
authors.affiliation: Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address: efrenzel@mdanderson.org.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Frenzel
authors.affiliation: Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Roy F
authors.initials: RF
authors.lastname: Chemaly
authors.affiliation: Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Ella
authors.initials: E
authors.lastname: Ariza-Heredia
authors.affiliation: Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Ying
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Dimpy P
authors.initials: DP
authors.lastname: Shah
authors.affiliation: Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Georgia
authors.initials: G
authors.lastname: Thomas
authors.affiliation: Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Linda
authors.initials: L
authors.lastname: Graviss
authors.affiliation: Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Issam
authors.initials: I
authors.lastname: Raad
mesh_terms: D003428:Cross Infection / Q000517:prevention & control*; D006282:Health Personnel; D006801:Humans; D017053:Infection Control / Q000379:methods; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D009369:Neoplasms / Q000150:complications*; D016134:Organizational Policy; D015995:Prevalence; D014611:Vaccination
chemical_list: D007252:Influenza Vaccines
keywords: Influenza; cancer; health care workers; nosocomial infection; vaccination