Measuring the impact of a mandatory province-wide vaccinate-or-mask policy on healthcare worker absenteeism in British Columbia, Canada

Michelle Murti, Michael Otterstatter, Alison Orth, Robert Balshaw, Khalif Halani, Paul D. Brown, Samar Hejazi, Darby Thompson, Sandra Allison, Aamir Bharmal, Meena Dawar, Dee Hoyano, Victoria Lee, Monika Naus, Sue Pollock, John Bevanda, Sandy Coughlin, John Fitzgerald, Dave Keen, Melanie MaracleStacy Sprague, Bonnie Henry

Research output: Contribution to journalArticle

Abstract

Objectives: Vaccinate-or-mask (VOM) policies aim to improve influenza vaccine coverage among healthcare workers (HCW) and reduce influenza-related illness among patients and staff. In 2012, British Columbia (BC) implemented a province-wide VOM influenza prevention policy. This study describes an evaluation of policy impacts on HCW absenteeism rates from before to after policy implementation. Methods: Using payroll data from regional and provincial Health Authorities (HA), we assessed all-cause sick rates (sick time as a proportion of sick time and productive time) before (2007–2011, excluding 2009–2010) and after (2012–2017) policy implementation, and during influenza season (December 1–March 31) and non-influenza season (April 1–November 30). We used a two-part negative binomial hurdle model to calculate odds ratios (OR) of taking any sick time, relative rates (RR) of sick time taken, and predicted mean sick rates, adjusting for age group, sex, job type, job classification, HA, year and vaccine effectiveness. Results: During influenza season, HCWs in the post-policy period were less likely to take any sick time (OR 0.989, 95%CI: 0.979–0.999) but had higher rates of sick time (RR 1.038, 95%CI: 1.030–1.045). However, during non-influenza season, HCWs in the post-policy period were more likely to take any sick time (OR 1.015, 95%CI: 1.008–1.022) but had lower rates of sick time (RR 0.971, 95%CI: 0.966–0.976). There was an overall increase in predicted mean sick rate from pre to post-policy in influenza season (4.392% to 4.508%) and non-influenza season (3.815% to 3.901%). Conclusions: The observed year-round increase in sick rates from pre-to-post policy was likely influenced by other factors; however, opposite trends in how HCWs took sick time in the influenza and non-influenza seasons may reflect policy influences and need further research to explore reasons for these differences.

Original languageEnglish (US)
JournalVaccine
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

Fingerprint

Absenteeism
British Columbia
health care workers
Masks
Canada
influenza
Delivery of Health Care
Human Influenza
odds ratio
Odds Ratio
vaccines
policy analysis
Influenza Vaccines
Health
Statistical Models
Vaccines
Age Groups
gender

Keywords

  • Absenteeism
  • Healthcare worker
  • Influenza vaccines
  • Organizational policy
  • Public health

ASJC Scopus subject areas

  • Molecular Medicine
  • Immunology and Microbiology(all)
  • veterinary(all)
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Measuring the impact of a mandatory province-wide vaccinate-or-mask policy on healthcare worker absenteeism in British Columbia, Canada. / Murti, Michelle; Otterstatter, Michael; Orth, Alison; Balshaw, Robert; Halani, Khalif; Brown, Paul D.; Hejazi, Samar; Thompson, Darby; Allison, Sandra; Bharmal, Aamir; Dawar, Meena; Hoyano, Dee; Lee, Victoria; Naus, Monika; Pollock, Sue; Bevanda, John; Coughlin, Sandy; Fitzgerald, John; Keen, Dave; Maracle, Melanie; Sprague, Stacy; Henry, Bonnie.

In: Vaccine, 01.01.2019.

Research output: Contribution to journalArticle

Murti, M, Otterstatter, M, Orth, A, Balshaw, R, Halani, K, Brown, PD, Hejazi, S, Thompson, D, Allison, S, Bharmal, A, Dawar, M, Hoyano, D, Lee, V, Naus, M, Pollock, S, Bevanda, J, Coughlin, S, Fitzgerald, J, Keen, D, Maracle, M, Sprague, S & Henry, B 2019, 'Measuring the impact of a mandatory province-wide vaccinate-or-mask policy on healthcare worker absenteeism in British Columbia, Canada', Vaccine. https://doi.org/10.1016/j.vaccine.2019.06.007
Murti, Michelle ; Otterstatter, Michael ; Orth, Alison ; Balshaw, Robert ; Halani, Khalif ; Brown, Paul D. ; Hejazi, Samar ; Thompson, Darby ; Allison, Sandra ; Bharmal, Aamir ; Dawar, Meena ; Hoyano, Dee ; Lee, Victoria ; Naus, Monika ; Pollock, Sue ; Bevanda, John ; Coughlin, Sandy ; Fitzgerald, John ; Keen, Dave ; Maracle, Melanie ; Sprague, Stacy ; Henry, Bonnie. / Measuring the impact of a mandatory province-wide vaccinate-or-mask policy on healthcare worker absenteeism in British Columbia, Canada. In: Vaccine. 2019.
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title = "Measuring the impact of a mandatory province-wide vaccinate-or-mask policy on healthcare worker absenteeism in British Columbia, Canada",
abstract = "Objectives: Vaccinate-or-mask (VOM) policies aim to improve influenza vaccine coverage among healthcare workers (HCW) and reduce influenza-related illness among patients and staff. In 2012, British Columbia (BC) implemented a province-wide VOM influenza prevention policy. This study describes an evaluation of policy impacts on HCW absenteeism rates from before to after policy implementation. Methods: Using payroll data from regional and provincial Health Authorities (HA), we assessed all-cause sick rates (sick time as a proportion of sick time and productive time) before (2007–2011, excluding 2009–2010) and after (2012–2017) policy implementation, and during influenza season (December 1–March 31) and non-influenza season (April 1–November 30). We used a two-part negative binomial hurdle model to calculate odds ratios (OR) of taking any sick time, relative rates (RR) of sick time taken, and predicted mean sick rates, adjusting for age group, sex, job type, job classification, HA, year and vaccine effectiveness. Results: During influenza season, HCWs in the post-policy period were less likely to take any sick time (OR 0.989, 95{\%}CI: 0.979–0.999) but had higher rates of sick time (RR 1.038, 95{\%}CI: 1.030–1.045). However, during non-influenza season, HCWs in the post-policy period were more likely to take any sick time (OR 1.015, 95{\%}CI: 1.008–1.022) but had lower rates of sick time (RR 0.971, 95{\%}CI: 0.966–0.976). There was an overall increase in predicted mean sick rate from pre to post-policy in influenza season (4.392{\%} to 4.508{\%}) and non-influenza season (3.815{\%} to 3.901{\%}). Conclusions: The observed year-round increase in sick rates from pre-to-post policy was likely influenced by other factors; however, opposite trends in how HCWs took sick time in the influenza and non-influenza seasons may reflect policy influences and need further research to explore reasons for these differences.",
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T1 - Measuring the impact of a mandatory province-wide vaccinate-or-mask policy on healthcare worker absenteeism in British Columbia, Canada

AU - Murti, Michelle

AU - Otterstatter, Michael

AU - Orth, Alison

AU - Balshaw, Robert

AU - Halani, Khalif

AU - Brown, Paul D.

AU - Hejazi, Samar

AU - Thompson, Darby

AU - Allison, Sandra

AU - Bharmal, Aamir

AU - Dawar, Meena

AU - Hoyano, Dee

AU - Lee, Victoria

AU - Naus, Monika

AU - Pollock, Sue

AU - Bevanda, John

AU - Coughlin, Sandy

AU - Fitzgerald, John

AU - Keen, Dave

AU - Maracle, Melanie

AU - Sprague, Stacy

AU - Henry, Bonnie

PY - 2019/1/1

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N2 - Objectives: Vaccinate-or-mask (VOM) policies aim to improve influenza vaccine coverage among healthcare workers (HCW) and reduce influenza-related illness among patients and staff. In 2012, British Columbia (BC) implemented a province-wide VOM influenza prevention policy. This study describes an evaluation of policy impacts on HCW absenteeism rates from before to after policy implementation. Methods: Using payroll data from regional and provincial Health Authorities (HA), we assessed all-cause sick rates (sick time as a proportion of sick time and productive time) before (2007–2011, excluding 2009–2010) and after (2012–2017) policy implementation, and during influenza season (December 1–March 31) and non-influenza season (April 1–November 30). We used a two-part negative binomial hurdle model to calculate odds ratios (OR) of taking any sick time, relative rates (RR) of sick time taken, and predicted mean sick rates, adjusting for age group, sex, job type, job classification, HA, year and vaccine effectiveness. Results: During influenza season, HCWs in the post-policy period were less likely to take any sick time (OR 0.989, 95%CI: 0.979–0.999) but had higher rates of sick time (RR 1.038, 95%CI: 1.030–1.045). However, during non-influenza season, HCWs in the post-policy period were more likely to take any sick time (OR 1.015, 95%CI: 1.008–1.022) but had lower rates of sick time (RR 0.971, 95%CI: 0.966–0.976). There was an overall increase in predicted mean sick rate from pre to post-policy in influenza season (4.392% to 4.508%) and non-influenza season (3.815% to 3.901%). Conclusions: The observed year-round increase in sick rates from pre-to-post policy was likely influenced by other factors; however, opposite trends in how HCWs took sick time in the influenza and non-influenza seasons may reflect policy influences and need further research to explore reasons for these differences.

AB - Objectives: Vaccinate-or-mask (VOM) policies aim to improve influenza vaccine coverage among healthcare workers (HCW) and reduce influenza-related illness among patients and staff. In 2012, British Columbia (BC) implemented a province-wide VOM influenza prevention policy. This study describes an evaluation of policy impacts on HCW absenteeism rates from before to after policy implementation. Methods: Using payroll data from regional and provincial Health Authorities (HA), we assessed all-cause sick rates (sick time as a proportion of sick time and productive time) before (2007–2011, excluding 2009–2010) and after (2012–2017) policy implementation, and during influenza season (December 1–March 31) and non-influenza season (April 1–November 30). We used a two-part negative binomial hurdle model to calculate odds ratios (OR) of taking any sick time, relative rates (RR) of sick time taken, and predicted mean sick rates, adjusting for age group, sex, job type, job classification, HA, year and vaccine effectiveness. Results: During influenza season, HCWs in the post-policy period were less likely to take any sick time (OR 0.989, 95%CI: 0.979–0.999) but had higher rates of sick time (RR 1.038, 95%CI: 1.030–1.045). However, during non-influenza season, HCWs in the post-policy period were more likely to take any sick time (OR 1.015, 95%CI: 1.008–1.022) but had lower rates of sick time (RR 0.971, 95%CI: 0.966–0.976). There was an overall increase in predicted mean sick rate from pre to post-policy in influenza season (4.392% to 4.508%) and non-influenza season (3.815% to 3.901%). Conclusions: The observed year-round increase in sick rates from pre-to-post policy was likely influenced by other factors; however, opposite trends in how HCWs took sick time in the influenza and non-influenza seasons may reflect policy influences and need further research to explore reasons for these differences.

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KW - Organizational policy

KW - Public health

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