Influenza vaccination medical waivers among healthcare workers at an academic health system

According to the Advisory Committee on Immunization Practices (ACIP), the only absolute medical contraindication to the influenza vaccine is a personal history of severe allergic reaction to any influenza vaccine components or the vaccine itself.2 For the 2019–2020 influenza season, Employee Health Services (EHS) staff reviewed all medical waivers pertaining to the influenza vaccine, implemented ACIP-compliant standards for approval of new medical waivers, and provided HCP specific education pertaining to vaccine safety. A greater proportion of employees with previous severe allergic reactions to egg products submitted personal waivers in 2019–2020 compared to both those with common side effects from the influenza vaccine (eg, flu-like symptoms, injection site reaction or shoulder injury related to vaccine administration; odds ratio [OR], 1.14; 95% confidence interval [CI], 0.34–3.87) as well as employees with reactions not commonly associated with the vaccine (eg, Guillain-Barré syndrome, exacerbation of an inflammatory condition, or other; OR, 1.62; 95% CI, 0.51–5.12). Characteristics of Employees With and Without a Medical Waiver for the 2018–2019 and 2019–2020 Flu Seasons Characteristic Employees With a Medical Waiver in 2018–2019, No. (%) Tracked UW Health Employees in 2018–2019, No. (%) Employees With a Medical Waiver in 2019–2020, No. (%) Tracked UW Health Employees in 2019–2020, No. (%) Total no. 131 15,135 33 15,541 Age, average y ± SD 48.5 ± 10.5 41.4 ± 12.4 48.6 ± 11.4 40.8 ± 12.3 Male gender 13 (10.0) 3,925 (25.9) 5 (15.2) 3,955 (25.4) Work area Hospital 56 (42.7) 9016 (59.6) 18 (54.5) 9156 (58.9) Clinic 46 (35.1) 3529 (23.3) 10 (30.3) 3693 (23.8) Administrative 28 (21.4) 2564 (16.9) 5 (15.2) 2692 (17.3) Works from home 1 (0.8) 26 (0.2) 0 (0) 0 (0)a 2019 outcomes Reason for waiver submission Received vaccine Medical Waiver Personal Waiver Terminated All reasons (N=131) 19 (14.5) 31 (23.7) 67 (51.1) 14 (10.7) History of severe allergic reaction to the influenza vaccine (N=35) 2 (5.7) 26 (74.3) 3 (8.6) 4 (11.4) History of severe allergic reaction to egg (N=22) 3 (13.6) 1 (4.6)b 16 (72.7) 2 (9.1) History of GBS within 6 weeks of receiving the influenza vaccine (N=12) 1 (8.3) 2 (16.7)c 5 (41.7) 4 (33.3) Flu-like symptoms following the influenza vaccine (N=19) 4 (21.1) 1 (5.3)c 14 (73.7) 0 (0) Injection site reaction or SIRVA (N=11) 3 (27.3) 0 (0) 7 (63.6) 1 (9.1) Exacerbation of an inflammatory condition, (N=10) 2 (20.0) 1 (10.0)c 6 (60.0) 1 (10.0)