Healthcare Worker Immunization Toolkit

This toolkit is designed to help healthcare organizations promote influenza and Tdap (tetanus, diphtheria, pertussis) immunization for their employees.  It was developed with the belief that it is the professional and ethical responsibility of healthcare workers to prevent the spread of infectious pathogens to the populations they serve by receiving recommended immunizations.  When you are ready to start working on your immunization campaign, you will find tools here to help you do so.

“Since we began offering no cost flu vaccinations to all our employees, there has been an increase in the number of staff members who have chosen to be vaccinated and the number of staff sick days has decreased. I strongly recommend offering no cost influenza vaccines to your healthcare employees.”

—Connie, RN, nursing supervisor at Northwest Pediatrics Center in Centralia and Chehalis

Arrow Arrow Make The Case

Many trusted national organizations have spoken out in support of immunizing healthcare workers, and research shows that it is both cost-effective and health-protective. Fully-vaccinated healthcare workers serve as key players in stopping the spread of vaccine-preventable diseases and also protect themselves from unnecessary illness.

Statements and Position Papers

American Academy of Pediatrics Policy Statement: Recommendation for Mandatory Influenza Immunization of All Healthcare Personnel
American Hospital Association: AHA Supports Mandatory Influenza Vaccination
Association for Professionals in Infection Control (APIC) Position Paper: Influenza Vaccination Should be a Condition of Employment for Healthcare Personnel, Unless Medically Contraindicated
Infectious Diseases Society of America (IDSA) Policy on Mandatory Immunization of Healthcare Workers Against Seasonal and Pandemic Influenza
National Foundation for Infectious Diseases Call to Action: Influenza Immunization Among Healthcare Personnel
Society for Healthcare Epidemiology of America (SHEA) Revised Position Paper: Influenza Vaccination of Healthcare Personnel

Immunization Action Coalition: First Do No Harm: Mandatory Influenza Vaccination Policies for Healthcare Personnel Help Protect Patients


Healthcare providers as sources of vaccine-preventable diseases
Influenza Vaccination Coverage Among Health-Care Personnel
Predicting influenza vaccination uptake among healthcare workers: What are the key motivators?
Requiring Influenza Vaccination for Healthcare Workers: Seven Truths We Must Accept
Two nosocomial pertussis outbreaks and their associated costs—King County, Washington, 2004
Use of models to identify cost-effective interventions: pertussis vaccination for pediatric healthcare workers
Vaccinating Healthcare Workers Against Influenza to Protect the Vulnerable—Is it a Good Use of Healthcare Resources?

Success Stories

Employee Influenza Program: Brigham & Women’s Hospital, Boston, MA
Influenza Vaccination Honor Roll
Virginia Mason Story: Mandatory Influenza Vaccination

Arrow Arrow Plan Your Program

These resources will help you identify the steps you need to take to raise employee immunization rates in your facility. Below, you will find planning calendars, checklists, and sample immunization policies.

Influenza-Specific Tools

NFID—Improving Influenza Vaccination Rates in Healthcare Workers: Strategies to Increase Protection for Workers & Patients—includes rationale, selected strategies

General Tools

APIC—Protect Yourself, Protect Your Patients Toolkit—includes checklist, sample newsletter and email content, and sample declination form
The Joint Commission: Tdap Vaccination Strategies for Adolescents and Adults, Including Healthcare Personnel—includes information about Tdap among health care workers and strategies for implementing a Tdap immunization program, including research and examples
Planning Calendar—Employee Influenza Immunization Campaigns

CDC Guidance for Planning Vaccination Clinics Held at Satellite, Temporary, or Off-Site Locations

Sample Policies

Sample Hospital Immunization Policy
Sample Immunization Policy A
Sample Influenza Policy
Sample Masking Requirement Policy
Sample Masking Requirement Statement

Arrow Arrow Immunization Recommendations

The CDC recommends that healthcare workers provide proven immunity to the following diseases: Tetanus, Diphtheria and Pertussis (Tdap vaccine); Measles, Mumps and Rubella (MMR vaccine); Hepatitis B; Varicella (chicken pox); and the seasonal Influenza vaccine. The recommendations apply to all staff in medical and dental offices, long term care facilities and daycare centers, regardless of whether they have direct client contact. It also applies to all students, volunteers, and contract workers working in these settings. However, many healthcare workers do not know their immunity status. The following resources explain and summarize recommendations from the CDC and ACIP (the Advisory Committee on Immunization Practices).

CDC Recommended Adult Immunization Schedule
CDC Recommendations for use of Tdap Among Health-Care Personnel
CDC Recommendations on Influenza Immunization of Health-Care Personnel
CDC Recommendations on Immunization of Health-Care Personnel
Recommendations from the National Vaccine Advisory Committee: Standards for Adult Immunization Practice
Summary of Healthcare Personnel Vaccination Recommendations

You can access your immunization records online at

Arrow Arrow Promote Your Campaign

Encourage participation in your immunization campaign with posters, brochures, and other promotional materials found below. Many organizations have found it helpful to offer incentives to employees who receive recommended immunizations, such as gift cards or free snacks or beverages. Some foster friendly competition between teams or departments by offering prizes for those with the highest immunization rates or to those who meet specific goals.

Posters and Flyers

CDC Flu Vaccine Poster
CDC Immunization Poster for Healthcare Workers

Employee Letters and Emails

Sample Email from Leadership
Sample Flu Clinic Email
Sample Letter Introducing Policy
Sample Letter for New Staff

Employee Newsletter Articles

Sample Flu Clinic Newsletter
Sample Flu Season Newsletter

Arrow Arrow Provide Vaccine

To increase the success of your campaign, vaccine should be available free of charge to employees during their regular work hours. If your organization is unable to provide vaccine on-site, consider allowing employees to get vaccinated off-site during their work hours rather than their personal time. The more convenient, affordable, and accessible vaccination is, the more successful your campaign will be.

If your organization is not equipped to provide vaccine to your employees, here is a list of providers who can do a mobile immunization clinic at your workplace.

The Joint Commission’s report “Tdap Vaccination Strategies for Adolescents and Adults, Including Healthcare Personnel” recommends the following strategies for providing vaccine to healthcare workers:

  • Provide vaccine free of charge.
  • Offer vaccinations at multiple times and locations (including weekends) so that staff on all shifts have access.
  • Promote “vaccine days” when vaccine is offered to all staff.
  • Use mobile carts to make vaccinations convenient to all units and departments.
  • Offer incentives to employees or teams who are vaccinated such as raffle prizes, buttons, pens, notepads, coupons for coffee or snacks, or gift certificates.
  • Link vaccination to a required activity such as an annual TB test or mandatory safety training.
  • If your facility does not have capacity to provide vaccine, reach out to your insurance carriers and local pharmacies.

Arrow Arrow Measure Success

It’s important to track the number of employees who receive the Tdap vaccine and the yearly influenza vaccine in order to measure the success of your campaign and be able to quickly identify unvaccinated employees during an outbreak. Employees who refuse immunization could be asked to sign a declination or exemption form. You may also find your organization’s electronic medical record system helpful for tracking employee immunizations.

Declination of Influenza Vaccination Form
Sample Employee Immunization Exemption Form
Sample Employee Immunization Tracking Spreadsheet

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