Carrots and Sticks: Achieving High Healthcare Personnel Influenza Vaccination Rates without a Mandate

2015 ◽  
Vol 36 (6) ◽  
pp. 717-724 ◽  
Author(s):  
Marci Drees ◽  
Kathleen Wroten ◽  
Mary Smedley ◽  
Tabe Mase ◽  
J. Sanford Schwartz
Keyword(s):  
Influenza Vaccination ◽  
Financial Incentives ◽  
Vaccination Campaign ◽  
Peer Pressure ◽  
Vaccination Rate ◽  
Healthcare Personnel ◽  
Quality Improvement Initiative ◽  
Vice Presidents ◽  
Healthcare Organizations ◽  
Vaccination Rates

OBJECTIVEAchieving high healthcare personnel (HCP) influenza vaccination rates has typically required mandating vaccination, which is often challenging to implement. Our objective was to achieve >90% employee influenza vaccination without a mandate.DESIGNProspective quality improvement initiativeSETTING AND PARTICIPANTSAll employees of a 2-hospital, 1,100-bed, community-based academic healthcare system.METHODSThe multimodal HCP vaccination campaign consisted of a mandatory declination policy, mask-wearing for non-vaccinated HCP, highly visible “I’m vaccinated” hanging badges, improved vaccination tracking, weekly compliance reports to managers and vice presidents, disciplinary measures for noncompliant HCP, vaccination stations at facility entrances, and inclusion of a target employee vaccination rate (>75%) metric in the annual employee bonus program. The campaign was implemented in the 2011–2012 influenza season and continued throughout the 2012–2013 through 2014–2015 influenza seasons. Employee compliance, vaccination, exemption and declination rates were calculated and compared with those of the seasons prior to the intervention.RESULTSCompared with vaccination rates of 57%–72% in the 3 years preceding the intervention, employee influenza vaccination increased to 92% in year 1 and 93% in years 2–4 (P<.001). The proportion of employees declaring medical/religious exemptions or declining vaccination decreased during the 4 years of the program (respectively, 1.2% to 0.5%,P<.001; 4.4% to 3.8%,P=.001).CONCLUSIONSAn integrated multimodal approach incorporating peer pressure, accountability, and financial incentives was associated with increased employee vaccination rate from ≤72% to ≥92%, which has been sustained for 4 influenza seasons. Such programs may provide a model for behavioral change within healthcare organizations.Infect Control Hosp Epidemiol2015;00(0): 1–8

Correlates of Improved Influenza Vaccination of Healthcare Personnel: A Survey of Hospitals in Louisiana

2013 ◽  
Vol 34 (7) ◽  
pp. 723-729 ◽  
Author(s):  
Kayla L. Fricke ◽  
Mariella M. Gastañaduy ◽  
Renee Klos ◽  
Rodolfo E. Bégué
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Influenza Vaccination ◽  
Vaccination Campaign ◽  
Vaccination Rate ◽  
Healthcare Personnel ◽  
Patient Contact ◽  
Hospital Type ◽  
Vaccination Rates ◽  
Item Questionnaire

Objective.To describe practices for influenza vaccination of healthcare personnel (HCP) with emphasis on correlates of increased vaccination rates.Design.Survey.Participants.Volunteer sample of hospitals in Louisiana.Methods.All hospitals in Louisiana were invited to participate. A 17-item questionnaire inquired about the hospital type, patients served, characteristics of the vaccination campaign, and the resulting vaccination rate.Results.Of 254 hospitals, 153 (60%) participated and were included in the 124 responses that were received. Most programs (64%) required that HCP either receive the vaccine or sign a declination form, and the rest were exclusively voluntary (36%); no program made vaccination a condition of employment. The median vaccination rate was 67%, and the vaccination rate was higher among hospitals that were accredited by the Joint Commission; provided acute care; served children, pregnant women, oncology patients, or intensive care unit patients; required a signed declination form; or imposed consequences for unvaccinated HCP (the most common of which was to require that a mask be worn on patient contact). Hospitals that provided free vaccine, made vaccine widely available, advertised the program extensively, required a declination form, and imposed consequences had the highest vaccination rates (median, 86%; range, 81%–91%).Conclusions.The rate of influenza vaccination of HCP remains low among the hospitals surveyed. Recommended practices may not be enough to reach 90% vaccination rates unless a signed declination requirement and consequences are implemented. Wearing a mask is a strong consequence. Demanding influenza vaccination as a condition of employment was not reported as a practice by the participating hospitals.

scholarly journals Promotion of the influenza vaccination to hospital staff during pre-employment health check: a prospective, randomised, controlled trial

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Michael Currat ◽  
Catherine Lazor-Blanchet ◽  
Giorgio Zanetti
Keyword(s):  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Healthcare Workers ◽  
Vaccination Campaign ◽  
Intervention Group ◽  
Vaccination Rate ◽  
Health Check ◽  
Control Group ◽  
Vaccination Rates ◽  
Newly Hired

Abstract Background Vaccination is the most effective prevention of seasonal influenza. Despite its recommendation and active promotion, vaccination coverage remains low among healthcare staff. The goal of the study was to test if a pre-employment health check is a good opportunity to promote future vaccination against influenza among healthcare workers newly hired by a university hospital. Methods All new hospital employees active at the bedside who underwent a pre-employment health check between the end of 2016’s influenza epidemic and the start of the next influenza vaccination campaign were randomly allocated to a control group or an intervention group. The intervention consisted of a semi-structured dialog and the release of an information leaflet about influenza and influenza vaccination during the check-up, and the shipment of a postcard reminder 2 weeks before the next vaccination campaign. Vaccination rates during the campaign were compared among the two groups. Results Three hundred fifty-seven employees were included. Vaccination rates were similar in both groups: 79/172 (46%) in the control and 92/185 (50%) in the intervention group. A significantly higher rate of vaccination was noted among physicians (70/117, 60%) than among other employees (101/240, 42%, p = 0.001). In a pre-defined exploratory analysis among physicians, the vaccination rate was higher in the intervention group (36/51, 71%) than in the control group (34/65, 52%, p = 0.046). Conclusions Promotion of the influenza vaccine during pre-employment health check did not improve the vaccination rate of newly hired hospital healthcare workers overall during the next influenza vaccination campaign. Results suggest a favourable impact on the vaccination rate of physicians. Thus, there may be an interest in using communication strategies tailored to the different categories of healthcare workers to promote the influenza vaccine during pre-employment health check. Trial registration ClinicalTrials, NCT02758145. Registered 26 April 2016.

Voluntary to Mandatory: Evolution of Strategies and Attitudes toward Influenza Vaccination of Healthcare Personnel

2012 ◽  
Vol 33 (1) ◽  
pp. 63-70 ◽  
Author(s):  
Kathleen Quan ◽  
David M. Tehrani ◽  
Linda Dickey ◽  
Eugene Spiritus ◽  
Denise Hizon ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Vaccination Campaign ◽  
Vaccine Uptake ◽  
Healthcare Personnel ◽  
Vaccination Policy ◽  
Vaccination Rates ◽  
Hospital Policies ◽  
Mandatory Vaccination ◽  
Vaccination Campaigns ◽  
The Impact

Background.Assessing the relative success of serial strategies for increasing healthcare personnel (HCP) influenza vaccination rates is important to guide hospital policies to increase vaccine uptake.Objective.To evaluate serial campaigns that include a mandatory HCP vaccination policy and to describe HCP attitudes toward vaccination and reasons for declination.Design.Retrospective cohort study.Methods.We assessed the impact of serial vaccination campaigns on the proportions of HCP who received influenza vaccination during die 2006–2011 influenza seasons. In addition, declination data over these 5 seasons and a 2007 survey of HCP attitudes toward vaccination were collected.Results.HCP influenza vaccination rates increased from 44.0% (2,863 of 6,510 HCP) to 62.9% (4,037 of 6,414 HCP) after institution of mobile carts, mandatory declination, and peer-to-peer vaccination efforts. Despite maximal attempts to improve accessibility and convenience, 27.2% (66 of 243) of die surveyed HCP were unwilling to wait more than 10 minutes for a free influenza vaccination, and 23.3% (55 of 236) would be indifferent if they were unable to be vaccinated. In this context, institution of a mandatory vaccination campaign requiring unvaccinated HCP to mask during the influenza season increased rates of compliance to over 90% and markedly reduced the proportion of HCP who declined vaccination as a result of preference.Conclusions.A mandatory influenza vaccination program for HCP was essential to achieving high vaccination rates, despite years of intensive vaccination campaigns focused on increasing accessibility and convenience. Mandatory vaccination policies appear to successfully capture a large portion of HCP who are not opposed to receipt of die vaccine but who have not made vaccination a priority.Infect Control Hosp Epidemiol 2012;33(1):63-70

scholarly journals Influenza Vaccination among Healthcare Workers: Ten-Year Experience of a Large Healthcare Organization

2010 ◽  
Vol 31 (3) ◽  
pp. 233-240 ◽  
Author(s):  
M. Cristina Ajenjo ◽  
Keith F. Woeltje ◽  
Hilary M. Babcock ◽  
Nancy Gemeinhart ◽  
Marilyn Jones ◽  
...  
Keyword(s):  
Occupational Health ◽  
Influenza Vaccination ◽  
Vaccination Campaign ◽  
Vaccination Rate ◽  
Healthcare Organization ◽  
Occupational Health Services ◽  
Health Staff ◽  
Vaccination Rates ◽  
Quality Scorecard ◽  
Aggressive Interventions

Objective.To describe the results of different measures implemented to improve adherence to the healthcare worker (HCW) influenza immunization program at BJC HealthCare during the period from 1997 through 2007.Design.Descriptive retrospective study.Setting.BJC HealthCare, a 13-hospital nonprofit healthcare organization in the Midwest.Methods.We reviewed and analyzed HCW influenza vaccination data from all BJC HealthCare Occupational Health Services and hospitals during the period from 1997 through 2007. Occupational health staff, infection prevention personnel, and key influenza vaccination campaign leaders were also interviewed regarding implementation measures during the study years.Results.At the end of 2007, BJC HealthCare had approximately 26,000 employees. With the use of multiple progressive interventions, influenza vaccination rates among BJC employees increased from 45% in 1997 to 72% in 2007 (P<.001). The influenza vaccination rate in 2007 was significantly higher than in 2006: 72%, compared with 54% (P<.001). Five hospitals had influenza vaccination rates that exceeded the target goal of 80% in 2007. The most successful interventions were adding influenza vaccination rates to the quality scorecard incentive program and the use of declination statements, both of which were implemented in 2007. The most important barriers to success identified by interview respondents were HCWs' misconceptions about influenza vaccination and a perceived lack of leadership support.Conclusions.Influenza vaccination rates among HCWs significantly improved with multiple interventions over the years. However, the BJC HealthCare influenza vaccination target of 80% was not attained at all hospitals with these measures. More aggressive interventions, such as implementing mandatory influenza vaccination policies, are needed to achieve higher vaccination rates.

Championing Patient Safety through Mandatory Influenza Vaccination for All Healthcare Personnel and Affiliated Physicians

2011 ◽  
Vol 32 (4) ◽  
pp. 375-379 ◽  
Author(s):  
Lynne V. Karanfil ◽  
Jan Bahner ◽  
Joan Hovatter ◽  
William L. Thomas
Keyword(s):  
Influenza Vaccination ◽  
Seasonal Influenza ◽  
Influenza Season ◽  
Vaccination Rate ◽  
Vaccination Program ◽  
Healthcare Personnel ◽  
Full Time ◽  
Seasonal Influenza Vaccination ◽  
Vaccination Rates ◽  
For Profit

Objective.To determine whether a mandatory seasonal influenza vaccination program will increase vaccination rates among healthcare personnel (HCP) and affiliated physicians.Setting.MedStar Health is a not-for-profit regional healthcare organization that includes 9 hospitals with approximately 25,000 HCP and approximately 4,000 affiliated physicians. HCP describes any person employed by MedStar Health.Methods.With previous vaccination rates parallel to reported national rates of 54% among HCP, MedStar Health introduced a mandatory seasonal influenza vaccination program promulgated during the 2009–2010 influenza season. HCP and affiliated physicians were given an opportunity to apply for medical or religious exemptions. Noncompliant HCP were terminated. Noncompliant physicians had their privileges administratively suspended for the influenza season.Results.HCP compliance (vaccinated and exempt) was 99.9%. The influenza vaccination rate among HCP was 98.5%. There were 338 approved medical exemptions and 18 approved religious exemptions. Only 0.01% of HCP (9 full-time, 2 part-time, and 17 per diem employees) were terminated. Overall, 93% of the affiliated physicians were vaccinated; 7 religious and 99 medical exemptions were granted. In total, 149 physicians (4%) had their admitting privileges suspended during the influenza season.Conclusion.A mandatory influenza vaccination program achieves high rates of vaccination among HCP and affiliated physicians.

Effect of A Hospital Campaign for Influenza Vaccination of Healthcare Workers

2006 ◽  
Vol 27 (6) ◽  
pp. 612-617 ◽  
Author(s):  
Joon Young Song ◽  
Cheong Won Park ◽  
Hye Won Jeong ◽  
Hee Jin Cheong ◽  
Woo Joo Kim ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Healthcare Workers ◽  
Vaccination Campaign ◽  
Intervention Strategy ◽  
Vaccination Rate ◽  
Demographic Characteristics ◽  
Tailored Intervention ◽  
Vaccination Rates ◽  
Knowledge And Attitudes ◽  
Item Questionnaire

Objective.To identify the factors that inhibit or motivate influenza vaccination among healthcare workers (HCWs).Methods.In March 2000, we prepared 34-item questionnaire for both vaccine recipients and nonrecipients regarding demographic characteristics, factors motivating and inhibiting vaccination, and knowledge and attitudes about influenza vaccination. On the basis of the results of our survey, an aggressive hospital vaccination campaign was undertaken. In April 2004, after the 4-year campaign, the same questionnaire was again administered to HCWs.Results.In both 2000 and 2004, the main motives for undergoing influenza vaccination were “hospital campaign” and “recommendation by colleagues”; the percentage of respondents who were motivated by the hospital campaign had remarkably increased from 27% in 2000 to 52% in 2004 (P<.001), whereas the percentage who were motivated by recommendation by colleagues had not changed significantly (21% vs 14%). Qverall, the 4 reasons most frequently cited by HCWs for noncompliance with vaccination were insufficient available time, confidence in their health, doubt about vaccine efficacy, and fear of injection. In 2000, vaccination rates were below 30%, irrespective of occupation. After an aggressive vaccination campaign, the increase in the vaccination rate was highest among the nursing staff, increasing from 21% in 2000 to 92% in 2004, whereas the vaccination rate among the physicians was still below 60%.Conclusion.We conclude that a hospital campaign can markedly improve influenza vaccination rates among HCWs. Both a mobile cart system and free vaccine supply contributed to improving the vaccination rates in our study. In addition, a specifically tailored intervention strategy was required.

scholarly journals P04 A quality improvement initiative to improve influenza and pneumococcal vaccination rates in patients receiving biological DMARDS (bDMARDs) in the mid-west of Ireland

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Wan Lin Ng ◽  
Aqeel Anjum ◽  
Alwin Sebastian ◽  
Joe Devlin ◽  
Alexander Fraser
Keyword(s):  
Quality Improvement ◽  
Influenza Vaccination ◽  
Primary Care Physicians ◽  
Action Plan ◽  
Pneumococcal Vaccination ◽  
Vaccination Rate ◽  
Quality Improvement Initiative ◽  
Immunocompromised Patients ◽  
Vaccination Rates ◽  
Common Diagnosis

Abstract Background bDMARDs have been the panacea for rheumatic diseases but their use may increase the risk of infection. Morbidity and mortality in patients with chronic disease can be prevented with influenza and pneumococcal (PCV) vaccinations. Methods We implemented a multifaceted quality improvement (QI) approach at our infusion unit using the Plan-Do-Study-Act methodology. Interventions included training of rheumatology nurses, individual patient consultations and distribution of Arthritis UK booklet on vaccination. During the first cycle, patients on bDMARDs attending the rheumatology infusion unit between January to April 2018 were recruited. Initial data included patients’ demographics, diagnosis, bDMARD, their influenza and PCV vaccination statuses with reasons for not having vaccination. The second cycle was carried out from January to April 2019. Results 92 patients were recruited in the first cycle; mean age was 53.2 years with 63 (68.5%) females. The uptake of vaccination was 52 (56.5%) for influenza and 31 (33.7%) for PCV. More importantly, 39 (42.4%) patients did not receive either vaccination. Of the 18 (19.6%) patients aged ≥65 years, 5 (27.8%) received influenza vaccination alone and 8 (44.4%) received both. The most common diagnosis from our cohort was rheumatoid arthritis (37%), followed by spondylarthritis (13%), Behçet’s disease (9.8%) and others (40.2%). 48 (52.2%) were on rituximab, 37 (40.2%) on infliximab, 6 (6.5%) were on tocilizumab and 1 (1.1%) was on abatacept. 40 (43.5%) who did not receive the influenza vaccination stated that they were either unaware (45%), uninterested (25%), afraid of SEs (12.5%), forgotten (5%), unaware it was recommended (5%). Of the 61 (66.3%) patients who did not receive the PCV, 44 (72.1%) were unaware of its availability, 6 (9.8%) were uninterested, 8 (13.2%) were fearful of side effects (SEs) and 3 (4.9%) were unaware it was recommended. Patients who did not have vaccination were interviewed again during second cycle after QI interventions. There was satisfactory improvement in the vaccination rate of influenza vaccination (71.7%) and PCV (56.5%). The most common reason for the lack of vaccination were fear of SEs for influenza vaccination and unaware of its availability for PCV. 6 (9.7%) had serious infections in the preceding year requiring hospital admission; 3 had chest infections, 1 had urinary tract infection, 1 had cellulitis and 1 had necrotising fasciitis. Conclusion Although the baseline vaccination rate was suboptimal in our cohort, there was a significant improvement after the QI interventions. The lack of awareness is the main reason for failure to be vaccinated. There is a need of a more robust action plan involving both the rheumatology team and primary care physicians to ensure adequate vaccination in immunocompromised patients. In the next step, we also aim to implement these QI interventions to the immunocompromised patients attending outpatient clinics. Disclosures W. Ng None. A. Anjum None. A. Sebastian None. J. Devlin None. A. Fraser None.

Use Of A Mobile Cart Influenza Program For Vaccination Of Hospital Employees

2004 ◽  
Vol 25 (11) ◽  
pp. 918-922 ◽  
Author(s):  
Catherine Sartor ◽  
Herve Tissot-Dupont ◽  
Christine Zandotti ◽  
Francoise Martin ◽  
Pierre Roques ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Vaccination Rate ◽  
Associate Professor ◽  
University Hospital ◽  
Vaccination Program ◽  
Vaccination Rates ◽  
Vaccination Acceptance ◽  
The Impact ◽  
Haenszel Test

AbstractObjective:Rates of annual influenza vaccination of healthcare workers (HCWs) remained low in our university hospital. This study was conducted to evaluate the impact of a mobile cart influenza vaccination program on HCW vaccination.Methods:From 2000 to 2002, the employee health service continued its annual influenza vaccination program and the mobile cart program was implemented throughout the institution. This program offered influenza vaccination to all employees directly on the units. Each employee completed a questionnaire. Vaccination rates were analyzed using the Mantel–Haenszel test.Results:The program proposed vaccination to 50% to 56% of the employees. Among the nonvaccinated employees, 52% to 53% agreed to be vaccinated. The compliance with vaccination varied from 61% to 77% among physicians and medical students and from 38% to 55% among nurses and other employees. Vaccination of the chief or associate professor of the unit was associated with a higher vaccination rate of the medical staff (P < .01). Altogether, the vaccination program led to an increase in influenza vaccination among employees from 6% in 1998 and 7% in 1999 before the mobile cart program to 32% in 2000, 35% in 2001, and 32% in 2002 (P < .001).Conclusions:The mobile cart program was associated with a significantly increased vaccination acceptance. Our study was able to identify HCW groups for which the mobile cart was effective and highlight the role of the unit head in its success.

A Successful Mandatory Influenza Vaccination Campaign Using an Innovative Electronic Tracking System

2009 ◽  
Vol 30 (12) ◽  
pp. 1137-1142 ◽  
Author(s):  
Tara N. Palmore ◽  
J. Patrick Vandersluis ◽  
Joan Morris ◽  
Angela Michelin ◽  
Lisa M. Ruprecht ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Tracking System ◽  
Vaccination Campaign ◽  
Healthcare Providers ◽  
Data Entry ◽  
Dramatic Improvement ◽  
Patient Contact ◽  
Hospital Policy ◽  
Vaccination Rates ◽  
Clinical Center

Background.Although influenza vaccination of healthcare workers reduces influenza-like illness and overall mortality among patients, national rates of vaccination for healthcare providers are unacceptably low. We report the implementation of a new mandatory vaccination policy by means of a streamlined electronic enrollment and vaccination tracking system at the National Institutes of Health (NIH) Clinical Center.Objective.To evaluate the outcome of a new mandatory staff influenza vaccination program.Methods.A new hospital policy endorsed by all the component NIH institutes and the Clinical Center departments mandated that employees who have patient contact either be vaccinated annually against influenza or sign a declination specifying the reason(s) for refusal. Those who fail to comply would be required to appear before the Medical Executive Committee to explain their rationale. We collected in a database the names of all physician and nonphysician staff who had patient contact. When a staff member either was vaccinated or declined vaccination, a simple system of badge scanning and bar-coded data entry captured essential data. The database was continuously updated, and it provided a list of noncompliant employees with whom to follow up.Results.By February 12, 2009, all 2,754 identified patient-care employees either were vaccinated or formally declined vaccination. Among those, 2,424 (88%) were vaccinated either at the NIH or elsewhere, 36 (1.3%) reported medical contraindications, and 294 (10.7%) declined vaccination for other reasons. Among the 294 employees without medical contraindications who declined, the most frequent reason given for declination was concern about side effects.Conclusions.Implementation of a novel vaccination tracking process and a hospital policy requiring influenza vaccination or declination yielded dramatic improvement in healthcare worker vaccination rates and likely will result in increased patient safety in our hospital.

Abstract P271: Influenza and Herpes Zoster Vaccination in United States Stroke Survivors: A Nationwide Analysis

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Mu Ji Hwang ◽  
Setareh Salehi Omran ◽  
Saad Mir ◽  
Alexander E Merkler ◽  
Hooman Kamel ◽  
...  
Keyword(s):  
United States ◽  
Herpes Zoster ◽  
Influenza Vaccination ◽  
Vaccination Rate ◽  
Behavioral Risk ◽  
Stroke Survivors ◽  
Cross Sectional ◽  
Vaccination Rates ◽  
Increased Risk ◽  
Prior Stroke

Introduction: Patients with stroke face an increased risk of contracting influenza and herpes zoster. We compared vaccination rates in stroke survivors versus the general United States population. Methods: We performed a cross-sectional analysis of data from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System, which is an annual, nationally representative, health survey. Respondents are asked about medical conditions and care. We used the most recent years with complete data for influenza (2018) and zoster (2017). We utilized survey procedures to estimate CDC-recommended vaccination rates for influenza (annual vaccination for all) and zoster (one-time vaccination for those at least 50 years old). Multiple logistic regression was used to compare the odds of vaccination in those with and without prior stroke, while adjusting for demographics (including income and health insurance) and comorbidities that may influence vaccination rates (obesity, diabetes, heart disease, cancer, pulmonary disease, and smoking). Results: In 2018, 8,254,136 (3.4%; 95% CI, 3.3-3.5) Americans were stroke survivors. The influenza vaccination rate was 44.4% (95% CI, 42.8-46.2) in stroke survivors and 32.8% (95% CI, 32.5-33.1) otherwise. In unadjusted models, stroke survivors were more likely to have had an influenza vaccination in the past year than those without stroke (OR, 1.6; 95% CI, 1.5-1.8). In 2017, 5,839,186 (5.7%; 95% CI, 5.5-5.9) Americans over 50 years old (i.e., eligible for zoster vaccination) were stroke survivors. The zoster vaccination rate was 30.3% (95% CI, 28.8-32.0) in stroke survivors and 27.6% (95% CI, 27.3-28.0) in those without prior stroke. Stroke survivors were more likely to have had zoster vaccination than those without stroke (OR, 1.14; 95% CI, 1.06-1.23). However, after accounting for demographics and comorbidities, stroke survivors were not more likely to be vaccinated for influenza (OR, 1.01; 95% CI, 0.93-1.10) or zoster (OR, 1.00; 95% CI, 0.90-1.12). Conclusion: Stroke survivors were not vaccinated at higher rates than expected based on demographics and comorbidities, and absolute vaccination rates were low, especially for zoster. Efforts to increase vaccination after stroke may be needed.

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