The IP’s role in vaccine compliance has traditionally centered on influenza shots, but that all changed with SARS-CoV-2.
The infection preventionist’s (IP’s) role in vaccine compliance has traditionally centered on influenza shots, but that all changed with SARS-CoV-2. Encouraging vaccination and assisting with vaccine acceptance was a role that fell partly on the IP’s shoulders in many health care systems, including at Emory University Hospital.
In a poster presented at the Association for Professionals in Infection Control and Epidemiology (APIC) 2022 Annual Conference, held June 13-15, 2022, in Indianapolis, Indiana, Jessica Tarabay, MPH, MHR, CIC, manager of infection prevention at Emory University Hospital, shared how the team at Emory built trust to implement interventions that boosted SARS-CoV-2 vaccine compliance and resulted in more than 1000 employees successfully completing the vaccine series. She detailed the process in a video interview with Infection Control Today®.
This transcript has been edited for clarity and length.
ICT®: Can you discuss the role of trust and how that factors into vaccination decisions in general?
Tarabay: I feel like with trust, it's really building those rapports with your frontline teams, all the departments, and people [who] have very big influence within your organization. Building that partnership…goes along the same lines as building that trust. Ultimately, I look at our department and infection prevention as a relationship department. We are a support department, and so having the trust within our teams really helps us to do the work. WE can’t do that without those rapports.
ICT®: Can you discuss the role of the IP in vaccination compliance prior to SARS-CoV-2?
Tarabay: Especially around flu, we give a presentation during new employee orientation on why it's so important, but really hitting the whys behind why vaccine compliance is so important. And I feel that with SARS-CoV-2, really just understanding the hesitancy within certain groups within health care and the communities as a whole, and really just learning to listen, that was one of the biggest components of building that trust.
What we did is we went to departments, specifically those that have very low compliance, and we just learned. We wanted to see what was truly going on, we learned part of it was that transportation was a barrier. We also learned that some people just really didn't have the resources that if they were to go into the emergency room for some reason, they couldn't pay that copay. There are a lot of questions that, as an organization, we weren't able to answer right away, and just building those rapports—sitting and listening—that's where we were really truly able to deliver on some of those frequently asked questions that really helped increase compliance.
ICT®: What were some of the barriers to vaccine compliance that were encountered once SARS-CoV-2 vaccination was made mandatory?
Tarabay: I think the barriers of like, when something is forced, and once it became that mandate, really understanding who then are those key influential team members in a department and if it's a leader that is completely hesitant, that's going to be our first source, right? So if a leader of an entire department is vaccine non-compliant, it does set the stage and it cascades down to their team. And so I think it just starts with listening to them and truly just being observant of what's going on within your organization. Town Halls don't do anything because we truly weren't reaching the people that needed to hear it the most.
ICT®: Your poster details different methods that were tried out to increase compliance. Can you talk us through some of those?
Tarabay: So it's going into department huddles and just listening. It was literally one-on-one conversations with staff members, all the way from [environmental services] to director level and just truly understanding. We even have team members who would go down whenever we were offering on-site vaccination. We went down, each of us, and we held the hands of certain team members and we waited through…the 15-minute or 30-minute wait time [post-vaccine] just depending on certain risks levels. And that, honestly, cascaded down. We did it with one person and they went and told another team member and they told another team member and then it just became like this camaraderie and that's really how we saw that vaccine compliance increase.
Also just partnering with our management engineers and nursing colleagues, very respected people in the organization who were able to deliver roving carts around the hospital itself to each department, and really just trying to get a group there so we're coming to you, you're not going to have to come to us. It took a bit, I will say it took many months to get there. But I will say that, ultimately, it's not the complete topic of conversation anymore. It was because we did what we needed to do.
ICT®: What were the overall results?
Tarabay: The departments with the lowest compliance, even getting them to 80% compliance rate or 70% when they're coming from 40%, those are huge, huge results. Ultimately, we did have a mandatory vaccination that we had to have results met by October 1, and so we did see instrumental impact with that with each of those methods.