Hospitals can greatly improve their flu vaccination rate among health care workers by forcing employees to get them, finds the Henry Ford Health System where they did just that.

Citing its own data, Henry Ford researchers say the health system achieved employee vaccination rates of 99 percent in the first two years of its mandatory policy, in which annual vaccination compliance is a condition of employment. Nationally, 63 percent of health care workers were immunized against the flu in the past two years, according to the Centers for Disease Control and Prevention. 

Allison Weinmann, M.D., a Henry Ford Hospital physician and paper co-author, says it was only after the health system went to the mandatory policy for the 2012-13 flu season did the vaccination rate substantial improve. 

"As expected we got push-back from employees. But we always believed it was the right thing to do for patient and employee safety," says Weinmann. They say less than 1 percent left their jobs rather than be forced to get the vaccine or got exemptions, which also shows corporations the power of social authoritarianism in a bad economy. 

More than 9,600 people were hospitalized for the flu during the 2013-14 flu season, and 60 percent of them were between the ages 18-64, the CDC says. The CDC recommends vaccination for anyone six months and older. Prior to forcing employees to receive vaccines, its vaccination rate hovered between 41 percent and 55 percent. 

For the 2010-11 flu season, Henry Ford made a shift in policy, requiring:

• Annual vaccination for employees in patient care areas.
• An opt-out measure allowed employees in patient care areas to forgo vaccination for wearing a mask.
• Vaccination was highly recommended, though not required, for employees in non-patient care areas.

Vaccination rates jumped to 84 percent and 87 percent between 2010-2012.

For the 2012-13 flu season, Henry Ford revised its policy once more, this time requiring annual vaccination for all employees. The result was a 99 percent vaccination rate of over 23,000 employees. An opt-out measure allowed employees to decline vaccination for a medical or religious reason. These employees must complete a declination form, which requires their physician or religious leader to state the reason for forgoing vaccination and to sign their name.

"A big hurdle was addressing the myths associated with the vaccine itself and reassuring employees this was all safety driven," Weinmann says.