Mandatory vaccination policies may be needed to reverse poor uptake of influenza vaccine by haematology staff in blood and marrow transplant units, researchers suggest.

Vaccinating health workers against flu has consistently been shown to reduce rates of nosocomial influenza and seasonal patient mortality.

Yet on average, less than 50% of medical and nursing staff in three major blood and marrow transplant (BMT) units in NSW were vaccinated in 2017, according to an audit published in the Internal Medicine Journal.

Uptake was higher among specialists and advanced trainees vaccinated with 74% vacccinated compared to 44% of registrars and junior medical officers.

For nurses, the average rate of uptake across the three BMT sites was 40%.

Researchers carried out the audit in response to a new policy decision by NSW Health to make flu vaccination mandatory for health care workers working in ‘Category A’ high-risk areas.

High risk areas include transplant and oncology wards looking after immunosupressed patients, a group for which complications associated with flu cause death in 23% of cases, according to international data.

The policy came after NSW experienced its worst flu season in almost a decade in 2017, with over 100,000 confirmed cases and 654 deaths.

The authors of the study did not explore the reasons workers were not vaccinated.

But reasons such as misconception of benefit, inconvenience, fear of needles and adverse effects have been cited by previous research, write Dr Yadanar Lwin from the haematology department at St Vincent’s Hospital and her co-authors.

The audit’s results suggest it may be reasonable for hospitals in other jurisdictions to adopt mandatory influenza vaccination policies, at least on a trial basis in units looking after high-risk patients, the authors write.

“But if such a policy is to be introduced, like it has in NSW, it is essential that it is comprehensively evaluated and implemented within a respectful and collegial work environment.

“Even if such policies raise challenges of their own – we owe it to our patients to try.”