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Health Officer Order for Licensed Health Care Facilities in Monterey County to Implement Influenza Vaccination Programs for Health Care Workers During the 2020-2021 Influenza Season

Preface Vaccination of health care workers (HCWs) against influenza virus protects medically fragile patients and reduces employee absenteeism during influenza season. State law requires that acute care hospitals and certain employers offer influenza vaccinations to employees or have the employee sign a declination statement if they choose not to be vaccinated (California Health & Safety Code $1288.7(a); Title 8 California Code Regulations $5199 (c)(6)(D) & (h)(10)). Mandatory vaccination and masking policies in health care facilities have been shown to increase HCW vaccination rates to above 90%. Prior to 2013, influenza vaccination rates among health care workers in Monterey County hospitals ranged from 64% to 81%. Beginning in 2013, I have issued a Health Officer Order each year to licensed health care facilities requiring that facilities implement programs that require their HCWs to provide evidence of influenza vaccination or to wear a surgical mask while working in patient care areas during the influenza season. Under the Health Officer order, HCW influenza vaccination rates have increased and have remained higher than in years prior to the annual Health Officer order. During the 2018-2019 influenza season, the most recent influenza season for which influenza vaccination rates among hospital health care personnel are publicly available, influenza vaccination rates ranged from 84% to 90% at our local hospitals. The 2020-2021 influenza season will provide additional challenges due to the COVID-19 pandemic. Overlapping surges in influenza and COVID-19 could burden the health care system. Protecting health care workers and patients from influenza by aggressive vaccination of the health care workforce will be important to reduce stress on the health care system. Health Officer Order Health Care Worker Influenza Vaccination October 14, 2020 Therefore, to maintain a higher rate of influenza vaccination among HCWs which protects patients from morbidity and mortality associated with influenza infection, am issuing the following Health Officer Order. Order I, as Health Officer of Monterey County, hereby order, pursuant to my authority under Section 120175 of the California Health and Safety Code, all licensed health care facilities within the County of Monterey to develop and implement a written influenza vaccination policy and program for the 2019-2020 influenza season under which a health care worker at such facility either provides evidence of vaccination with an influenza vaccine or, if the health care worker is unable to provide such evidence, wears a surgical mask for the duration of the influenza season while working in patient care areas. Definitions For the purposes of this order: “Health care worker” shall be defined as any employed or non-employed individual who provides direct patient care or who works in a patient care area. "Licensed health care facility" shall be defined as any facility, place, or building licensed by the California Department of Public Health Licensing and Certification Branch that is organized, maintained, and operated for the diagnosis, care, prevention, and treatment of human illness, physical or mental, including convalescence and rehabilitation care and including care during and after pregnancy, or for any one or more of these purposes, for one or more persons. A searchable list of facilities licensed by the California Department of Public Health Licensing and Certification Branch can be found at: https://data.chhs.ca.gov/dataset/healthcare-facility locations/resource/Oa0476ba-442c-40ff-97dc-dc840fa7e907. "Influenza season" is defined as November 1, 2020 through April 30, 2021. If influenza surveillance data suggest that the influenza season may end before or extend beyond April 30, 2021, then this order may be amended to shorten or extend the influenza season. Health Officer Order Health Care Worker Influenza Vaccination October 14, 2020 "Influenza vaccine" shall be defined as a vaccine approved by the U.S. Food and Drug Administration or recommended by the Advisory Committee on Immunization Practices for the 2020-2021 influenza season. "Patient care area" shall be defined and determined by the facility, in consultation with the Monterey County Health Department. Existing Health Officer Orders This order does not replace the Order of the Health Officer of the County of Monterey Requiring Members of the Public and Workers to Wear Face Coverings issued April 28, 2020, and the California Health Officer Guidance for the Use of Face Coverings issued June 18, 2020, and revised June 29, 2020 nor does it replace more restrictive COVID-19 masking policies implemented by individual facilities. Resources Monterey County is committed to assisting facilities that are subject to this order. Please contact the Monterey County Health Department's Communicable Disease Unit at 831-755-4521 with questions. IT IS SO ORDERED. 10/14/20 Edward L. Moreno, MD, MPH Health Officer and Director of Public Health Date of Issuance of Order

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