Influenza Immunization Requirements for Health Care Agencies & Facilities
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Influenza Immunization Requirements for Health Care Agencies & Facilities

Purpose of the Board of Health Rule

People with chronic or acute health conditions, pregnant women, people over 65 and young children are much more likely to suffer from deadly side effects of the flu than others. In short – the people served by health care workers are at great risk for dying if they get the flu.

That’s why the Board of Health Employee Influenza Immunization Rule was established. We must, “First, do no harm.” Health care agencies and facilities that ensure that their staffs receive annual flu shots are working to prevent the spread of flu to patients, as well as to their workers and their families. Those that immunize 90% or more of their employees meet the Best Practices Benchmark.

Beginning on page 47, the Colorado Board of Health Rule, addresses the subject of providing influenza immunizations to health care workers.

  • The Rule applies to all health care facilities and agencies that are licensed by the State of Colorado. This includes (but is not limited to) Home Health Agencies, Hospice Care and Inpatient Facilities, Long- term Care Facilities, Assisted Living Residences, Resident Treatment Centers, Hospital Units, Ambulatory Surgery Centers, and Hospitals.
  • At this time, the Rule is not mandatory. Instead, the rule is meant to provide information and tools to assist entities to develop policies and procedures that support annual influenza immunizations.

The Printable Fact Sheet about Board of Health Rule covers most of the information needed to meet the requirements of the Rule.

Five Requirements of the Board of Health Rule

  1. Develop an immunization policy that ensures employees have the opportunity to receive an annual influenza immunization
  2. Provide information about the benefits, risks and availability of flu immunizations to staff
  3. Help staff get immunized
    • Host a clinic at your facility
    • Provide paid time for staff to be immunized elsewhere
    • Consider covering the cost of the immunization (optional but effective)
  4. Track status of employee flu immunizations
  5. Report the immunization status of employees through the State Health Facilities Division (HFD) or the National Health Safety Network (NHSN)

Developing an Influenza Immunization Policy

Benefits of an Annual Influenza Immunization Policy

  • Developing and implementing an influenza immunization policy will bring your agency into compliance with the Colorado Board of Health Rule.
  • Your clients will see that you do the best to protect them from the flu.
  • You will demonstrate to your staff that you value them and their families and want to help them stay healthy.
  • Your absenteeism rate may be lower.
  • You can post information on your website to inform potential clients about how you take pro-active approaches to protect those you serve.

Elements of an Effective Influenza Policy

  • Purpose & Benefits of the Policy
  • General scope of the policy – to whom it applies
  • Specific requirements – should include whether the requirement is mandatory,deadline for when immunizations are due, how staff can receive immunizations, links to information about influenza disease and immunization
  • Exemptions – who might quality for a waiver to the policy and how it is granted
  • Responsibilities – roles and responsibilities are spelled out for administration and staff

Resources for Writing an Influenza Immunization Policy

Motivating Staff to Get Immunized

Why don’t Health Care Workers Get Immunized?

  • They don’t believe the vaccine is effective
  • They are afraid the vaccine will give them the flu or make them sick
  • They don’t believe they need it

Flu is Wiley – Little-known Reasons Why Health Care Workers Should Get Immunized

  • Staff can have a mild case of the flu without suffering from any symptoms, but can still can be contagious.
  • Staff can be contagious for 1 day before they have symptoms and up to 7 days after symptoms are gone.
  • Staff can infect others up to six feet away through coughing and even talking.
  • Health care workers often work even when they feel sick
  • Staff can become infected from their patients and then infect their own families

Proven Strategies to Encourage Health Care Workers to Get Immunized

  • Develop an Influenza Immunization Policy. Coverage is highest among health care workers working with employer-mandated vaccination requirements. Waivers can be granted due to medical contraindications and religious contraindications.
  • Provide flu shots at no cost, either onsite or offsite; offer more than one opportunity to get the shot; provide information about other locations in the community where flu shots are available;
  • Provide information about flu disease; focus on protecting the worker and their family; include information about when workers are contagious and how they can spread the disease.
  • Provide information about the vaccine.

Resources for Motivating Employees to get Immunized

Reporting to the State Health Facilities Division (HFD) Portal or National Health Safety Network (NHSN)

Staff in the following job categories should receive annual flu immunizations and should be included in your reporting data.

  • Direct care
  • Administration
  • Clerical
  • Licensed independent professionals (MD, NP, RN, PT, OT, etc.)
  • If you report through the National Health Safety Network (NHSN) you need to report on Contract workers (workers from a different agency, with whom you contract to work at your facility such as medical assistants, companions, housekeepers, etc.) and volunteer and student workers.
  • If you report through the State HFD Portal you do not need to include these workers. However, they DO put your patients at risk if they are not immunized, and you can report on them.

Data Required for Reporting

In order to complete the State report, you will need the number of all paid staff who:

  • Have worked at least one day between October 1, 2015 – December 31, 2015.
  • Received an influenza immunization at your site.
  • Received an influenza immunization from a different provider. (Written documentation is required showing the date, type of vaccine, and clinic where it was given.)
  • Have a documented medical contraindication.
  • Do not fit into any of the categories above and/or whose status is unknown (e.g., refuse due to religious or philosophical reasons, say they cannot receive the shot, but don’t provide medical documentation, etc.).

How to Report

Information can be reported to though the National Health Safety Network (NHSN) or the State Health Facilities Division (HFD) Portal.

National Health Safety Network (NHSN)

To report healthcare personnel flu vaccination data through NHSN to the Colorado Department of Public Health and Environment (CDPHE), you will need to go to the Reporting Influenza Immunization Data into NHSN page on the CDPHE website.

Through the State Health Facilities Division (HFD), the Portal Administrator, (ie: the person listed on your state license) is responsible for reporting through the State HFD Portal. The log-on and password for access to the HFD Portal are the same as those used to access your state license information. The Portal Administrator can give others reporting authority by logging on to the State License website and clicking on “Special Menu” and then on “User Account Set-up Options.”

Choose the Internet provider you use to get the correct link to the portal.

Reporting Deadline

Data can be entered any time after October 1 and may be changed any time up to March 31. Reporting must be completed by March 31 of each year.

Reporting resources

Other Resources

Get Help

Access to the State Reporting Portal

  • CDPHE Licensure Customer Assistance – 303-692-2836

Access to the National Health Safety Network (NHSN)

  • Tamara Hoxworth – 303-692-2930

Questions About Reporting

  • Erica Bloom – 303-692-2789
  • Tamara Hoxworth – 303-692-2930

General Assistance; Policy Development; Immunization Tracking

  • Pat Hood – 303-413-7527

Information About Studies on Influenza Disease and/or Vaccine and other Flu Data

  • Jamie Feld – 303-413-7530
  • Kylie Chilton – 303-413-7531

Contact Us


Immunization Program

Main: 303-413-7799
Submit a question


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