The rate of Massachusetts health care workers vaccinated against the flu and COVID-19 is declining, despite state officials pushing for the vast majority of providers to get their shots in order to stunt the spread of illnesses.
The Department of Public Health’s goal is to achieve an annual flu and COVID immunization rate of 90% or higher among eligible health care personnel at all licensed facilities and emergency medical services. That figure is based on a previous national target, DPH Director of Health Care Strategy and Planning Katherine Fillo told the Public Health Council Wednesday.
During the 2024-25 respiratory virus season, an average of 83.5% of providers in acute care hospitals were vaccinated against the flu, according to presentation slides shown at the council meeting. That compares to 75.3% of providers in non-acute care hospitals, 74.9% in ambulatory surgical centers, 57.8% in dialysis centers, 60.8% in clinics, 52.3% in nursing homes, 68.7% in rest homes, 52.2% in adult day health programs, 21.2% in EMS and 65.4% in hospice. Clinics include community health centers and CVS Minute clinics, as well as some urgent care centers and outpatient practices, according to a DPH spokesperson.
Providers in acute care hospitals reached or surpassed the 90% flu vaccination goal in the 2020-21, 2021-22 and 2022-23 season, and fell below that threshold in the 2023-24 season.
“There were notable differences in the mean and median vaccination rates,” said DPH epidemiologist Fareesa Hasan of the 2024-25 season. “For example, acute care hospitals had a mean of 83% but a median of 95%. This difference suggests that while many individual facilities maintained high vaccination rates, there are a few facilities with significantly lower vaccination rates, either due to many personnel claiming exemptions or being reported as having unknown status.”
Across other facilities analyzed for the 2024-25 season, the median flu vaccination rate was 81.1% in non-acute care hospitals, 79.7% in ambulatory surgical centers, 58.3% in dialysis centers, 61.9% in clinics, 51.5% in nursing homes, 67.9% in rest homes, 50.5% in adult day health programs, 9.5% in EMS and 68.5% in hospice.
State public health leaders also discussed shifting federal vaccine policy, particularly with U.S. Health and Human Services Secretary Robert Kennedy Jr. reshaping a key advisory panel. Providers shared how they are working to counter misinformation and work with parents to drive up pediatric vaccination rates.
While DPH licensure requirements seek to ensure that all providers are vaccinated against the flu and COVID, workers are able to claim exemptions. Health care facilities must notify workers about the requirements, educate them about the benefits and risks of immunizations, and arrange free vaccinations, Fillo said.
Average flu vaccination rates in the 2024-25 season trended downward for ambulatory surgical centers, clinics, nursing homes, rest homes, and adult day health programs, though there was an increase at dialysis centers.
COVID vaccination reporting requirements started in 2023, and all health care facilities are far below the 90% target.
In the 2024-25 season, an average of 21.6% of providers in acute care hospitals had their COVID shot, compared to 19% in non-acute care hospitals, 38.4% in ambulatory surgical centers, 5.3% in dialysis centers, 41.6% in clinics, 16.5% in nursing homes, 48.2% in rest homes, 28.9% in adult day health programs, 16.3% in EMS and 39.6% in hospice. Hasan cautioned that dialysis centers also had the highest rates of providers with unknown vaccination statuses, which she said means “the true vaccination rate is simply underestimated.”
“Overall, there has been a decrease in flu and COVID vaccination uptake among health care providers in Massachusetts, which is similar to the trends that are reported nationally,” Hasan said.
Eileen McHale, DPH’s health care associated infection coordinator, said the department “strongly” recommends that all providers receive their flu shots in September. DPH is also holding webinars about flu and COVID shots, with the first session slated for September.
Masking is also encouraged to limit exposure and the spread of respiratory viruses in health care facilities, but DPH Commissioner Robbie Goldstein acknowledged limitations to that strategy.
“While we have regulations that require a plan, a mitigation plan that may include masking, it’s variable across the state -- who uses masks, when they use masks, and if that’s only in response to an outbreak, or if it is a universal masking recommendation,” Goldstein said.
