Relationship of Influenza Vaccination Declination Statements and Influenza Vaccination Rates for Healthcare Workers in 22 US Hospitals

The use of declination statements was associated with a mean increase of 11.6% in influenza vaccination rates among healthcare workers at 22 hospitals. In most hospitals, there were no negative consequences for healthcare workers who refused to sign the forms, and most policies were implemented along with other interventions designed to increase vaccination rates.