Protecting our frontline: vaccination policies for health care workers in the Americas.

OBJECTIVE

This paper explores vaccination policies for health care workers (HCWs) in effect in all 35 Pan American Health Organization (PAHO) countries plus the British territory of Anguilla to highlight strengths and challenges within the region and inform relevant policies and interventions.

METHODS

Data were collected in two phases. Phase 1 (March-September 2021) was conducted as part of a global survey examining characteristics of national vaccination policies for HCWs. The questions addressed policy enforcement, antigens included in policies, funding, vaccination monitoring, and emergency vaccination plans. Respondents were representatives from 21 countries. In Phase 2 (March-August 2023), 15 country representatives who did not respond to the initial survey completed an amended, web-based version of the original questionnaire.

RESULTS

Of the 36 countries, 15 (42%) reported having a national HCW vaccination policy, and 3 (8%) planned to introduce one within 5 years. Among those with policies, 80% integrated them into occupational health regulations. All policies covered influenza and hepatitis B, while many also included tetanus, measles, rubella, diphtheria, and COVID-19. Over half of respondents had emergency vaccination mechanisms, and 44% reported national monitoring systems. Ten countries had comprehensive vaccination policies for HCWs.

CONCLUSIONS

To strengthen HCW vaccination policy in the Americas, future efforts should support countries in developing tailored national policies, expanding antigen coverage-especially for outbreak-prone diseases-and investing in strong monitoring systems. Additionally, scaling up behavioral research, enhancing communication strategies, and institutionalizing emergency mechanisms will be critical for addressing vaccine hesitancy and ensuring both pandemic preparedness and routine care continuity.