Resource Materials

APIC’s "Protect Your Patients. Protect Yourself." program features a variety of helpful resource materials infection preventionists may use to encourage healthcare institutions to implement or expand their healthcare personnel immunization programs.

Materials in this kit include sample communications tools designed to help institutions reach healthcare personnel with information about the importance of annual influenza immunization, and promote in-house influenza immunization programs sponsored by employers.


Influenza Immunization Program Checklist

This checklist provides detailed, month-by-month instructions for infection preventionists to use in planning, implementing and promoting an influenza immunization program for healthcare personnel.

Tip: Use the checklist when you meet with your influenza immunization program team to guide your discussion.

Influenza Immunization Program Checklist


Sample Employee Education Materials

These sample communications materials can be tailored for use during healthcare personnel influenza vaccination programs. Use the template materials to educate staff and volunteers about the dangers of influenza transmission and the importance of annual vaccination.

Tip: Educate early and re-educate often.

Tip: Try to use the term “influenza” consistently in your materials (instead of “flu”) to help keep the focus on a serious, life-threatening respiratory illness.

Human Resources newsletter articles – Communicate the importance of annual influenza immunization to staff and raise awareness about influenza in various internal newsletters. Featured are a series of sample articles that can be used before influenza season and to promote institutional immunization programs.

Tip: Consider writing additional articles on influenza for your Human Resources Department or other groups such as Volunteers, including a mid-season update about healthcare personnel immunization rates.

Newsletter #1 - New Staff Influenza Immunization Initiative
Newsletter #2 - Influenza Season is Coming... Are You Prepared?
Newsletter #3 - Get Vaccinated: Free Influenza Immunization Offered to Healthcare Personnel


Staff e-mail messages – Use to forward staff e-mail message from the CEO, hospital administration or other key management staff to emphasize the importance of the healthcare personnel influenza immunization program. The messages correspond to the newsletter articles, alerting all staff to the importance and availability of influenza immunization.

Tip: Ensure these messages will come from the management’s e-mail address (CEO, President, etc.) and do not appear to be from an administrative assistant or other e-mail address. This underscores the top management's commitment and directive for influenza immunization.

Tip: Send the messages the same weeks the newsletter articles are published to strengthen your facility’s position on healthcare personnel immunization.

Email #1 - Message from CEO to Encourage Immunization
Email #2 - Announcing Influenza Clinic Dates and Times


APIC Position Statement on Influenza Vaccination

APIC has issued an updated position statement on influenza immunization of healthcare personnel that is consistent with CDC recommendations. This statement underscores APIC’s commitment to increasing immunization rates for healthcare personnel and encourages organizations to develop or maximize their own policies and programs.

Tip: Refer to the APIC position statement when you meet with institutional management to emphasize the importance of healthcare personnel influenza immunization policies and programs.

APIC Position Statement


Sample Declination Forms
APIC’s position paper on influenza immunization of healthcare personnel says that organizations should adopt a system in which an informed declination is obtained from employees that decline for other than medical reasons and that the information should be used by the facility to develop improvement strategies for the following vaccine season.

Click on the following links to see sample declination forms:

Sample Declination Form #1 Immunization Action Coalition
Sample Declination Form #2 State of New York