Acute Communicable
Disease Control

Contact Information
County of Los Angeles
Department of Public Health
Acute Communicable Disease Control
313 N. Figueroa Street, #212
Los Angeles, CA 90012
Phone: (213) 240-7941
Fax: (213) 482-4856

Call 211 For Information 24/7

Have questions about things like where to go for vaccinations or other health care services?

Call 2-1-1.

Adobe Reader

Note: PDF documents on this site were created using Adobe Acrobat 5.0 or later. If you are using an earlier version of Adobe Acrobat Reader (4.x or less), document functionality may be reduced.
Health Officer Order- Influenza Vaccination and Masking for Health Care Personnel
Toolkit: Skilled Nursing Facilities (SNFs)


In 2013 Jonathan E. Fielding, MD, MPH, who was the Director of the Los Angeles County Department of Public Health and Health Officer, issued a health officer order that was designed to protect health care personnel (HCP) from influenza and lower the risk of the transmission of influenza to patients. This order remains in effect for the duration of the current influenza season and all future seasons, unless rescinded.

The health officer order mandates that HCP in licensed acute care hospitals, skilled nursing facilities, intermediate care facilities, and emergency medical services (EMS) provider agencies in Los Angeles County assist their HCP to obtain influenza immunizations by requiring that those HCP who decline immunization wear a mask when they are in contact with patients during the annual influenza season. The goal of the order is to lower the rates of transmission of influenza among healthcare personnel and the vulnerable populations that they serve.

The influenza immunization order applies to all individuals working in licensed acute care hospitals, skilled nursing facilities, intermediate care facilities, and emergency medical services (EMS) provider agencies who have direct patient contact or work in patient care areas during the influenza season (November 1 through April 30). It excludes facilities in the cities of Long Beach and Pasadena, which are separate health jurisdictions.

This toolkit is being launched as a guide to increasing flu vaccination among HCP in SNF setting.  The toolkit contains the following contents to assist skilled nursing facilities in complying with the Health Officer Order.

Table of Contents

Health Officer Order Resources



Los Angeles County Mandated Health Officer Order: Influenza Immunization and Masking for Healthcare Personnel for the 2022-2023 Influenza Season
(Revised 9-27-22) 
Adobe PDF Document

This order is a reminder that the “Health Officer Order for Annual Influenza Immunization Programs for Healthcare Personnel or Masking of Health Care Personnel during the Influenza Season” remains in effect.

Rationale for Mandated Influenza Immunization for Healthcare Personnel in Los Angeles County   (Revised 9-21-22)  Adobe PDF Document

This document provides supporting evidences for Los Angeles County (LAC) Health Officer Order.

Health Officer Order Frequently Asked Questions  (Revised 9-21-22)  Adobe PDF Document The FAQ sheet is a quick reference to the most commonly asked questions about Health Officer Order.

Frequently Asked Questions about Influenza Vaccinations for Healthcare Personnel             (Revised 9-21-22) Adobe PDF Document

The FAQ sheet is a quick reference to the most commonly asked questions about Influenza Vaccinations for health-care personnel (HCP).

Healthcare Personnel Influenza Vaccination Timeline/Checklist  Adobe PDF Document This timeline/checklist offers examples of best practices from successful influenza vaccination campaigns. 
Sample Declination of Influenza Vaccination Forms Sample1  Adobe PDF Document Sample2  Adobe PDF Document These sample forms can be customized and used to document declination of influenza vaccination.
Stickers: for Providers (CDC)  Adobe PDF Document These downloadable stickers can be printed on laser and inkjet printers. A sticker may be affixed to the badge of HCP who have received the influenza vaccination.

Influenza Vaccination Information (Immunization Program)



Educational Materials



Best Practices for Improving Influenza Immunization Coverage Amongst Healthcare Personnel This handout highlights high impact best practices to improve influenza immunization coverage amongst healthcare personnel. This handout also discusses possible barriers to improving influenza immunization coverage and strategies to address these barriers.

ACDC Influenza Health Education Materials

Link to ACDC Influenza Health Education Materials

Frequently Asked Questions about Influenza in Skilled Nursing Facilities for HCP and Residents & Visitors Adobe PDF Document

The FAQ sheet is provided as a quick reference to the most commonly asked questions about the Influenza in Skilled Nursing Facilities.

Poster: Customizable Poster Regarding Masking Adobe PDF Document This poster can be customized and used to remind HCP to get vaccinated or wear a mask.

Poster: Protect Your Patients, Your Co-workers, and Yourself  Adobe PDF Document

This poster can be used to educate employees about flu vaccination.

Poster: Visitors Are Welcome But the Flu is Not  Adobe PDF Document

This poster can be used to remind visitors not to visit patient/resident when they are sick with flu symptoms.

Influenza Specimen Collection and Infection Control



Influenza Specimen Collection (CDC) Guide  Adobe PDF Document  Poster Adobe PDF Document 

The desk reference guide and poster provide different methods for Influenza testing, packing, storing, shipping, and considerations.

Cover Your Cough Materials (CDC)

Printable formats of “Cover Your Cough” are available in different languages.

Respiratory Hygiene/Cough Etiquette in Healthcare Settings (CDC)

This resource site can be helpful in educating staff, visitors about respiratory hygiene/cough etiquette in health care settings.


Additional Resources

California Department of Public Health (CDPH)

Centers for Disease Control and Prevention (CDC)

New York State Department of Health

Public Health has made reasonable efforts to provide accurate translation. However, no computerized translation is perfect and is not intended to replace traditional translation methods. If questions arise concerning the accuracy of the information, please refer to the English edition of the website, which is the official version.
Los Angeles County Seal: Enriching lives through effective and caring services