OBJECTIVES: In 2009, voluntary public reporting of hospital health care personnel (HCP) vaccination rates began in Illinois. We describe our experience over 4 influenza seasons (2009-2013) and examine the impact universal policies have had on performance. METHODS: A secure website was used to report monthly HCP vaccination rates by each participating hospital. Overall and individual hospital performance was publicly reported each month.  Statistical analysis was performed to compare the HCP vaccination rate before and after adoption of a universal policy to compare HCP vaccination rate by policy type for each month of the flu season. RESULTS: In the first two seasons, there were 11 hospitals reporting with an average end of season rate of 76% (2009–2010) and 81% (2010–2011). In the 2011–2012 season, there were 22 hospitals reporting, 9 of which had a new universal policy for HCP influenza vaccination. The average 2011–2012 end of season rate was 72% for hospitals with a voluntary program and 95% for hospitals with a universal policy. HCP were also vaccinated earlier in the influenza season when a universal policy was in place, providing greater benefit over time.  We found that there was a statistically significant difference in vaccination rate by type of policy at both the beginning of the influenza season and at the end of the influenza season.  In the 2012-2013 season, there are 34 hospitals voluntary participating which reflects a huge increase in terms of public reporting of HCP influenza vaccinations; updated results will be presented. CONCLUSIONS: A variety of factors may contribute to the rate of hospital HCP influenza vaccination. Public reporting of HCP influenza vaccination rates may contribute to implementation of universal employee vaccination policies. Hospitals with universal policies have higher vaccination rates than those with voluntary vaccination programs.  Our study has demonstrated that implementation of a universal policy contributes to a dramatic increase in performance.