Senior living communities that successfully encourage flu vaccination among staff members may have a marketing advantage over competing communities, a new study suggests.

The University of Michigan Institute for Healthcare Policy and Innovation polled a nationally representative sample of 2,007 Americans aged 50 to 80 years in research sponsored by AARP and Michigan Medicine, the university’s academic medical center.

Seventy-three of respondents said that medical staff members at assisted living and nursing homes should be vaccinated against influenza, and 71% said that nonmedical staff should be vaccinated.

Poll participants felt so strongly about flu vaccination that 70% said that if they found out that one-third of a community’s staff members were not vaccinated, then they would be less likely to choose the community for themselves or their loved ones.

Only 68% of long-term care workers, including those in assisted living, were vaccinated against the flu in 2016-2017, compared with more than 92% of hospital workers, the Centers for Disease Control and Prevention said in September. The federal agency recommends vaccination for anyone aged more than 65 years, those with chronic health conditions and those who work with older adults, among others.

“We’ve finally gotten to the point in the last few years where most inpatient hospitals require their staff to get vaccinated against the flu, or at least strongly promote it,” Preeti Malani, M.D., director of the poll and a professor of internal medicine at the U-M Medical School, said in a statement. “These results suggest that other types of care facilities should do the same to protect vulnerable patients — or potentially risk losing business.”

Most respondents (93%) said that assisted living communities and nursing homes should offer flu shots to staff members at work, at no charge, an approach that the CDC said increases vaccination rates. In 2016-2017, according to the agency, coverage among healthcare workers was highest among workers who were required by their employers to be vaccinated (97%) and lowest among those working in settings where vaccination was not required, promoted or offered onsite (46%).

Fifty-five percent of survey-takers said that flu vaccination should be mandatory for staff members to keep their jobs. Communities will want to ensure that any vaccination policies they implement are not discriminatory, however. A Pennsylvania health center, for instance, was sued by the U.S. Equal Employment Opportunity Commission in 2016 and subsequently agreed to pay $300,000 in back pay and compensatory damages after firing six employees who objected to a flu vaccination policy on religious grounds.