Background Institutionalized adults are at increased risk of morbidity and mortality from influenza and pneumococcal infection. Influenza and pneumococcal vaccination have been shown to be effective in reducing hospitalization and deaths due to pneumonia and influenza in this population. Objective Assess trends in influenza vaccination coverage among U.S. nursing home residents from the 2005–06 through 2014–15 influenza seasons and trends in pneumococcal vaccination coverage from 2006–2014 among U.S. nursing home residents, by state and demographic characteristics. Methods Data were analyzed from the Centers for Medicare and Medicaid Services’ (CMS) Minimum Data Set (MDS). Influenza and pneumococcal vaccination status were assessed for all residents of CMS-certified nursing homes using data reported to the MDS by all certified facilities. Results Influenza vaccination coverage increased from 71.4% in the 2005–06 influenza season to 75.7% in the 2014–15 influenza season and pneumococcal vaccination coverage increased from 67.4% in 2006 to 78.4% in 2014. Vaccination coverage varied by state, with influenza vaccination coverage ranging from 50.0% to 89.7% in the 2014–15 influenza season and pneumococcal vaccination coverage ranging from 55.0% to 89.7% in 2014. Non-Hispanic black and Hispanic residents had lower coverage compared with non-Hispanic white residents for both vaccines, and these disparities persisted over time. Conclusion Influenza and pneumococcal vaccination among U.S. nursing home residents remains suboptimal. Nursing home staff should employ strategies such as provider reminders and standing orders to facilitate offering vaccination to all residents along with culturally-appropriate vaccine promotion to increase vaccination coverage among this vulnerable population.

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Fibroids affect most women, up to 80% of black women, and nearly 70% of white women in the United States by the age of 50 years, 1 and the incidence of fibroids increases with age up to menopause. 2 Risk factors for fibroids include reproductive factors (i.e., nulliparity, early menarche, and early use of combined oral contraceptive pills) and genetic factors. 3 Fibroids rarely undergo malignant transformation. Leiomyosarcomas are thought to arise de novo, with the incidence of occult uterine sarcoma upon resection for leiomyoma approximately 0.3%. 4 Nevertheless, symptomatic fibroids are the most common indication for hysterectomies in the United States. 5 Although many women are asymptomatic, approximately 20% to 50% of women with fibroids experience symptoms, 6 including abnormal uterine bleeding with associated anemia,

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