Influenza and Pneumococcal Vaccination in Long Term Care Facilities in Two Regions of Quebec

Abstract

OBJECTIVES: To evaluate the use of influenza and pneumococcal vaccines in long term care facilities.DESIGN: Cross-sectional survey in a random sample of 30 facilities in two regions of Quebec. Information was collected from the general manager or the chief of nursing, all consultant physicians and a random sample of 20 residents in each facility.RESULTS: Twenty-nine centres agreed to participate. The mean influenza vaccination rate was 70%, and was not influenced by differences in the types of facilities or the organization of the programs for immunization. The main obstacle to influenza vaccination reported by physicians was nonacceptance by a significant proportion of residents. Of the residents who did not initially request influenza vaccine, only 64% accepted vaccination when it was offered. The vast majority of residents were satisfied with the information they had received and the respect shown for their freedom of choice. Forty per cent of residents were unfit to provide a valid consent and the vaccination rate was 76% in this group. Only one-third of the physicians regularly obtained authorization from a relative or the legal guardian before prescribing vaccination for incompetent residents. None of the facilities studied had an effective program for pneumococcal vaccination, only 43% of the physicians reported any use of pneumococcal vaccine and 98% of residents had never heard of the vaccine.CONCLUSIONS: The national objective of 95% coverage with influenza vaccine will be difficult to achieve in long term care facilities, mainly because a minority of residents are not likely to be convinced of the benefit of immunization. Much remains to be done to promote and administer pneumococcal vaccine in this setting.

Tracking Influenza Immunization in the Community

“…Currently, influenza vaccination rates of eligible groups are much lower than the target rate of 90%, since vaccination rates of residents living in long term care facilities is only 70%, and only 20% to 40% of adults and children with medical conditions that leave them susceptible to complications related 2 to influenza, receive the vaccine annually (Duclos, Arruda, & Dessau, 1996;Dewals, Carbonneau, & Payette, 1996). Studies of health care workers in hospitals and long term care facilities have shown influenza vaccination rates of 26% to 61% (Potter, Stott, & Roberts, 1999;Wilde, McMillan, & Serwint, 1999;Nichol & Hauge, 1997).…”

Influenza Vaccination

“…3 Recent studies also reveal that only 26-61% of health care workers become vaccinated. [4][5][6][7] Sub-optimal vaccination rates among health care providers are of particular concern as unvaccinated personnel can act as transmission vectors to high-risk patients. Health care workers also play an important role in the education of patients and their families about influenza vaccination and may be viewed as role models by their patients.…”

Influenza Vaccination in Long-Term–Care Facilities: Structuring Programs for Success

“…13 Although influenza vaccination programs in LTCFs have been shown to be effective in increasing vaccination rates and decreasing morbidity, the characteristics of such programs are not well described, and vaccination rates in LTCFs continue to lag behind public-health targets. 14 ' 15 Although several reports have documented that the method of obtaining consent [16][17][18][19][20][21] and the presence of written policies 1722 ' 23 are associated with increased influenza vaccination rates of residents, there is little systematic information available on the characteristics of successful influenza vaccination programs. We undertook a survey of Canadian LTCFs to determine which aspects of vaccination programs were associated with increased influenza vaccination rates of residents and staff.…”