Skip to main content
    • Aa
    • Aa

Importance of Employee Vaccination against Influenza in Preventing Cases in Long-Term Care Facilities

  • Aaron M. Wendelboe (a1) (a2), Catherine Avery (a2), Bernardo Andrade (a3), Joan Baumbach (a2) and Michael G. Landen (a2)...

Employees of long-term care facilities (LTCFs) who have contact with residents should be vaccinated against influenza annually to reduce influenza incidence among residents. This investigation estimated the magnitude of the benefit of this recommendation.


The New Mexico Department of Health implemented active surveillance in all of its 75 LTCFs during influenza seasons 2006-2007 and 2007-2008. Information about the number of laboratory-confirmed cases of influenza and the proportion vaccinated of both residents and direct-care employees in each facility was collected monthly. LTCFs reporting at least 1 case of influenza (defined alternately by laboratory confirmation or symptoms of influenza-like illness [ILI]) among residents were compared with LTCFs reporting no cases of influenza. Regression modeling was used to obtain adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for the association between employee vaccination coverage and the occurrence of influenza outbreaks. Covariates included vaccination coverage among residents, the staff-to-resident ratio, and the proportion of filled beds.


Seventeen influenza outbreaks were reported during this 2-year period of surveillance. Eleven of these were laboratory confirmed (n = 21 residents) and 6 were defined by ILI (n = 40 residents). Mean influenza vaccination coverage among direct-care employees was 51% in facilities reporting outbreaks and 60% in facilities not reporting outbreaks (P = .12). Increased vaccination coverage among direct-care employees was associated with fewer reported outbreaks of laboratory-confirmed influenza (aOR, 0.97 [95% CI, 0.95-0.99]) and ILI (aOR, 0.98 [95% CI, 0.96-1.00]).


High vaccination coverage among direct-care employees helps to prevent influenza in LTCFs.

Corresponding author
Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences, 801 NE 13th Street, Room 323, Oklahoma City, OK 73104 (
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

4. LR Shugarman , C Hales , CM Setodji , B Bardenheier , J Lynn . The influence of staff and resident immunization rates on influenza-like illness outbreaks in nursing homes. J Am Med Dir Assoc 2006;7(9):562567.

5. D Rivetti , T Jefferson , R Thomas , et al. Vaccines for preventing influenza in the elderly. Cochrane Database Syst Rev 2006;3: CD004876.

6. KL Nichol , J Wuorenma , T von Sternberg . Benefits of influenza vaccination for low-, intermediate-, and high-risk senior citizens. Arch Intern Med 1998;158(16):17691776.

9. J Potter , DJ Stott , MA Roberts , et al. Influenza vaccination of health care workers in long-term-care hospitals reduces the mortality of elderly patients. J Infect Dis 1997;175(1):16.

10. WF Carman , AG Elder , LA Wallace , et al. Effects of influenza vaccination of health-care workers on mortality of elderly people in long-term care: a randomised controlled trial. Lancet 2000; 355(9198):9397.

11. AC Hayward , R Harling , S Wetten , et al. Effectiveness of an influenza vaccine programme for care home staff to prevent death, morbidity, and health service use among residents: cluster randomised controlled trial. BMJ 2006;333(7581):1241.

12. C van den Dool , MJ Bonten , E Hak , JC Heijne , J Wallinga . The effects of influenza vaccination of health care workers in nursing homes: insights from a mathematical model. PLoS Med 2008; 5(10):e200.

13. SA Harper , JS Bradley , JA Englund , et al. Seasonal influenza in adults and children: diagnosis, treatment, chemoprophylaxis, and institutional outbreak management: clinical practice guide-lines of the Infectious Diseases Society of America. Clin Infect Dis 2009;48(8):10031032.

17. KP High , SF Bradley , S Gravenstein , et al. Clinical practice guide-lines for the evaluation of fever and infection in older adult residents of long-term care facilities: 2008 update by the Infectious Diseases Society of America. Clin Infect Dis 2009;48(2): 149171.

20. EA Bolyard , OC Tablan , WW Williams , ML Pearson , CN Shapiro , SD Deitchmann . Guideline for infection control in health-care personnel, 1998. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1998;19(6): 407463.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Full text views

Total number of HTML views: 0
Total number of PDF views: 4 *
Loading metrics...

Abstract views

Total abstract views: 192 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 23rd May 2017. This data will be updated every 24 hours.