Skip to main content
×
Home
    • 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)...
Abstract
Objective.

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.

Methods.

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.

Results.

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]).

Conclusions.

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

Copyright
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 (Aaron-Wendelboe@ouhsc.edu)
References
Hide All
1. Centers for Disease Control and Prevention. Leading causes of death. FastStats Web site. http://www.cdc.gov/nchs/FASTATS/lcod.htm. 2009. Accessed July 28, 2009.
2. Centers for Disease Control and Prevention. Infection control measures for preventing and controlling influenza transmission in long term care facilities, http://www.cdc.gov/flu/professionals/infectioncontrol/longtermcare.htm. 2008. Accessed July 28, 2009.
3. McArthurMA, SimorAE, CampbellB, McGeerA. Influenza vaccination in long-term-care facilities: structuring programs for success. Infect Control Hosp Epidemiol 1999;20(7):499503.
4. ShugarmanLR, HalesC, SetodjiCM, BardenheierB, LynnJ. 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. RivettiD, JeffersonT, ThomasR, et al. Vaccines for preventing influenza in the elderly. Cochrane Database Syst Rev 2006;3: CD004876.
6. NicholKL, WuorenmaJ, von SternbergT. Benefits of influenza vaccination for low-, intermediate-, and high-risk senior citizens. Arch Intern Med 1998;158(16):17691776.
7. Influenza vaccines. Wkly Epidemiol Rec 2005;80(33):279287.
8. PearsonML, BridgesCB, HarperSA. Influenza vaccination of health-care personnel: recommendations of the Healthcare Infection Control Practices Advisory Committee (HICPAC) and the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2006;55(RR-2):116.
9. PotterJ, StottDJ, RobertsMA, 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. CarmanWF, ElderAG, WallaceLA, 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. HaywardAC, HarlingR, WettenS, 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. van den DoolC, BontenMJ, HakE, HeijneJC, WallingaJ. The effects of influenza vaccination of health care workers in nursing homes: insights from a mathematical model. PLoS Med 2008; 5(10):e200.
13. HarperSA, BradleyJS, EnglundJA, 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.
14. Centers for Disease Control and Prevention. Update: influenza activity, United States, September 30-December 1, 2007. MMWR Morb Mortal Wkly Rep 2007;56(49):12871291.
15. StokesME, DavisCS, KochGG. Categorical Data Analysis Using the SAS System. Cary, NC: SAS Institute; 2000.
16. R Development Core Team. R: A language and environment for statistical computing [computer program]. Vienna: R Foundation for Statistical Computing; 2009.
17. HighKP, BradleySF, GravensteinS, 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.
18. Centers for Disease Control and Prevention. Flu season summary (October 1, 2006-May 19,2007). 2006-07 Influenza (Flu) Season Web site, http://www.cdc.gov/flu/about/qa/0607season.htm. 2007. Accessed July 30, 2009.
19. Centers for Disease Control and Prevention. Flu season summary (September 30, 2007-May 17, 2008). 2007-2008 Influenza (Flu) Season 2008 Web site, http://www.cdc.gov/flu/weekly/weeklyarchives2007-2008/07-08summary.htm. 2008. Accessed July 30, 2009.
20. BolyardEA, TablanOC, WilliamsWW, PearsonML, ShapiroCN, DeitchmannSD. Guideline for infection control in health-care personnel, 1998. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1998;19(6): 407463.
21. Centers for Disease Control and Prevention. Guide to community preventive services. National Center for Health Marketing Web site. http://www.thecommunityguide.org/vaccines/targeted/indexhtml. 2009. Accessed December 4, 2009.
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? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 5 *
Loading metrics...

Abstract views

Total abstract views: 298 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 20th October 2017. This data will be updated every 24 hours.