Impact of influenza vaccination policies on staff coverage in long-term care facilities

Abstract

Background: Influenza vaccine has been provided to staff of long-term care facilities (LTCFs) in Ontario through the public health program since 1993. To promote high levels of coverage, in 1999 the Ministry issued an influenza prevention and control protocol for LTCFs emphasizing staff vaccination. The protocol requires reporting of coverage by the facility, which facilitated an examination of factors associated with high and low rates. Methods: Coverage reports were collected and compared with reports of LTCF outbreaks. LTCFs from high and low coverage groups were selected for a survey of factors that contributed to higher immunization levels. Results: The majority of LTCFs had staff coverage rates greater than 70% and 38% had rates greater than 90%. 100 of these facilities were randomly selected and compared with 97 facilities with rates lower than 70%. A 77% response was achieved in both groups. Educational sessions, individual counseling and on-site immunization clinics were associated with higher coverage rates. The development of facility specific policies, particularly those with a policy that excluded unimmunized workers from the facility without pay during an outbreak, were associated with higher staff coverage rates. Conclusion: Influenza vaccination policies are an effective measure to increase staff influenza vaccination rates in LTCFs.