Should staff in long-stay hospitals for elderly patients be vaccinated against influenza?

Abstract

Most people who die from influenza are aged over 75 years and have a chronic medical disorder, and about half the deaths from influenza occur in people in residential care. 1 Ahmed AE Nicholson KG Nguyen-Van-Tam JS Reduction in mortality associated with influenza vaccine during 1989–90 epidemic. Lancet. 1995; 346: 591-595 Summary PubMed Google Scholar Many European countries, including the UK, target nursing-home residents for vaccination.2 Although influenza vaccination of the elderly is associated with substantial reductions in morbidity and mortality, outbreaks of influenza can occur in care facilities for the elderly despite influenza vaccination of a high proportion of residents (85%) and nursing staff (34–46%). 3 Drinka PJ Gravenstein S Krause P Schilling M Miller BA Shult P Outbreaks of influenza A and B in a highly immunized nursing home population. J Fam Pract. 1997; 45: 509-514 PubMed Google Scholar , 4 Drinka PJ Gravenstein S Schilling M Krause P Miller BA Shult P Duration of antiviral prophylaxis during nursing home outbreaks of influenza A: a comparison of 2 protocols. Arch Intern Med. 1998; 158: 2155-2159 Crossref PubMed Scopus (34) Google Scholar In a comparison of homes where outbreaks occurred with those with only sporadic cases, the former were larger and had lower vaccination rates among residents. 5 Patriarca PA Weber JA Parker RA et al. Risk factors for outbreaks of influenza in nursing homes. A case-control study. Am J Epidemiol. 1986; 124: 114-119 Crossref PubMed Scopus (94) Google Scholar Effects of influenza vaccination of health-care workers on mortality of elderly people in long-term care: a randomised controlled trialVaccination of health-care workers was associated with a substantial decrease in mortality among patients. However, virological surveillance showed no associated decrease in non-fatal influenza infection in patients. Full-Text PDF