Low influenza vaccination rates among nursing home employees put residents at risk, study finds

Influenza is associated with as many as 7,300 deaths annually in nursing home residents, but the vaccination rate for nursing home staff is only 54 percent, according to a study in the February issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC).

Researchers from the Emory University Rollins School of Public Health and Florida Health Care Association surveyed 1,965 nursing home employees to determine influenza vaccination rates and beliefs. This study included 37 nursing homes in Florida, Georgia, and Wisconsin.

Despite previous studies demonstrating the inverse relationship between staff vaccination rates and the likelihood of an influenza outbreak, only 54 percent of all nursing home personnel received an influenza vaccination during the 2010-2011 and 2011-2012 seasons, according to the study. Conversely, previous research has shown that 72 percent of nursing home residents received the influenza vaccination. The susceptible elderly population relies on high staff vaccination rates for added protection against influenza outbreaks.

"As evidence accumulates questioning the effectiveness of the influenza vaccine in older adults, it is increasingly important to consider staff as a source of influenza transmission," the authors stress. "Low staff vaccination rates put vulnerable populations at risk of contracting influenza."

The survey also examined influenza vaccination beliefs among nursing home personnel. "Many employees hold inaccurate beliefs about influenza and vaccination," the researchers state. Survey respondents who perceived the vaccination to be effective were 28 percentage points more likely to receive the influenza vaccination. Additionally, nearly 40 percent of those surveyed incorrectly believed that the vaccine caused influenza. Respondents who believed the vaccine did not cause influenza were 12 percentage points more likely to get the vaccination.

"Vaccination rates would be higher if staff held accurate beliefs about vaccination and influenza," the researchers conclude.

APIC supports mandatory influenza vaccination as a condition of employment for healthcare personnel. Mandatory vaccination programs have proven to be the single most effective strategy to increase healthcare worker influenza vaccination rates.