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

Published online by Cambridge University Press:  02 January 2015

Aaron M. Wendelboe ,
Catherine Avery ,
Bernardo Andrade ,
Joan Baumbach  and
Michael G. Landen
Aaron M. Wendelboe*
Affiliation:
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia Epidemiology and Response Division, New Mexico Department of Health, Santa Fe, New Mexico
Catherine Avery
Affiliation:
Epidemiology and Response Division, New Mexico Department of Health, Santa Fe, New Mexico
Bernardo Andrade
Affiliation:
Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
Joan Baumbach
Affiliation:
Epidemiology and Response Division, New Mexico Department of Health, Santa Fe, New Mexico
Michael G. Landen
Affiliation:
Epidemiology and Response Division, New Mexico Department of Health, Santa Fe, New Mexico
*
Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences, 801 NE 13th Street, Room 323, Oklahoma City, OK 73104 ([email protected])
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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.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 32 , Issue 10 , October 2011 , pp. 990 - 997
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2011

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