Preventing the Spread of Seasonal Flu: Measuring the Impact of a Voluntary Program on Influenza Immunization Coverage among Long Term Care Facility Residents and Employees

Over 200,000 individuals are hospitalized for influenza annually, a disproportionate number are over 65 and more likely to reside in long-term care facilities (LTCFs). On April 1, 2000, New York State enacted the Long-Term Care Resident and Employee Immunization Act for LTCFs. This law requires LTCFs to provide optional influenza vaccines to all residents and employees and report coverage to the New York State Department of Health (NYSDOH). Without a mandate for immunization of healthcare workers and residents, there is a need to monitor trends in vaccination coverage rates and to determine whether the current law is sufficient to improve immunization coverage.

Annual immunization report data from 2000-2007 was analyzed to identify trends in immunization coverage for employees and residents of NYS LTCFs. Site visits were made to LTCFs to provide educational resources on adult immunizations and methods for immunization coverage and reporting improvement.

The mean influenza vaccination coverage for residents reported in NYS LTCFs during 2000-2007 was 84.0% (Range: 82 - 86%). Immunization levels for employees fall far below that of residents at only 36% (Range: 32 - 42%). Despite efforts to improve immunization coverage, there have been no major increases in immunization levels since 2000.

Continued low influenza immunization coverage of LTCF employees is evidence that optional immunization programs have not been effective and that residents are continually put at risk. The results of this analysis will contribute objective data to assess the need for an influenza vaccine mandate for healthcare workers in LTCFs and other settings.