Influenza Prevention and Control in Long-Term Care Facilities—Philadelphia, 2008

Influenza remains a significant cause of morbidity and mortality in residents of long-term care facilities (LTCFs). Low vaccination rates among LTCF staff increase the risk for facility-wide influenza outbreaks. During the 2007-2008 influenza season, the number of LTCF influenza outbreaks reported to the Philadelphia Department of Public Health (PDPH) was the highest on record. PDPH subsequently surveyed all Philadelphia LTCFs to identify gaps and successes in influenza prevention and control strategies.

In June 2008, PDPH mailed surveys to administrators of all Philadelphia LTCFs. The survey focused on facility demographics, administrator-reported influenza vaccination rates and practices, surveillance, and outbreak prevention and control measures. Wilcoxon tests measured differences in vaccination rates according to size and ownership.

Forty-one of 49 LTCFs returned a completed survey. Median influenza vaccination rates were 84% for residents and 37% for direct-care staff. Personal reasons (85%) were cited as the main basis for staff vaccination refusal. Vaccination rates for residents or direct-care staff did not differ by facility size, ownership type, or presence of a reported outbreak. All facilities offered the flu vaccine to both residents and staff on-site and at no cost. The implementation of recommended outbreak control measures varied.

Vaccination rates among Philadelphia LTCF direct-care staff are consistent with poor national averages despite minimal cost and access barriers. LTCFs should implement recommended influenza infection control strategies annually. PDPH is using the survey results to develop targeted public health educational materials in an effort to boost vaccination rates and standardize influenza prevention practices within LTCFs.