Online Program

A novel approach to improving employee influenza vaccination rates in long-term care facilities

Monday, November 2, 2015

Cori Ofstead, MSPH, Ofstead & Associates, Inc., Saint Paul, MN
Litjen Tan, MS, PhD, Immunization Action Coalition, Saint Paul, MN
Miriam Amelang, BA, Ofstead & Associates, Inc., Saint Paul, MN
Evan Doyle, BS, Ofstead & Associates, Inc., Saint Paul, MN
Otis Heymann, BA, Ofstead & Associates, Inc., Saint Paul, MN
Gavin Mark, BS, CNA, Ofstead & Associates, Inc., Saint Paul, MN
Harry Wetzler, MD, MSPH, Ofstead & Associates, Inc., Saint Paul, MN
Background: Annual influenza vaccination is recommended for all healthcare professionals (HCPs). Influenza vaccination rates in long-term care facilities (LTCFs) remain lower than in hospitals and are particularly low among nursing assistants. Outbreaks of influenza-like illness (ILI) occur in LTCFs despite high resident vaccination rates.

Methods: The Vaccination Intervention for Nursing Assistants and Aides (VINAA) program assessed barriers to vaccination in four Midwestern LTCFs and implemented customized, evidence-based interventions. Baseline data on vaccination policies and practices, HCP illness and absenteeism, attitudes about vaccination, and immunization rates were collected from administrative records, management interviews, and HCP surveys. Interventions included engaging leadership and union representatives, setting vaccination goals, implementing declination policies, and offering educational programs and kick-off events.

Results: At baseline, all LTCFs offered free on-site vaccination, but lacked formal policies, tracking mechanisms, and educational programs. Employee turnover was high (22%, 81%, 99%, 141% annually), and absenteeism due to ILI was common (21% to 35%). Overall, 20% of HCPs were uninsured. Misconceptions about influenza and vaccination were common among unvaccinated HCPs (59% believed vaccine transmits influenza; 39% believed they did not need vaccination). Only 31% of HCPs’ high-risk dependents received influenza vaccination. Baseline HCP vaccination rates were low and increased following interventions (5% to 76%, 47% to 89%, 62% to 79%, 75% to 99%).

Conclusions: LTCFs lack robust employee vaccination programs and have low HCP influenza immunization rates. ILI contributes to absenteeism and lost productivity. Interventions including new policies, goal-setting, improved tracking mechanisms, and educational programs significantly improved vaccination rates in these LTCFs.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Occupational health and safety
Protection of the public in relation to communicable diseases including prevention or control
Public health or related research

Learning Objectives:
Discuss the impact of influenza-like illness on employee productivity and economics in long-term care facilities Describe common barriers to influenza vaccination for long-term care facility employees Explain strategies that increased the uptake of influenza vaccine among nursing staff in long-term care facilities

Keyword(s): Immunizations, Long-Term Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the co-principal investigator for the Vaccination Intervention for Nursing Assistants and Aides (VINAA) Study, and have designed and conducted several other studies related to occupational health, wellness programs, and infection prevention. I serve as a reviewer for three journals (AJIC, Vaccine, and Preventive Medicine), and I have spoken at several national conferences. I am an active member of the Occupational Health section of APHA.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Pfizer Adult vaccination Research grant

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.