Policies to increase influenza and pneumococcal immunizations in chronically ill and institutionalized settings

• Published in: American journal of infection control 2005-10, Vol.33 (8), p.463-468
• Main Authors: Goldstein, Adam O., Kincade, Jean E., Resnick, Jennifer E., Gamble, George, Bearman, Rachel S.
• Format: Article
• Language: English
• Subjects: Ambulatory Care Facilities; Assisted Living Facilities; Bacterial diseases; Biological and medical sciences; Epidemiology. Vaccinations; General aspects; Health Policy; Home Care Agencies; Hospitals; Human bacterial diseases; Human viral diseases; Humans; Immunization Programs; Infectious diseases; Influenza Vaccines - administration & dosage; Influenza, Human - prevention & control; Interviews as Topic; Medical sciences; Miscellaneous; North Carolina; Nursing Homes; Pneumococcal Infections - prevention & control; Pneumococcal Vaccines - administration & dosage; Public health. Hygiene; Public health. Hygiene-occupational medicine; Staphylococcal infections, streptococcal infections, pneumococcal infections; Viral diseases; Viral diseases of the respiratory system and ent viral diseases
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2005.01.008

The objective of this study was to understand better the status of and ways to improve dissemination of influenza and pneumococcal standing-order vaccination policies to at-risk adults in health care institutions. A statewide sample of 5 different types of institutions serving at-risk elderly persons in North Carolina was surveyed. A 45-question telephone survey was administered to infection control nurses or facility directors at 267 (86% response rate) health care facilities involved in direct patient care. A majority of respondents reported that influenza (81%) and pneumococcal (59%) diseases were important to their facility, and 63% stated that the influenza vaccine was very effective versus 47% for pneumococcal. Except nursing homes, few facilities reported adoption of standing-order policies to vaccinate routinely the at-risk adults. Over 70% of respondents stated that their facilities might consider adopting standing-order policies for influenza and pneumococcal disease. A majority of respondents also supported a state law that requires such vaccines for high-risk patients unless contraindicated or the patient refuses. Respondents across diverse health care institutions appear interested in adopting standing-order policies to increase influenza and pneumococcal vaccination rates and are more likely to do so if provided with appropriate administrative and/or financial support for implementation.