Flu vaccination up among LTC workers, down among older adults

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CDC Director Tom Frieden, M.D., M.P.H., right, gets a flu shot from Sharon of MedStar Visiting Nurse Association during a Sept. 29 press conference. (Photo by Lois A. Bowers)
CDC Director Tom Frieden, M.D., M.P.H., right, gets a flu shot from Sharon of MedStar Visiting Nurse Association during a Sept. 29 press conference. (Photo by Lois A. Bowers)

The good news is that influenza vaccination is up among those working in long-term care settings. The bad news is that the inoculation rate among LTC workers remains lower than it is among workers in other healthcare settings. Also, one-third of adults aged 65 or more years are not getting vaccinated.

That's according to public health officials citing data from the 2015-2016 flu season at a press conference Thursday as well as information in the Sept. 30 issue of the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report, which also was published Thursday.

During the 2015-2016 flu season, the vaccination rate among LTC workers was 69.2%, up from 63.9% the previous year and up 17 percentage points since the 2011-2012 flu season.

“Although low, this is the only [healthcare] setting with an appreciable increase in coverage compared with last season,” the MMWR authors noted. “Influenza vaccination among healthcare personnel in long-term care settings is especially important because influenza vaccine effectiveness is generally lowest in the elderly. In addition, multiple studies have demonstrated that vaccination of healthcare personnel in long-term care settings confers a health benefit to patients, including reduced risk for mortality.”

Requiring or promoting vaccination and making vaccination available on-site at no cost are some of the ways that LTC communities can increase vaccination among workers, according to the authors. Communities will want to ensure that any vaccination policies they implement are not discriminatory, however; on Monday, the U.S. Equal Employment Opportunity Commission announced that it is suing a health system for not granting accommodations to six employees who objected to its flu vaccination policy on religious grounds.

Public health officials recommend vaccination as soon as possible but by the end of October at the latest because of the unpredictability of the flu season.

“A vaccination deferred is often a vaccination forgotten,” CDC Director Tom Frieden, M.D., M.P.H., said at the press conference, which was held by the National Foundation for Infectious Diseases and the CDC.

Vaccination among older adults

Although the vaccination rate among LTC workers is encouraging, the decrease in inoculation among older adults is concerning, Frieden said. “We saw about a 3% decrease in flu vaccination rates in both the 50-to-64s and also the 65s-and-over,” he said.

Vaccination “substantially reduces the risk of hospitalization, especially in people over 50, people with lung disease or diabetes or heart disease,” Frieden said, noting that the hospitalization rate from the flu is highest among people aged more than 65 years and that second-highest hospitalization rate due to flu is among  those aged 50 to 64 years.

Flu hits the elderly the hardest, Wilbur H. Chen, M.D. (pictured), an associate professor at the University of Maryland School of Medicine, told those at the press conference.

“Seventy [percent] to 90% of influenza deaths that occur every year occur in the population of 65 years and older,” said Chen, who also is chief of the adult clinical studies section at the Center for Vaccine Development and director of the UMB Travelers' Health Clinic. “For hospitalizations, 50 [percent] to 70% of hospitalizations due to flu occur in the 65-and-over population. So the older adult population is an important population for us to target, not just for influenza but for pneumococcal vaccination as well.”

Public health officials recommend that those aged 65 or more years and those with certain chronic health conditions get vaccinated against pneumonia.

“Unfortunately, if you look just at people over the age of 65, four out of 10 still haven't been vaccinated against pneumonia,” Frieden said. “So we have much further to go in terms of pneumonia vaccination, and it's a great idea to get your pneumonia vaccine at the same time you get your flu vaccine.”

For more information about this year's flu vaccination recommendations, see “Shots in, sprays out for 2016-2017 flu season.”

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