Prevalence and predictors of influenza vaccination among residents of long-term care facilities

Hao Yi Tan; Elisa Lai; Mohana Kunasekaran; Abrar A Chughtai; Mallory Trent; Christopher J Poulos; Chandini R MacIntyre

doi:10.1016/j.vaccine.2019.09.021

Prevalence and predictors of influenza vaccination among residents of long-term care facilities

Vaccine. 2019 Oct 8;37(43):6329-6335. doi: 10.1016/j.vaccine.2019.09.021. Epub 2019 Sep 13.

Authors

Hao Yi Tan¹, Elisa Lai¹, Mohana Kunasekaran², Abrar A Chughtai¹, Mallory Trent³, Christopher J Poulos⁴, Chandini R MacIntyre²

Affiliations

¹ School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, Australia.
² The Biosecurity Program, Kirby Institute, UNSW Medicine, University of New South Wales, Sydney, Australia.
³ The Biosecurity Program, Kirby Institute, UNSW Medicine, University of New South Wales, Sydney, Australia. Electronic address: mallory.trent@unsw.edu.au.
⁴ School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, Australia; HammondCare, Sydney, Australia.

PMID: 31526622
DOI: 10.1016/j.vaccine.2019.09.021

Abstract

Influenza is a respiratory illness which results in significant morbidity and mortality, especially in the older population. Older people living in Long-Term Care Facilities (LTCFs) have a significantly higher risk of infection and complications from influenza. Influenza vaccine is considered the best strategy to prevent infection in high-risk populations. In Australia, the Communicable Diseases Network Australia (CNDA) suggests a vaccination coverage rate of 95% in both staff and residents¹. This study aims to measure the vaccination coverage rates for residents in LTCFs and identify predictors of vaccination uptake for these individuals. This study was conducted in nine LTCFs in four sites from March to September 2018. This was done via medical record reviews for residents over 65 years old in these LTCFs, collecting information such as vaccination status, age, gender, ethnicity and occupation. Simple and multivariable logistic regression was used to calculate the Odds Ratio (OR) to determine significant predictors of influenza vaccination uptake. The overall vaccination rate among LTCF residents was 83.6%. Significant predictors of vaccination were LTCF location, ethnicity and previous year vaccination status. Residents in LTCF Site D were less likely to be vaccinated compared to Site A (OR 0.11, 95% CI 0.02-0.61), non-Caucasians were less likely to get vaccinated (OR 0.09, 95% CI 0.01-0.67), and residents who refused the 2017 vaccine were less likely to be vaccinated (OR 0.04, 95% CI 0.01-0.15). Compared with previous Australian studies on LTCF vaccination rates, the overall vaccination rate was high in these LTCFs (83.6% versus 66-84%), but it varied across different sites. Reasons for varying vaccination rates should be explored further - for example, lower rates in non-Caucasians with diverse cultural backgrounds. Better understanding the causes of under-vaccination can help improve vaccination programs in LTCFs.

Keywords: Aged care; Ageing; Influenza; Long term care facilities; Outbreaks.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Australia / epidemiology
Disease Outbreaks / prevention & control*
Female
Humans
Influenza Vaccines / administration & dosage*
Influenza, Human / epidemiology
Influenza, Human / prevention & control*
Logistic Models
Long-Term Care
Male
Nursing Homes*
Odds Ratio
Prevalence
Vaccination Coverage / statistics & numerical data*

Substances

Influenza Vaccines