KEYWORDS:
Adult Immunization; Immunization Rates; Standing Orders Programs; Long-Term Care

BACKGROUND:
Despite Healthy People 2010 goals of 90% for influenza and pneumococcal vaccination of residents of LTCs, self-reported data suggests that few LTC residents are adequately immunized.

OBJECTIVE(S):
To determine 1) coverage rates for influenza and pneumoccoal vaccination among LTC residents; and 2) association of coverage rates with vaccination practices in the LTC.

METHOD(S):
As part of the CMS-CDC Standing Orders Project, medical chart abstraction was used to collect pneumococcal and influenza vaccination information on 22,304 residents of 20 LTCs in each of 14 states. A survey was sent to all Directors of Nursing to collect information on vaccination practices, including the use of standing order programs which authorize non-physician staff to vaccinate without direct physician involvement at the time of vaccination.

RESULT(S):
Immunization data was abstracted from 21,619 (97%) of 22,304 residents sampled in 273 LTCs in 14 states. 58% of residents were immunized for influenza; 10 states had rates of >50% (range 27% - 74%). 33% of residents had received at least one pneumococcal vaccine; 3 states had rates of >50% (range 8% - 61%). Most (>80%) of vaccinated residents received influenza vaccine during Oct 15- November 30. For those residents not vaccinated for influenza, the most commonly cited reason was patient or family refusal (60%). Association of vaccination practices at the LTC with coverage rates will be presented.

CONCLUSIONS(S):
Success to reach HP2010 goals for influenza and pneumococal vaccination of LTC residents will require a dramatic increase from rates obtained in our study in 2000. Use of effective immunization programs in LTCs may be required to reach these goals.

LEARNING OBJECTIVES: