Statewide Long Term Care (LTC) Facility Immunization Reporting Data: 2003-2009

Background: Although the ACIP and CDC recommend standing orders and immunization of residents and employees of LTCs, recommendation uptake and vaccination levels were unknown for Utah.  Due to infection control risks and the vulnerability of LTC residents to influenza and pneumonia, the Utah Department of Health initiated an immunization licensing rule to promote and monitor vaccination levels in nursing care, assisted living I & II, small care facilities and hospital swing beds.  

Setting: Utah Department of Health Bureau of Epidemiology, Bureau of Licensing and Immunization Program and all licensed LTCs in Utah.  

Population: LTC residents/occupants and employees.

Project Description: In December of 2002 a licensing rule was approved requiring all LTCs in Utah to offer and annually report resident influenza and pneumococcal vaccination and employee influenza vaccination.  An online reporting system was developed and data has been collected since 2003.  This data shows the level of rule compliance, the annual coverage rates for residents and employees and coverage trends over time.  Annual bound reports of aggregate data are distributed to LTC facilities, the Utah adult immunization coalitions, local health department immunization coordinators and epidemiologists and the Bureau of Licensing.  The report is also posted online.  Presentation analysis provides further comparison of rural and urban rates and rates by facility type and size.    

Results/Lessons Learned: Until 2009 rates for resident influenza vaccination remained consistently lower than Utah’s BRFSS rates and rates for resident pneumococcal vaccination remain over 20% lower than the BRFSS rate.  The employee influenza vaccination rate remains over 30% lower than the hospital HCW rate for the state.  Educational materials and immunization management tools have been provided since 2003, with little positive impact.  Public reporting of site specific data is slated to begin in 2011. It is hoped that competition and public disclosure will provide incentive for improvement.