Trends in Influenza and Pneumococcal Vaccination Among US Nursing Home Residents, 2006-2014.
Carla L Black, Walter W Williams, Inaki Arbeloa and 5 others
PMID 28623156WHAT IT FOUND
Influenza vaccination coverage in US nursing homes reached 75.7% in 2014-15, and pneumococcal coverage stayed about 78-80% through 2014.
Most unvaccinated residents had been offered vaccine and declined, though unvaccinated non-white residents were less often offered vaccine.
Key findings
01Influenza vaccination coverage was 75.7% in the 2014-15 season, an increase of 4.3 percentage points since 2005-06, and 2.7 percentage points below the 78.4% peak in 2009-10.
02Pneumococcal vaccination coverage increased from 67.4% in 2006 to 79.9% in 2009, then remained about 78-80% through 2014.
03In 2014-15, 71.9% of unvaccinated residents were offered influenza vaccine and declined, and 10.6% had not been offered; in 2014, 73.2% of unvaccinated residents were offered pneumococcal vaccine and declined, and unvaccinated non-white residents were less likely than unvaccinated white residents to be offered vaccine.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Vaccination status was reported by individual facilities to the MDS, and the paper says there were no quality checks to ensure assessments were conducted uniformly. Influenza status had one validation study; agreement varied by facility and state, and pneumococcal status had no published validation. Some residents had inconsistent vaccination entries across assessments, and how those entries were handled could change coverage estimates. The study describes coverage and associations, not the effect of any vaccination strategy, so it cannot show that standing orders, reminders, or education improved vaccination. Pneumococcal coverage estimates for 2014 may not fully reflect a September 2014 recommendation change for PCV13 and PPSV23. The analysis covers CMS-certified nursing homes and long-term care facilities only, so it does not describe residents outside those settings.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the rise in coverage as proof that all nursing home residents were offered vaccine or that racial disparities were only due to refusal. Unvaccinated non-white residents were less likely than unvaccinated white residents to be offered vaccine, and the study did not test vaccination strategies.