Long-Term Care Survey Alert

Published on Sat Jan 17, 2004 PDF

The flu epidemic has been big news this season, and Long-Term Care Survey Alert has received numerous reader questions about  flu immunization. We've combined these below with answers from   our experts.
 
Question: How far into the season should we immunize residents against the flu?
 
Answer: Facilities should continue to provide flu vaccinations to new admissions through the end of the flu season in March, advises James Marx, RN, CIC, principal of BroadStreet Solutions in San Diego. "Facilities do a good job of immunizing people at the start of the season in November but should continue giving the flu shots throughout the season," he says.
 

Question: How much protection does the flu shot really offer to residents - even when it contains the flu strains causing illness?
 
Answer: Even when the flu vaccine contains the strains causing the flu during any given season, only about 60 percent of elderly people will obtain full immunity, according to Marx. "Some of those will only have lessened severity of symptoms, but that may be enough to prevent the same rate of hospitalization that would occur without the flu vaccination."
 

Question: Why didn't the flu vaccine contain the Fujian strain causing the deaths in this year's outbreaks? Does the flu vaccine offer much protection against this strain of flu?
 
Answer: Last spring, the Fujian strain hadn't presented itself, so it wasn't included as part of the vaccine, reports Centers for Disease Control & Prevention spokeswoman Rhonda Smith. "But there are strains in the vaccine similar to the mutant Fujian strain," she adds. "And CDC believes that the vaccine may thus provide some protective effects - how much and how effective it will be in preventing the    flu or decreasing the severity of Fujian flu symptoms remain to     be seen."
 

Question: Can facilities get cited for not providing the flu vaccine to all residents?
 
Answer: Some facilities have been cited under an infection control tag when they record "0" for flu and immunizations on the roster of resident conditions, Marx observes.

Also keep in mind that there's a difference between offering and administering the flu vaccination, adds Richard Butler, JD, a survey consultant in Indianapolis. "The facility should, as part of good clinical practice, offer the flu and pneumonia vaccination to all residents, unless contraindicated," he advises. "Document instances where the  resident refused the vaccination  and why."