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Nace DA, Archbald-Pannone LR, Ashraf MS, Drinka PJ, Frentzel E, Gaur S, Mahajan D, Mehr DR, Mercer WC, Sloane PD, Jump RLP. Pneumococcal Vaccination Guidance for Post-Acute and Long-Term Care Settings: Recommendations From AMDA's Infection Advisory Committee. J Am Med Dir Assoc 2017; 18:99-104. [PMID: 28126142 DOI: 10.1016/j.jamda.2016.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 11/09/2016] [Indexed: 11/15/2022]
Abstract
Efforts at preventing pneumococcal disease are a national health priority, particularly in older adults and especially in post-acute and long-term care settings The Advisory Committee on Immunization Practices recommends that all adults ≥65 years of age, as well as adults 18-64 years of age with specific risk factors, receive both the recently introduced polysaccharide-protein conjugate vaccine against 13 pneumococcal serotypes as well as the polysaccharide vaccine against 23 pneumococcal serotypes. Nursing facility licensure regulations require facilities to assess the pneumococcal vaccination status of each resident, provide education regarding pneumococcal vaccination, and administer the appropriate pneumococcal vaccine when indicated. Sorting out the indications and timing for 13 pneumococcal serotypes and 23 pneumococcal serotypes administration is complex and presents a significant challenge to healthcare providers. Here, we discuss the importance of pneumococcal vaccination for older adults, detail AMDA-The Society for Post-Acute and Long-Term Care Medicine (The Society)'s recommendations for pneumococcal vaccination practice and procedures, and offer guidance to postacute and long-term care providers supporting the development and effective implementation of pneumococcal vaccine policies.
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Affiliation(s)
- David A Nace
- Division of Geriatric Medicine, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA.
| | - Laurie R Archbald-Pannone
- Divisions of General, Geriatric, Palliative, and Hospital Medicine and Infectious Diseases and International Health, Department of Internal Medicine, University of Virginia, Charlottesville, VA
| | - Muhammad S Ashraf
- Division of Infectious Diseases, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE
| | - Paul J Drinka
- Divisions of Internal Medicine and Geriatric Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | | | - Swati Gaur
- Northeast Georgia Health System, Gainesville, GA; Senior Care Advances, Gainesville, GA
| | - Dheeraj Mahajan
- Chicago Internal Medicine Practice and Research (CIMPAR), Chicago, IL; University of Illinois, Chicago, IL
| | - David R Mehr
- Department of Family and Community Medicine, University of Missouri-Columbia School of Medicine, Columbia, MO
| | - William C Mercer
- Peterson Rehabilitation Hospital and Geriatric Center, Wheeling, WV; Wheeling Ohio County Health Department, Wheeling, WV
| | - Philip D Sloane
- Program on Aging, Disability and Long-Term Care, Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC
| | - Robin L P Jump
- Geriatric Research Education and Clinical Center, Division of Infectious Diseases, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH; Division of Infectious Diseases and HIV Medicine, Department of Medicine, Case Western Reserve University, Cleveland, OH
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Marsteller JA, Tiggle R, Remsburg R, Shefer A, Bardenheier B. Influenza Immunization in Nursing Homes: Who Does Not Get Immunized and Whose Status Is Unknown? Infect Control Hosp Epidemiol 2016; 27:388-96. [PMID: 16622818 DOI: 10.1086/502686] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2005] [Accepted: 11/21/2005] [Indexed: 11/03/2022]
Abstract
Objective.To identify nursing home resident and facility characteristics associated with patients not receiving influenza immunization and having unknown immunization status.Design.Secondary data analysis using multinomial logistic regression of data from the National Nursing Home Survey, a nationally representative establishment-based survey.Setting.A total of 1,423 nursing facilities of all ownerships and certifications systematically sampled with probability proportional to number of beds.Patients.A total of 7,350 randomly sampled people aged 65 years or older residing in nursing homes between July and December 1999 (approximately 6 per facility).Main Outcome Measure.Immunization status of residents.Results.Fifteen percent of residents were not immunized and 19% had unknown immunization status. In multivariate analysis, lack of immunization and unknown immunization status were each separately associated with being newly admitted, with no or unknown pneumococcal immunization, and with facility failures to screen for immunization and to record inoculation in the medical record. High-risk status and staff immunization requirements had no effect. Separate analyses showed that residents with unknown immunization status are statistically significantly different from both those vaccinated and those not vaccinated.Conclusion.This study indicates that both resident and facility characteristics are associated with failure to be immunized for influenza. Facilities should consider targeting younger, newly admitted, and residential care residents for influenza immunization, since they are more likely to be missed. Further research into the barriers to immunization specific to nursing home resident choice or opportunity may be warranted.
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Affiliation(s)
- Jill A Marsteller
- Division of Health Care Statistics, National Center for Health Statistics, 3311 Toldeo Road, Hyattsville, MD 20782, USA.
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Nace DA. Improving Pneumococcal Vaccination Rates. J Am Med Dir Assoc 2003. [DOI: 10.1016/s1525-8610(04)70290-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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