Use of Influenza Vaccine in stay Geriatric Units

Abstract

A postal questionnaire sent to all consultant geriatricians in Great Britain and Northern Ireland determined that less than one consultant in five offered influenza vaccine to patients in continuing-care wards. The main reasons given were that vaccine was inappropriate or unnecessary. This information prompted a prospective study of viral illness during the winter months of 1986-87 in eight continuing-care wards with a population of 196 patients. There were 70 episodes of influenza-like illness (ILI), but only 17 viruses were isolated, the commonest being rhinovirus (seven patients). As most cases of ILI in this population were caused by viruses other than influenza, the reluctance of most geriatricians to give influenza vaccine to continuing-care patients appears justified.

Influenza Vaccination of Health Care Workers in Long-Term-Care Hospitals Reduces the Mortality of Elderly Patients

“…Similar results have been reported in case-control studies of those dying of influenza [4]. Despite this, many specialists in geriatric medicine in the UK are skeptical of the value of routine influenza vaccination; in a survey, <20% said they offered it to elderly people in their long-term-care wards [5]. There are reasons why influenza vac-cine may not be effective in this group.…”

“…Most cases of influenza-like illness in long-term care are due to other pathogens, such as coronavirus, RSV, rhinovirus, and adenovirus, all of which can cause pneumonia [5,18]. We found evidence of RSV and adenovirus infection.…”

“…We found evidence of RSV and adenovirus infection. Most authorities accept that influenza vaccination of elderly institutionalized patients is worthwhile, but many clinicians remain uncertain about the quality of the evidence for benefit [5]. A recent meta-analysis showed that vaccination of elderly institutionalized persons is associated with reduced risk of pneumonia or death [3].…”

Effectiveness of influenza vaccine in reducing hospital admissions during the 1989–90 epidemic

“…children with chronic pulmonary disease including asthma, chronic heart disease, chronic renal failure, diabetes mellitus, for conditions involving immunosuppression due to disease or treatment, and also for people who live in residential care and other long stay facilities where rapid spread may follow the introduction of infection [6]. Despite these recommendations, less than half of high-risk patients in Britain are immunized each year [7][8][9][10][11][12]. Scepticism about vaccine effectiveness is partly responsible for the low immunization rate [7,9].…”

“…Despite these recommendations, less than half of high-risk patients in Britain are immunized each year [7][8][9][10][11][12]. Scepticism about vaccine effectiveness is partly responsible for the low immunization rate [7,9].…”