The Importance of Influenza Vaccination for Health Care Personnel in Long-Term Care

Influenza is a serious health threat for older adults.

Influenza can be a serious health threat, especially for people who are vulnerable to serious influenza illness, like older adults and people living with certain chronic medical conditions. People aged 65 years and older are at high risk for hospitalization and complications from influenza and account for the majority of influenza hospitalizations and deaths in the United States each year.

• It’s estimated that between 70 percent and 85 percent of seasonal influenza related deaths have occurred in people 65 years and older.
• It’s estimated that between 50 percent and 70 percent of seasonal influenza-related hospitalizations have occurred among people 65 years and older.

Risk of influenza for adults living in Long-Term Care facilities

Health care personnel who care for people who are at high risk of serious flu illness (with the exception of those who care for severely immunocompromised persons who require a protected environment) may receive any influenza vaccine that is otherwise indicated (inactivated influenza vaccine [IIV], recombinant influenza vaccine [RIV] or the nasal spray flu vaccine [live attenuated influenza vaccine or LAIV]). Persons who care for severely immunocompromised persons requiring a protected environment should receive either IIV or RIV.

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Health Care Personnel: At risk of occupationally acquired influenza and transmitting influenza to patients

CDC recommends that all adults be vaccinated against flu every year. This includes a continued emphasis on vaccinating people who live with or care for people who are at high risk of serious flu illness, including people who work in the field of long-term care (LTC).

Health care personnel in long-term care facilities may have direct or indirect contact with older adults, people with disabilities, and people with chronic medical conditions receiving care. Research shows that during a confirmed influenza outbreak in a long-term care facility, up to one in three residents and one in four staff develop an influenza-like illness. Preventing influenza among health care personnel can help reduce the spread of influenza in resident populations. Health care personnel may become infected with influenza viruses through contact with infected residents or someone in the community, and spread influenza to residents and other health care personnel.

A study has documented that health care personnel might report to work on days when they have a fever or a respiratory disease because they feel they are needed at work or they do not receive paid sick leave. Sometimes health care personnel have mild influenza symptoms but do not realize they have influenza and might report to work. Influenza among HCP is common, and 28% ꟷ 59% of cases estimated are subclinical.

During influenza season, health care personnel should not report to work if experiencing influenza symptoms. CDC also includes specific recommendations for influenza vaccination of health care personnel and recommendations for people who live with or care for persons at high risk for influenza-related complications.

Health care personnel should get annual influenza vaccination by the end of October. Since it takes about two weeks for antibodies to develop after being vaccinated, it’s important that health care personnel are protected before influenza infections becomes prevalent in the community.

Other recommended influenza prevention measures can be found in CDC’s Interim Guidance for Influenza Outbreak Management in Long-Term Care Facilities and CDC’s Prevention Strategies for Seasonal Influenza in Health Care Settings.

CDC recommends influenza vaccination for all health care personnel to reduce the spread of influenza, especially to vulnerable populations.

Vaccination is the most effective intervention to prevent influenza. The effectiveness of influenza vaccines varies depending on the match between the vaccine and the circulating strain in any given year, and the age and health of the recipient. Vaccination of all health care personnel is recommended by the Advisory Committee on Immunization Practices (ACIP). ACIP includes recommendations specifically for health care personnel  and those who live with or care for people at high risk for influenza-related complications. In addition, 14 medical and health professional organizations, including the American Academy of Family Physicians; American College of Physicians, and AMDA- the Society for Post-Acute and Long-Term Care Medicine have published position statements that support influenza vaccination for health care personnel.

The ACIP recommendations for health care personnel are based on a body of research that documents measurable benefits of vaccination.  Vaccination may reduce staff illness and absenteeism and influenza-related illness and hospitalization, especially among people at increased risk for severe flu illness. Even when viruses in the flu vaccine and circulating flu viruses are not well matched, vaccinated individuals are more likely to experience fewer complications due to flu than people who do not get vaccinated.