JAMDA 15 (2014) 296e302
JAMDA journal homepage: www.jamda.com
Letters to the Editor
How to Increase Seasonal Influenza Vaccine Coverage To the Editor: The recent report on “increase seasonal influenza vaccine coverage” is very interesting.1 Michel1 reported on the success in a focused group of nursing home residents. In fact, the coverage of influenza vaccine among nursing home residents is usually problematic. Shroufi et al2 recently reported that only 30% of studied nursing homes had a policy addressing influenza vaccination and 60% of residents were already vaccinated. How to increase seasonal influenza vaccine coverage is a topic that is widely discussed. Mandatory vaccination might be an effective way to increase vaccine coverage.3 In addition, the concern should be extended to the staff in the care homes. A recent report showed that the vaccine coverage rate among this population is low and lower than that of nursing home residents.4 References 1. Michel JP. How can we increase seasonal influenza vaccine coverage in nursing home residents? J Am Med Dir Assoc 2013;14:858e859. 2. Shroufi A, Copping J, Vivancos R, Slack RC. Influenza and pneumococcal vaccine uptake among nursing home residents in Nottingham, England: A postal questionnaire survey. BMC Geriatr 2008;8:11. 3. Shroufi A, Copping J, Musonda P, et al. Influenza vaccine uptake among staff in care homes in Nottinghamshire: A random cluster sample survey. Public Health 2009;123:645e649. 4. Wicker S, Marckmann G. Vaccination of health care workers against influenza: Is it time to think about a mandatory policy in Europe? Vaccine; 2013. Available at: http://dx.doi.org/10.1016/j.vaccine.2013.09.062.
Viroj Wiwanitkit, MD Hainan Medical University Bangkhae, Bangkok, Thailand http://dx.doi.org/10.1016/j.jamda.2013.12.006
protections, even if there is wide variation in how nursing home regulations exist.3 On one hand, most developed industrialized countries have workplace health and safety laws that require workers to be “free from risk of death, injury or illness caused by any workplace.” As flu is an annual and predictable workplace danger, vaccination of health care workers could be mandatory.4 Vaccinating nHCWs reduces both the rate of nosocomial influenza outbreaks and mortality among long term care patients, and has good impact on care costs while also reducing nHCW absenteeism.5,6 On the other hand, the term mandatory implies sanctions for noncompliance. Poland and colleagues7 argued for religious and medical exemptions with the option of an informed refusal. It could be argued, however, that immunization is not truly mandatory if you can opt out.8 I really think that we need to “advocate programs, using incentives, publicity, ready availability, and feedback to educate nHCWs about the personal benefit and the benefits to their patients.”8 References 1. Wiwanitkit V. How to increase seasonal influenza vaccine coverage. J Am Med Dir Assoc 2014;15:296. 2. Michel JP. How can we increase seasonal influenza vaccine coverage in nursing home residents? J Am Med Dir Assoc 2013;14:858e859. 3. Kossover RA, Chi CJ, Wise ME, et al. Infection prevention and control standards in assisted living facilities: Are residents’ needs being met? J Am Med Dir Assoc 2014;15:47e53. 4. Lambert SB. Mandatory flu vaccination. Patient care drives mandatory vaccination. BMJ 2008;337:a2588. 5. Helms CM, Polgreen PM. Should influenza immunisation be mandatory for healthcare workers? Yes. BMJ 2008;337:a2142. 6. Gavazzi G. Influenza vaccination in long-term care facilities: More than standing order programs? J Am Med Dir Assoc 2011;12:315e316. 7. Poland GA, Tosh P, Jacobson A. Requiring influenza vaccination for health care workers: Seven truths we must accept. Vaccine 2005;23:2251e2255. 8. Isaacs D, Laeash J. Should influenza immunisation be mandatory for health care workers? No. BMJ 2008;337:a2140.
Jean-Pierre Michel, MD Geneva University, Geneva, Switzerland http://dx.doi.org/10.1016/j.jamda.2013.12.086
Reply to the Letter to the Editor by Dr. Wiwanitkit To the Editor: I thank Viroj Wiwanitkit1 for raising the very controversial issue of mandatory vaccination of nursing home health care workers (nHCWs) that I just mentioned in the Journal.2 Indeed, nHCWs who provide housing and care to vulnerable persons (unable to live independently and have increasing care/ medical needs) have the duty of maintaining adequate resident
What Should a Case-Finding Tool for Dysphagia in Long Term Care Residents With Dementia Look Like? To the Editor: As the rate of dementia increases in long term care (LTC) so does the rate of dysphagia, with estimates ranging between 40%
JAMDA journal homepage: www.jamda.com
Letters to the Editor
How to Increase Seasonal Influenza Vaccine Coverage To the Editor: The recent report on “increase seasonal influenza vaccine coverage” is very interesting.1 Michel1 reported on the success in a focused group of nursing home residents. In fact, the coverage of influenza vaccine among nursing home residents is usually problematic. Shroufi et al2 recently reported that only 30% of studied nursing homes had a policy addressing influenza vaccination and 60% of residents were already vaccinated. How to increase seasonal influenza vaccine coverage is a topic that is widely discussed. Mandatory vaccination might be an effective way to increase vaccine coverage.3 In addition, the concern should be extended to the staff in the care homes. A recent report showed that the vaccine coverage rate among this population is low and lower than that of nursing home residents.4 References 1. Michel JP. How can we increase seasonal influenza vaccine coverage in nursing home residents? J Am Med Dir Assoc 2013;14:858e859. 2. Shroufi A, Copping J, Vivancos R, Slack RC. Influenza and pneumococcal vaccine uptake among nursing home residents in Nottingham, England: A postal questionnaire survey. BMC Geriatr 2008;8:11. 3. Shroufi A, Copping J, Musonda P, et al. Influenza vaccine uptake among staff in care homes in Nottinghamshire: A random cluster sample survey. Public Health 2009;123:645e649. 4. Wicker S, Marckmann G. Vaccination of health care workers against influenza: Is it time to think about a mandatory policy in Europe? Vaccine; 2013. Available at: http://dx.doi.org/10.1016/j.vaccine.2013.09.062.
Viroj Wiwanitkit, MD Hainan Medical University Bangkhae, Bangkok, Thailand http://dx.doi.org/10.1016/j.jamda.2013.12.006
protections, even if there is wide variation in how nursing home regulations exist.3 On one hand, most developed industrialized countries have workplace health and safety laws that require workers to be “free from risk of death, injury or illness caused by any workplace.” As flu is an annual and predictable workplace danger, vaccination of health care workers could be mandatory.4 Vaccinating nHCWs reduces both the rate of nosocomial influenza outbreaks and mortality among long term care patients, and has good impact on care costs while also reducing nHCW absenteeism.5,6 On the other hand, the term mandatory implies sanctions for noncompliance. Poland and colleagues7 argued for religious and medical exemptions with the option of an informed refusal. It could be argued, however, that immunization is not truly mandatory if you can opt out.8 I really think that we need to “advocate programs, using incentives, publicity, ready availability, and feedback to educate nHCWs about the personal benefit and the benefits to their patients.”8 References 1. Wiwanitkit V. How to increase seasonal influenza vaccine coverage. J Am Med Dir Assoc 2014;15:296. 2. Michel JP. How can we increase seasonal influenza vaccine coverage in nursing home residents? J Am Med Dir Assoc 2013;14:858e859. 3. Kossover RA, Chi CJ, Wise ME, et al. Infection prevention and control standards in assisted living facilities: Are residents’ needs being met? J Am Med Dir Assoc 2014;15:47e53. 4. Lambert SB. Mandatory flu vaccination. Patient care drives mandatory vaccination. BMJ 2008;337:a2588. 5. Helms CM, Polgreen PM. Should influenza immunisation be mandatory for healthcare workers? Yes. BMJ 2008;337:a2142. 6. Gavazzi G. Influenza vaccination in long-term care facilities: More than standing order programs? J Am Med Dir Assoc 2011;12:315e316. 7. Poland GA, Tosh P, Jacobson A. Requiring influenza vaccination for health care workers: Seven truths we must accept. Vaccine 2005;23:2251e2255. 8. Isaacs D, Laeash J. Should influenza immunisation be mandatory for health care workers? No. BMJ 2008;337:a2140.
Jean-Pierre Michel, MD Geneva University, Geneva, Switzerland http://dx.doi.org/10.1016/j.jamda.2013.12.086
Reply to the Letter to the Editor by Dr. Wiwanitkit To the Editor: I thank Viroj Wiwanitkit1 for raising the very controversial issue of mandatory vaccination of nursing home health care workers (nHCWs) that I just mentioned in the Journal.2 Indeed, nHCWs who provide housing and care to vulnerable persons (unable to live independently and have increasing care/ medical needs) have the duty of maintaining adequate resident
What Should a Case-Finding Tool for Dysphagia in Long Term Care Residents With Dementia Look Like? To the Editor: As the rate of dementia increases in long term care (LTC) so does the rate of dysphagia, with estimates ranging between 40%
