AGING AND DISABILITY SERVICES ADMINISTRATION
AASA: NH #2001-019
Subject:? Influenza and Pneumococcal Vaccinations
Dear Nursing Home Administrator:
This letter reminds you that it will soon be time for residents and staff to receive influenza and pneumococcal vaccinations.? We encourage you to ?gear up? for the immunization period.? Influenza epidemics occur nearly every year and are responsible for approximately 20,000 deaths per year in the United States.? Pneumococcal disease is responsible for more deaths than any other vaccine-preventable bacterial disease.? Influenza and pneumonia combined represent the fifth leading cause of death among the elderly.?
What is the nursing home?s responsibility for prevention of influenza and pneumococcal disease in its residents and staff?
- Nursing homes should have an assessment and vaccination program in place to reduce the risk of influenza and pneumonia outbreaks.
- Use physician order protocols to ensure that as many residents as possible receive needed vaccinations.? Every resident should receive immunizations, except those for whom vaccination is not appropriate or who refuse.? For quality assessment purposes, you may want to keep track of the number of residents immunized and the number of residents not immunized, including the reason.?
- Recognize that residents have the right to informed consent or refusal of any treatment.
- Offer or arrange for annual influenza vaccinations for staff and, where appropriate, pneumococcal vaccination.? This action will help prevent staff from possibly infecting your residents and/or losing time from work.?
- Ensure consistent use of infection control techniques including proper hand washing to help prevent and control outbreaks of illness.
Be well informed about influenza and pneumococcal disease.? Suggested sources of information:
Is a program to prevent influenza and pneumonia required by nursing home regulations?
Both federal and state regulations for infection control require the nursing home to establish and maintain an effective infection control program that will help prevent the development and transmission of disease and infection.? (WAC 388-97-140(1); 42 CFR 483.65)? Therefore, the nursing home should have a program in place to prevent influenza and pneumonia.? Now is the time to be sure that your current system will function effectively as we approach the annual immunization period.??
What should we do if we do not have a comprehensive program in place to prevent these diseases?
You must immediately take steps to comply with the regulations by working with your medical director to plan and implement an immunization program.??
When should nursing home residents and staff receive influenza vaccinations?
The influenza vaccine is administered annually, usually prior to the onset of the influenza season.? October and November are the ideal months for residents to receive annual influenza vaccination according to the Centers for Disease Control (CDC).? However, the vaccine can be given later.? It can also be given in September if vaccine is available.
When should nursing home residents and staff receive pneumococcal vaccinations?
The pneumococcal vaccine is generally administered once-in-a-lifetime or given several years apart, depending on what is appropriate for the individual.? Review the resident?s record to see if there has been previous vaccination, then consult with the resident?s physician regarding the appropriate action to take.?
Will there be delays in obtaining influenza vaccine in a timely way this year?
CDC?s Morbidity and Mortality Report for July 13, 2001 indicated that there might be delays in obtaining influenza vaccine this year.? However, this information is based on early projections from manufacturers and may change.? Nursing homes should develop contingency plans for possible delays in vaccine distribution (for example: by communication among partner organizations to redistribute vaccine to the those persons with the highest risk, preparing for a ?blitz? of immunization when the vaccine is received, etc.).? You may also want to go to the CDC website for current information about vaccine availability.
What documentation is important for influenza and pneumococcal vaccinations?
Keep a record of the immunizations that your residents receive.? This enables you to track the vaccination status of your residents and provides important medical history information to others in the event that a resident is hospitalized or transferred or if an outbreak occurs.?
How are resident influenza and pneumococcal vaccines paid for?
These vaccines are covered by Medicare Part B, Medicaid, and many insurance plans.? For residents, check the policies of applicable carriers.? If you have questions about vaccine coding for Medicaid residents, contact Mary Wendt (Medical Assistance Administration).? Her telephone number is (360) 725-1840.
How are employee influenza and pneumococcal vaccines paid for?
Employee immunizations are a reimbursable cost.? If you have questions, contact your rates analyst.?
Who should we call if we have other questions?
Please contact your Field Manager.?
Sincerely,
Patricia K. Lashway, Director Care Services
cc: David R. Cundiff? M.D., Medical Director
Medical Assistance Administration
Beth Hines, Immunization Program
Department of Health
