PRACTICES AND POLICIES FOR INFLUENZA IMMUNIZATION IN OLD PEOPLES HOMES IN NOTTINGHAM (UK) DURING THE 1992-1993 SEASON - POTENTIAL FOR IMPROVEMENT

Background The elderly residents of nursing and old people's homes are at substantially increased risk from influenza and its complications. Annual vaccination is therefore strongly recommended by the UK Depart ments of Health. However, few data exist on the uptake of influenza va ccine in this setting; this was last estimated to be 45 per cent in 19 88-1989. A major epidemic of influenza A occurred in 1989-1990 which m ay have changed vaccination behaviours. Methods A structured interview survey was conducted in 49 old people's homes in Nottingham to determ ine practices and policies for influenza vaccine. The medical records of 151 randomly selected elderly residents were examined to determine vaccine uptake in the 1992-1993 season. Results Twenty-five homes (52. 1 per cent) claimed to operate a policy for influenza immunization but only 3 (12.0 per cent) were written down and none set targets. Method s of vaccine promotion were generally weak. Accordingly, vaccine uptak e was only 39.6 per cent (95 per cent confidence interval 33.2-46.0). Conclusions In contrast to other high-risk groups living in the open c ommunity, no improvement in influenza vaccine uptake has occurred in n ursing and old people's homes since the late 1980s, Future attempts to increase vaccine uptake in this setting should focus on developing jo int policies between general practitioners and home staff to facilitat e better co-ordinated programmes of vaccine pro motion and administrat ion.