INFLUENZA AND PNEUMOCOCCAL VACCINATION AND TUBERCULIN SKIN TESTING PROGRAMS IN LONG-TERM-CARE FACILITIES - WHERE DO WE STAND

OBJECTIVES: 1) To compare policies and procedures for distribution of influenza and pneumococcal vaccines to long-term care facilities for t he elderly in Canada, 2) to determine vaccination rates of residents a nd staff, and 3) to describe vaccination and tuberculin skin testing p rograms in these facilities. DESIGN: A cross-sectional survey consisti ng of telephone interviews and a mailed questionnaire was conducted in the spring of 1991. Telephone interviews were conducted with provinci al/territorial epidemiologists. The questionnaire was sent to all (N=1 ,520) Canadian long-term care facilities for the elderly with greater than or equal to 25 beds. RESULTS: There were 1,270 responding facilit ies (84%). The mean overall influenza vaccination rate for residents w as 78.5%. The mean vaccination rate was higher in those provinces in w hich the vaccine was paid for by the government (79% versus 71%; P=0.0 02). Only 19% of facilities reported staff vaccination rates >25%; rat es again were higher in those provinces in which vaccine for staff was provided by the government. Pneumococcal vaccine was offered to resid ents in 12% of the facilities. The proportions of facilities with >10% and >75% of residents vaccinated were significantly higher in the pro vinces where the pneumococcal vaccine was recommended and paid for as compared with those where it was not (P<0.001 for both). Tuberculin sk in testing programs for residents existed in 360 long-term care facili ties (28%) across the country CONCLUSION: In 1990, the number of resid ents living in Canadian long-term care facilities who were vaccinated against influenza and Streptococcus pneumoniae was suboptimal. Staff i nfluenza vaccination rates were very low across the country. Most faci lities did not have a baseline tuberculin skin test status for their r esidents. Vaccination rates are higher in jurisdictions in which:gover nments provide the vaccine without charge