HOW COMPLETE IS INFLUENZA IMMUNIZATION COVERAGE - A STUDY IN 75 NURSING AND RESIDENTIAL HOMES FOR ELDERLY PEOPLE

Background. Elderly people in residential accommodation are particular ly susceptible to outbreaks of influenza. Up to 70% of residents can b ecome ill and many will develop complications or die. Immunization can prevent such out-breaks and is cost-effective. Aim. A study was under taken to measure influenza immunization coverage in residential accomm odation for elderly people and to identify factors that might influenc e uptake. Method In March 1992, a questionnaire survey was conducted o f all 113 registered nursing and residential homes for elderly people, in South Glamorgan. It asked about the demographic characteristics of people resident on I October 1991, their influenza immunization histo ry and the homes' arrangements for administering immunizations. Result s. Questionnaires were returned by respondents from 75 homes (66%). Me an influenza vaccine uptake was 67%. Uptake was higher in nursing home s (mean of 82% in eight nursing homes) than in homes registered as bot h nursing and residential homes (mean of 76% in six homes) or in resid ential homes (mean of 65% in 61 homes). Nearly all of those immunized (94%) had been immunized by the end of November 1991. Residents who we re reported to have underlying disease that increased their risk of co mplications if they contracted influenza were no more likely to have b een immunized than those without risk factors. immunization coverage v aried considerably both between homes and between general practices. M ost general practices in South Glamorgan had several elderly people in residential accommodation on their list, but only nine out of 64 prac tices had immunized all the elderly residents on their list and 12 pra ctices had immunized fewer than half. Routine recording of immunizatio n status in nursing and residential homes was variable, often as a con sequence of poor communication between the primary health care team an d staff at the home. Even where recorded, retrieval of the data was so metimes a problem. Conclusion. Influenza immunization coverage could b e improved if general practices held a case register of all at-risk pa tients including elderly residents, and if nursing and residential hom es were encouraged to keep better immunization records. These measures would facilitate year-on-year monitoring of influenza immunization co verage and the targeting of homes with low immunization coverage.