Factors affecting influenza vaccination rates in alder people admitted to hospital with acute medical problems

Influenza is a major problem both in the community and hospital and elderly people who are at particular risk should be included in vaccination progra mmes. In August 1998 the Chief Medical Officer for England extended the cur rent influenza immunization policy to include all those aged 75 years or ov er. However, prior to this date only those patients with co-existing cardia c or respiratory diseases at increased risk of influenza were vaccinated ro utinely. In order to determine whether such patients had been immunized, we approached all patients admitted to Care of the Elderly wards during an 8- week period in January and February. The study additionally identified fact ors that may have influenced patients' participation in this immunization p rogramme. Six hundred and forty-nine patients on Care of the Elderly wards with acute medical illness were questioned with regard to vaccination again st influenza during the previous year. Of the 649 patients 279 were suitabl e for entry into the study. Of these 39% had been vaccinated against influe nza. When considering the 171 who were not vaccinated, 25% (44 patients) ha d actually been offered and declined vaccination, in 46% of these cases due to previous side-effects, or fear of anticipated side-effects. In those un vaccinated three-quarters considered that the influenza vaccine was not eff icacious. Unfortunately, patients with co-existing cardiac, respiratory or endocrine diseases were no more likely to have been vaccinated than were th ose without these diseases. Many older patients admitted with acute medical problems had not been vaccinated against influenza and the reasons for thi s included not being offered vaccination, a belief that influenza vaccinati on was not efficacious and concerns about possible side-effects. The role o f community doctors and nurses in facilitating the vaccination of such an a t-risk group is evident and should be incorporated into resource planning.