Guidelines for the Prevention and Control of Influenza Outbreaks in Residential Care Facilities for Public Health Units in Australia
2.1 Vaccination
Influenza and pneumococcal vaccination of residential care residents is recommended to reduce the impact of these vaccine-preventable diseases.
In elderly patients, influenza vaccination has demonstrated efficacy in reducing the rate of infection with influenza virus, and the rate of severe morbidity and mortality. When a high proportion (>80%) of residents in a RCF are vaccinated, the herd immunity effect results in an additional benefit of reducing the risk of outbreaks in the facility .11
Influenza vaccine is provided free for:
Pneumococcal vaccine is recommended in specific age groups or who have a medical risk factor. Booster doses of pneumococcal vaccine may be required.13
Pneumococcal vaccine is provided free for:
Refer to the current edition of The Australian Immunisation Handbook for a full list of influenza and pneumococcal vaccination recommendations.
Influenza vaccination of people capable of transmitting influenza to residential care residents is recommended on an annual basis. This includes all employees, attending physicians and both health care and non-health care contract workers. Volunteers and visitors to the facility should also be encouraged to receive annual influenza vaccination.
Each RCF should have a resident vaccination policy for influenza and pneumococcal infection and a staff vaccination policy for influenza.
2.1.1 Residents
Prior to or upon admission, each resident should be assessed regarding vaccination status.
The recommended time for influenza vaccination is February to April in anticipation of annual outbreaks of influenza in the middle of the year. If the resident is admitted after the autumn vaccination program, vaccination should be offered unless the person has already received the current season’s influenza vaccine.
The immunisation record of the resident should be retained on a separate immunisation register. Upon transfer to another facility, the resident’s recent vaccination status should be shared with that facility.
Thereafter, each resident should be immunised between February and April with the current season’s influenza vaccine, unless medical contraindications exist.
2.1.2 Staff
Annual vaccination against influenza is recommended for all persons carrying on activities in the RCF.
If the time of hiring or placement occurs during the influenza season, the person responsible for vaccination in the facility should ask any new employee for evidence of vaccination with the current year's influenza vaccine.
Only the following should be accepted as proof of influenza vaccination:
If this documentation is not available, the RCF should not consider the staff member immunised, and the employer should recommend influenza vaccination to the person.
Facility administrative staff should keep an updated list or register of staff and resident vaccination status throughout the year.
2.1.3 Contraindications to influenza vaccination
Individuals with anaphylactic hypersensitivity to eggs should not be given influenza vaccine. This includes persons who, on ingestion of eggs, develop swelling of the lips or tongue or experience acute respiratory distress or collapse.
Individuals with hypersensitivity to any of the product components should not be vaccinated.
Individuals with an acute febrile illness (fever >38.50C) should not be vaccinated until their symptoms have abated.
Patients with a history of Guillain-Barre Syndrome (GBS) with an onset time related to influenza vaccination may be at increased risk of again developing GBS if given influenza vaccine.
It should also be noted that the product information on influenza vaccine refers to the possibility of the vaccine impairing the metabolism of drugs such as warfin, theophylline, phenytoin, phenobarbitone and carbamazepine. Therefore patients taking these drugs and given influenza vaccine should be monitored for possible elevated levels of medication.
