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 Road Map Offers Providers Recommendations on Immunization Efforts

With the start to flu season near, a recent report by The Gerontology Society of America (GSA) National Adult Vaccination Program gives long term care providers recommendations on how to advance immunization efforts in their facilities.

While acknowledging that even “the most motivated facility leaders” face obstacles at times to get staff and residents immunized, the report includes five priority actions.

These areas are: increase use of mandatory staff vaccination policies, make vaccination a condition of hire, implement mandatory resident vaccination policies across all long term care settings, create financing tip sheets (for example, roster billing, best practices, algorithms, calculator of outbreak costs), and examine tools and resources for opportunities to weave immunizations into other priorities for facilities.

Additional action items include having facilities increase the use of renewable consent documents, publish resident vaccination rates on facility websites, and compile and share state law best practices.

Other steps suggest facilities create sample score cards/dashboards/standing orders, work with legal consultants to clarify the why and how of consent, develop tips on staff incentives and processes, such as visual performance gauges and surveys. GSA said there could also be efforts made to combine educational messages with the immunization programs and to develop infomercials for staff and residents.

The report said among the challenges that present themselves for providers are that “immunization registries lack sufficient continuity and specificity, and facilities’ information technology infrastructures present challenges to capturing vaccination data.”

The report said, “Vaccine hesitancy among staff is another challenge. All the myths that people believe about influenza and other vaccines have to be addressed and overcome.”

But, on the positive side, the report said there are procedures in place for skilled nursing centers to handle immunization as the subject is in the Minimum Data Set (including the health care personnel safety component that covers staff vaccinations), long term care surveys of vaccination practices for staff and residents, and the reports of quality improvement organizations.

In assisted living communities, the report said vaccine programs cannot rely as much as they do in the skilled setting on “medically trained immunization champions, and residents generally obtain care from the plethora of providers they had before admission.”

These factors, GSA said, make the goals of universal vaccination more difficult to achieve, but no less important.

The white paper, “Charting a Path to Increase Immunization Rates in the Post-Acute and Long-Term Care Settings,” was developed with the support of Sanofi Pasteur, a part of the pharmaceutical company Sanofi.

Separately, the Centers for Disease Control and Prevention (CDC) released its outlook for the 2018-2019 flu season and noted that the optimal time for vaccination should occur before onset of influenza activity. “However, because timing of the onset, peak, and decline of influenza activity varies, the ideal time to start vaccinating cannot be predicted each season,” CDC said.

In addition, more than one outbreak might occur in a given area or community in a single year.

“In the United States, localized outbreaks that indicate the start of seasonal influenza activity can occur as early as October. However, in 75 percent of influenza seasons from 1982–83 through 2017–18, peak influenza activity (which often is close to the midpoint of influenza activity for the season) has not occurred until January or later, and in 58 percent of seasons, the peak was in February or later,” the outlook said.

Read the GSA report at https://www.navp.org/images/navp/PDF/ImmunizRatesWP_FNL.pdf.

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