Influenza & Pneumococcal Vaccinations

Influenza is an acute respiratory illness caused primarily by one of two influenza viruses — Influenza A or B. Influenza epidemics typically occur during late fall through early spring, and most cases are due to Influenza A infection. People 65 and older are especially vulnerable to serious complications, and approximately 90 percent of all influenza-related deaths occur in this age group. Nursing home residents may be particularly vulnerable to influenza because of chronic medical conditions, living in a closed environment and having less responsive immune systems.

Influenza is spread through close contact, droplet and air-borne transmission (e.g., sneezing, coughing and a runny nose). The incubation period is generally 1 to 4 days. Adults can be infectious the day before symptoms begin, through approximately 5 days after the onset of illness.

Immunization is the cornerstone of influenza control. Each nursing home resident and all health care workers should be immunized against influenza each year, unless specifically contraindicated. Antiviral medications may be used to prevent infection and for treatment purposes; however, they are not a substitute for immunization.

Pneumonia is a common infection and a major cause of morbidity, mortality and hospitalization among nursing home residents. It is especially common in winter and early spring when respiratory diseases are prevalent. The most common cause of bacterial pneumonia nursing facility residents is streptococcus pneumoniae.

Outbreaks of pneumococcal pneumonia are not common, and are preventable. When outbreaks occur, they usually occur in crowded environments, including nursing homes. During outbreaks, people with invasive disease often have underlying illness and may have a high fatality rate. Pneumococcal disease spreads from person to person by coughing, sneezing or close contact.

The pneumococcal polysaccharide vaccine (PPV23) is estimated to be 60 to 70 percent effective in preventing invasive pneumococcal disease. The vaccine may be less effective in preventing pneumococcal infection in some groups, particularly those with significant underlying illness; however, vaccination is still recommended because of the high risk of developing severe diseases. The pneumococcal vaccine should be administered routinely to nursing facility residents, regardless of age. Those 65 and older should receive a second dose of the pneumococcal vaccine if they received the vaccine more than 5 years previously and were under age 65 at the time of the first dose. People whose vaccination status is unknown should be vaccinated as well.

Resources Created by DADS

Resources from Other Organizations

  • A Toolkit for Long-Term Care Employers is a comprehensive resource, developed to help improve immunization rates among healthcare personnel in long-term care facilities.

  • Recommended Immunizations for Adults by Age (PDF) lists the current recommendations for adult immunizations by age and medical condition.
  • Vaccine Information Statements (VIS) provides information about the risks and benefits associated with vaccines. Vaccine providers are required to provide residents and/or their legal representative with the appropriate VIS before administering certain vaccines, including the seasonal influenza vaccine.

  • Influenza (Flu) provides links to information about flu basics, the prevention and treatment of influenza, and a variety of educational resources for healthcare professionals and patients.

  • Flublok Seasonal Influenza (Flu) Vaccination is an influenza vaccine approved for use in adults 18 through 49 years of age, manufactured without the use of the influenza virus or chicken eggs. This web page provides additional information about Flublok, the manufacturing process and the indications for use of Flublok.

  • Quadrivalent Influenza Vaccine is an influenza vaccine designed to protect against four strains of influenza. This web page provides additional information about the Quadrivalent Flu Vaccine, including the indications for use for different age groups.

  • Cell-based Flu Vaccines are influenza vaccines manufactured by growing the flu viruses in animal cells, instead of the traditional egg-based process. This web page provides more information on cell-based vaccines and their potential benefits.

  • Free Resources includes a variety of educational materials, addressing current recommendations for preventing influenza. All materials are free for download, and may be printed on a standard office printer.

  • Pneumococcal Vaccination provides information to patients and healthcare professionals about pneumococcal disease and the pneumococcal vaccines that are current available.

  • Vaccine Adverse Event Reporting System (VAERS) allows healthcare professionals to report any adverse events that follow immunization, including possible side effects of the vaccine. The reporting of such information is required.

  • Hand Hygiene in Healthcare Settings provides healthcare professionals and patients with a variety of resources about hand hygiene, including hand hygiene basics and guidelines for providers.

  • Standing orders for Administering Vaccines has standing orders for administering vaccines, including flu and pneumococcal vaccinations.

  • Standing Orders for Medical Management of Vaccine Reactions in Adults (PDF) outlines the types of vaccine reactions that can occur, as well as instructions for managing those reactions. The form also includes a list of recommended supplies to have available to manage any vaccine reactions that may occur.
  • Declination of Flu Vaccine (PDF) includes an acknowledgement of the recommendation for immunization for healthcare workers, as well as the risk to patients if the healthcare worker contracts influenza. The declination form is also available in Spanish (PDF).
  • Vaccine Administration Record/Adults (PDF) tracks an adult’s immunization status and can provide a cumulative record of the person’s immunizations.
  • Facts about Using Vaccine Information Statements (VISs) (PDF) provides healthcare professionals with information about the VISs and the requirements for their use. The handout also identifies the most current versions of the VISs available for each vaccine.