title: Influenza and pneumococcal vaccination and tuberculin skin testing programs in long-term care facilities: where do we stand?
abstract: OBJECTIVE
  1) To compare policies and procedures for distribution of influenza and pneumococcal vaccines to long-term care facilities for the elderly in Canada, 2) to determine vaccination rates of residents and staff, and 3) to describe vaccination and tuberculin skin testing programs in these facilities.
  
  
  METHODS
  A cross-sectional survey consisting of telephone interviews and a mailed questionnaire was conducted in the spring of 1991. Telephone interviews were conducted with provincial/territorial epidemiologists. The questionnaire was sent to all (N = 1.520) Canadian long-term care facilities for the elderly with > or = 25 beds.
  
  
  RESULTS
  There were 1,270 responding facilities (84%). The mean overall influenza vaccination rate for residents was 78.5%. The mean vaccination rate was higher in those provinces in which the vaccine was paid for by the government (79% versus 71%; P = 0.002). Only 19% of facilities reported staff vaccination rates > 25%; rates again were higher in those provinces in which vaccine for staff was provided by the government. Pneumococcal vaccine was offered to residents in 12% of the facilities. The proportions of facilities with > 10% and > 75% of residents vaccinated were significantly higher in the provinces where the pneumococcal vaccine was recommended and paid for as compared with those where it was not (P < 0.001 for both). Tuberculin skin testing programs for residents existed in 360 long-term care facilities (28%) across the country.
  
  
  CONCLUSIONS
  In 1990, the number of residents living in Canadian long-term care facilities who were vaccinated against influenza and Streptococcus pneumoniae was suboptimal. Staff influenza vaccination rates were very low across the country. Most facilities did not have a baseline tuberculin skin test status for their residents. Vaccination rates are higher in jurisdictions in which governments provide the vaccine without charge.
authors.affiliation: Department of Microbiology, Princess Margaret/Mount Sinai Hospitals, Toronto, Ontario, Canada.
authors.forename: M A
authors.initials: MA
authors.lastname: McArthur
authors.forename: A E
authors.initials: AE
authors.lastname: Simor
authors.forename: B
authors.initials: B
authors.lastname: Campbell
authors.forename: A
authors.initials: A
authors.lastname: McGeer
mesh_terms: D001428:Bacterial Vaccines / Q000191:economics; D002170:Canada; D003430:Cross-Sectional Studies; D006291:Health Policy; D006801:Humans; D017589:Immunization Programs; D007252:Influenza Vaccines / Q000191:economics; D007407:Interviews as Topic; D008134:Long-Term Care; D009735:Nursing Homes / Q000706:statistics & numerical data*; D013296:Streptococcus pneumoniae / Q000276:immunology*; D011795:Surveys and Questionnaires; D013689:Telephone; D014374:Tuberculin Test / Q000706:statistics & numerical data*; D014611:Vaccination / Q000191:economics / Q000706:statistics & numerical data*
chemical_list: D001428:Bacterial Vaccines; D007252:Influenza Vaccines