title: Effect of influenza vaccination of nursing home staff on mortality of residents: a cluster-randomized trial.
abstract: OBJECTIVE
  To evaluate the effect of staff influenza vaccination on all-cause mortality in nursing home residents.
  
  
  METHODS
  Pair-matched cluster-randomized trial.
  
  
  METHODS
  Forty nursing homes matched for size, staff vaccination coverage during the previous season, and resident disability index.
  
  
  METHODS
  All persons aged 60 and older residing in the nursing homes.
  
  
  METHODS
  Influenza vaccine was administered to volunteer staff after a face-to-face interview. No intervention took place in control nursing homes.
  
  
  METHODS
  The primary endpoint was total mortality rate in residents from 2 weeks before to 2 weeks after the influenza epidemic in the community. Secondary endpoints were rates of hospitalization and influenza-like illness (ILI) in residents and sick leave from work in staff.
  
  
  RESULTS
  Staff influenza vaccination rates were 69.9% in the vaccination arm versus 31.8% in the control arm. Primary unadjusted analysis did not show significantly lower mortality in residents in the vaccination arm (odds ratio=0.86, P=.08), although multivariate-adjusted analysis showed 20% lower mortality (P=.02), and a strong correlation was observed between staff vaccination coverage and all-cause mortality in residents (correlation coefficient=-0.42, P=.007). In the vaccination arm, significantly lower resident hospitalization rates were not observed, but ILI in residents was 31% lower (P=.007), and sick leave from work in staff was 42% lower (P=.03).
  
  
  CONCLUSIONS
  These results support influenza vaccination of staff caring for institutionalized elderly people.
authors.affiliation: Department of Epidemiology, Information Systems, and Modeling, University Pierre and Marie Curie Paris 6, UMR-S 707, Paris, France.
authors.forename: Magali
authors.initials: M
authors.lastname: Lemaitre
authors.forename: Thierry
authors.initials: T
authors.lastname: Meret
authors.forename: Monique
authors.initials: M
authors.lastname: Rothan-Tondeur
authors.forename: Joel
authors.initials: J
authors.lastname: Belmin
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Lejonc
authors.forename: Laurence
authors.initials: L
authors.lastname: Luquel
authors.forename: François
authors.initials: F
authors.lastname: Piette
authors.forename: Michel
authors.initials: M
authors.lastname: Salom
authors.forename: Marc
authors.initials: M
authors.lastname: Verny
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Vetel
authors.forename: Pierre
authors.initials: P
authors.lastname: Veyssier
authors.forename: Fabrice
authors.initials: F
authors.lastname: Carrat
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D004185:Disability Evaluation; D004196:Disease Outbreaks / Q000517:prevention & control* / Q000706:statistics & numerical data; D005260:Female; D005602:France; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D017589:Immunization Programs; D017757:Infectious Disease Transmission, Professional-to-Patient / Q000517:prevention & control* / Q000706:statistics & numerical data; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000401:mortality / Q000451:nursing* / Q000517:prevention & control* / Q000635:transmission; D008297:Male; D016555:Matched-Pair Analysis; D009735:Nursing Homes / Q000706:statistics & numerical data*; D009740:Nursing Staff / Q000706:statistics & numerical data*; D018582:Sick Leave; D016019:Survival Analysis
chemical_list: D007252:Influenza Vaccines