Effect of influenza vaccination of nursing home staff on mortality of residents: a cluster-randomized trial.

Autor: Lemaitre M; Department of Epidemiology, Information Systems, and Modeling, University Pierre and Marie Curie Paris 6, UMR-S 707, Paris, France., Meret T, Rothan-Tondeur M, Belmin J, Lejonc JL, Luquel L, Piette F, Salom M, Verny M, Vetel JM, Veyssier P, Carrat F
Jazyk: angličtina
Zdroj: Journal of the American Geriatrics Society [J Am Geriatr Soc] 2009 Sep; Vol. 57 (9), pp. 1580-6. Date of Electronic Publication: 2009 Aug 04.
DOI: 10.1111/j.1532-5415.2009.02402.x
Abstrakt: Objectives: To evaluate the effect of staff influenza vaccination on all-cause mortality in nursing home residents.
Design: Pair-matched cluster-randomized trial.
Setting: Forty nursing homes matched for size, staff vaccination coverage during the previous season, and resident disability index.
Participants: All persons aged 60 and older residing in the nursing homes.
Intervention: Influenza vaccine was administered to volunteer staff after a face-to-face interview. No intervention took place in control nursing homes.
Measurements: 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).
Conclusion: These results support influenza vaccination of staff caring for institutionalized elderly people.
Databáze: MEDLINE
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