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Effect of Influenza Vaccination of Nursing Home Staff on Mortality of Residents: A Cluster‐Randomized Trial
Author(s) -
Lemaitre Magali,
Meret Thierry,
RothanTondeur Monique,
Belmin Joel,
Lejonc JeanLouis,
Luquel Laurence,
Piette François,
Salom Michel,
Verny Marc,
Vetel JeanMarie,
Veyssier Pierre,
Carrat Fabrice
Publication year - 2009
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2009.02402.x
Subject(s) - medicine , vaccination , odds ratio , cluster (spacecraft) , randomized controlled trial , multivariate analysis , influenza vaccine , nursing homes , family medicine , emergency medicine , nursing , immunology , computer science , programming language
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.