scholarly journals Inducing Herd Immunity against Seasonal Influenza in Long-Term Care Facilities through Employee Vaccination Coverage: A Transmission Dynamics Model

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Aaron M. Wendelboe ◽  
Carl Grafe ◽  
Micah McCumber ◽  
Michael P. Anderson

Introduction. Vaccinating healthcare workers (HCWs) in long-term care facilities (LTCFs) may effectively induce herd immunity and protect residents against influenza-related morbidity and mortality. We used influenza surveillance data from all LTCFs in New Mexico to validate a transmission dynamics model developed to investigate herd immunity induction.Material and Methods. We adjusted a previously published transmission dynamics model and used surveillance data from an active system among 76 LTCFs in New Mexico during 2006-2007 for model validation. We used a deterministic compartmental model with a stochastic component for transmission between residents and HCWs in each facility in order to simulate the random variation expected in such populations.Results. When outbreaks were defined as a dichotomous variable, our model predicted that herd immunity could be induced. When defined as an attack rate, the model demonstrated a curvilinear trend, but insufficiently strong to induce herd immunity. The model was sensitive to changes in the contact parameterβbut was robust to changes in the visitor contact probability.Conclusions. These results further elucidate previous studies’ findings that herd immunity may not be induced by vaccinating HCWs in LTCFs; however, increased influenza vaccination coverage among HCWs reduces the probability of influenza infection among residents.

2011 ◽  
Vol 32 (10) ◽  
pp. 990-997 ◽  
Author(s):  
Aaron M. Wendelboe ◽  
Catherine Avery ◽  
Bernardo Andrade ◽  
Joan Baumbach ◽  
Michael G. Landen

Objective.Employees of long-term care facilities (LTCFs) who have contact with residents should be vaccinated against influenza annually to reduce influenza incidence among residents. This investigation estimated the magnitude of the benefit of this recommendation.Methods.The New Mexico Department of Health implemented active surveillance in all of its 75 LTCFs during influenza seasons 2006-2007 and 2007-2008. Information about the number of laboratory-confirmed cases of influenza and the proportion vaccinated of both residents and direct-care employees in each facility was collected monthly. LTCFs reporting at least 1 case of influenza (defined alternately by laboratory confirmation or symptoms of influenza-like illness [ILI]) among residents were compared with LTCFs reporting no cases of influenza. Regression modeling was used to obtain adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for the association between employee vaccination coverage and the occurrence of influenza outbreaks. Covariates included vaccination coverage among residents, the staff-to-resident ratio, and the proportion of filled beds.Results.Seventeen influenza outbreaks were reported during this 2-year period of surveillance. Eleven of these were laboratory confirmed (n = 21 residents) and 6 were defined by ILI (n = 40 residents). Mean influenza vaccination coverage among direct-care employees was 51% in facilities reporting outbreaks and 60% in facilities not reporting outbreaks (P = .12). Increased vaccination coverage among direct-care employees was associated with fewer reported outbreaks of laboratory-confirmed influenza (aOR, 0.97 [95% CI, 0.95-0.99]) and ILI (aOR, 0.98 [95% CI, 0.96-1.00]).Conclusions.High vaccination coverage among direct-care employees helps to prevent influenza in LTCFs.


Gerontology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Joël Belmin ◽  
Pierre Lutzler ◽  
Patrick Hidoux ◽  
Olivier Drunat ◽  
Carmelo Lafuente-Lafuente ◽  
...  

<b><i>Background:</i></b> Long-term care facilities (LTCFs) experienced severe burden from the Coronavirus 2019 (COVID-19), and vaccination against SARS-CoV-2 is a major issue for their residents. <b><i>Objective:</i></b> The objective of this study was to estimate the vaccination coverage rate among the residents of French LTCFs. <b><i>Method:</i></b> Participants and settings: 53 medical coordinators surveyed 73 LTCFs during the first-dose vaccination campaign using the BNT162b2 vaccine, conducted by health authorities in January and early February 2021. Measurements: in all the residents being in the LTCF at the beginning of the campaign, investigators recorded age, sex, history of clinical or asymptomatic COVID-19, serology for SARS-CoV-2 or severe allergy, current end-of-life situation, infectious or acute disease, refusal of vaccination by the resident or by the representative person of vaccine, and the final status, vaccinated or not. <b><i>Results:</i></b> Among the 4,808 residents, the average coverage rate for COVID-19 vaccination was 69%, and 46% of the LTCFs had a coverage rate &#x3c;70%. Among unvaccinated residents, we observed more frequently a history of COVID-19 or a positive serology for SARS-CoV-2 (44.6 vs. 11.2% among vaccinated residents, <i>p</i> &#x3c; 0.001), a history of severe allergy (3.7 vs. 0.1%, <i>p</i> &#x3c; 0.001), end-of-life situation (4.9 vs. 0.3%, <i>p</i> &#x3c; 0.001), current infectious or acute illness (19.6 vs. 0.3%, <i>p</i> &#x3c; 0.001), and refusal of vaccination by residents or representative persons (38.9 vs. 0.4%, <i>p</i> &#x3c; 0.001). <b><i>Conclusions:</i></b> About 3 out of 10 residents remained unvaccinated, and half of the LTCFs had a coverage rate &#x3c;70%. This suggests that COVID-19 will remain a threat to many LTCFs after the vaccination campaigns.


Vaccines ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 165 ◽  
Author(s):  
Angela Bechini ◽  
Chiara Lorini ◽  
Patrizio Zanobini ◽  
Francesco Mandò Tacconi ◽  
Sara Boccalini ◽  
...  

Healthcare workers (HCWs) in long-term care facilities (LTCFs) can represent a source of influenza infection for the elderly. While flu vaccination coverage (VC) is satisfactory in the elderly, HCWs are less likely to be vaccinated. There is no definitive evidence on which types of healthcare system-based interventions at LTCFs would be more useful in improving the vaccination uptake among HCWs. We performed a systematic review in different databases (Pubmed, Cochrane Database of Systematic Reviews, Health Evidence, Web of Science, Cinahl) to provide a synthesis of the available studies on this topic. Among the 1177 articles screened by their titles and abstracts, 27 were included in this review. Most of the studies reported multiple interventions addressed to improve access to vaccination, eliminate individual barriers, or introduce policy interventions. As expected, mandatory vaccinations seem to be the most useful intervention to increase the vaccination uptake in HCWs. However, our study suggests that better results in the vaccination uptake in HCWs were obtained by combining interventions in different areas. Educational campaigns alone could not have an impact on vaccination coverage. LTCFs represent an ideal setting to perform preventive multi-approach interventions for the epidemiological transition toward aging and chronicity.


PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249588
Author(s):  
Henri Christian Junior Tsoungui Obama ◽  
Nessma Adil Mahmoud Yousif ◽  
Looli Alawam Nemer ◽  
Pierre Marie Ngougoue Ngougoue ◽  
Gideon Akumah Ngwa ◽  
...  

Background Different levels of control measures were introduced to contain the global COVID-19 pandemic, many of which have been controversial, particularly the comprehensive use of diagnostic tests. Regular testing of high-risk individuals (pre-existing conditions, older than 60 years of age) has been suggested by public health authorities. The WHO suggested the use of routine screening of residents, employees, and visitors of long-term care facilities (LTCF) to protect the resident risk group. Similar suggestions have been made by the WHO for other closed facilities including incarceration facilities (e.g., prisons or jails), wherein parts of the U.S., accelerated release of approved inmates is taken as a measure to mitigate COVID-19. Methods and findings Here, the simulation model underlying the pandemic preparedness tool CovidSim 1.1 (http://covidsim.eu/) is extended to investigate the effect of regularly testing of employees to protect immobile resident risk groups in closed facilities. The reduction in the number of infections and deaths within the risk group is investigated. Our simulations are adjusted to reflect the situation of LTCFs in Germany, and incarceration facilities in the U.S. COVID-19 spreads in closed facilities due to contact with infected employees even under strict confinement of visitors in a pandemic scenario without targeted protective measures. Testing is only effective in conjunction with targeted contact reduction between the closed facility and the outside world—and will be most inefficient under strategies aiming for herd immunity. The frequency of testing, the quality of tests, and the waiting time for obtaining test results have noticeable effects. The exact reduction in the number of cases depends on disease prevalence in the population and the levels of contact reductions. Testing every 5 days with a good quality test and a processing time of 24 hours can lead up to a 40% reduction in the number of infections. However, the effects of testing vary substantially among types of closed facilities and can even be counterproductive in U.S. IFs. Conclusions The introduction of COVID-19 in closed facilities is unavoidable without a thorough screening of persons that can introduce the disease into the facility. Regular testing of employees in closed facilities can contribute to reducing the number of infections there, but is only meaningful as an accompanying measure, whose economic benefit needs to be assessed carefully.


2001 ◽  
Vol 22 (08) ◽  
pp. 519-521 ◽  
Author(s):  
Xiao Wei Cui ◽  
Marcia M. Nagao ◽  
Paul V. Effler

Abstract Influenza and pneumococcal vaccination rates among Hawaii long-term-care facilities (LTCFs) statewide during the 1996/97 through the 1998/99 influenza seasons revealed that resident influenza vaccination rates remained over 89%, but pneumococcal vaccination was underutilized. LTCF staff influenza vaccination rates over the same time period were low.


2020 ◽  
Vol 75 (Supplement_2) ◽  
pp. ii33-ii41
Author(s):  
Marcella Sibani ◽  
Fulvia Mazzaferri ◽  
Elena Carrara ◽  
Maria Diletta Pezzani ◽  
Fabiana Arieti ◽  
...  

Abstract Background In long-term care facilities (LTCFs) residents often receive inappropriate antibiotic treatment and infection prevention and control practices are frequently inadequate, thus favouring acquisition of MDR organisms. There is increasing evidence in the literature describing antimicrobial stewardship (AMS) activities in LTCFs, but practical guidance on how surveillance data should be linked with AMS activities in this setting is lacking. To bridge this gap, the JPIAMR ARCH and COMBACTE-MAGNET EPI-Net networks joined their efforts to provide practical guidance for linking surveillance data with AMS activities. Materials and methods Considering the three main topics [AMS leadership and accountability, antimicrobial usage (AMU) and AMS, and antimicrobial resistance (AMR) and AMS], a literature review was performed and a list of target actions was developed. Consensus on target actions was reached through a RAND-modified Delphi process involving 40 experts from 18 countries and different professional backgrounds adopting a One Health approach. Results From the 25 documents identified, 25 target actions were retrieved and proposed for expert evaluation. The consensus process produced a practical checklist including 23 target actions, differentiating between essential and desirable targets according to clinical relevance and feasibility. Flexible proposals for AMS team composition and leadership were provided, with a strong emphasis on the need for well-defined and adequately supported roles and responsibilities. Specific antimicrobial classes, AMU metrics, pathogens and resistance patterns to be monitored are addressed. Effective reporting strategies are described. Conclusions The proposed checklist represents a practical tool to support local AMS teams across a wide range of care delivery organization and availability of resources.


2020 ◽  
pp. 1-7
Author(s):  
Gundu H R Rao ◽  

The new novel coronavirus was discovered by a Scottish virologist in London in 1964. As is usual with new discoveries, it seems the article she wrote about this discovery, was rejected by a peer reviewed journal. Dr Almeida wrote to the prestigious journal Nature (Nature 220, 1968), outlining her findings and proposed the name “coronavirus” for the new family of viruses. The name referred to the “crown like” appearance, she first observed on these viruses by electron microscopy. While SARS CoV-2 infection seems to be in control in China (less than 100,000 for a population of over billion), where it originated, the epidemic has moved briskly to the rest of the world. What seemed to be impossible to achieve, - imposing and enforcing strict quarantine of people, -is now a reality in majority of the countries. Success of preventive efforts is related, to how best the key principles of prevention strategies are followed; testing for infection, contact tracing, social distancing, wearing masks, and containment of the infected individuals. In December of 2019, several people in Wuhan, China, developed pneumonia and respiratory failure, like what happened during SARS epidemic of 2003. This virus is easily transmissible by symptomatic as well as asymptomatic individuals. As early as January 2020, SARS CoV-2 virus was found to spread during workshops, company meetings. Hospitals seem to provide a favorable environment for the propagation of coronavirus disease(Covid-19). Long-term care facilities are high-risk settings for infections of respiratory diseases. In the long-term care facilities, majority of the senior citizens, seem to have pre-existing conditions, such as hypertension, obesity, type-2 diabetes or cardiovascular diseases, which puts them at high-risk associated with Covid-19 severity. Several mass gatherings have been associated with explosive outbreaks of Covid-19, including political rallies, protests, sports and entertainment events. The possible role of children in transmission of the coronavirus is still not clear. Several individuals who had recovered from the COVID-19 have tested positive again at a later date, suggesting that the infection has been reactivated. These observations raise question about immunity in covid-19 patients for future infections, as well as the ‘herd immunity’ that we all are hoping for. In the absence of an evidence-based cure, the only choice we have of preventing infection is social distancing, wearing masks where needed, hand washing, contact tracing, and containment. SARS CoV-2 virus spreads through a receptor called angiotensin(ACE 2), which is expressed on many cells including the nasopharyngeal epithelial cells, by attaching to these receptors via its spike like external projections.In view of this observation, there is considerable interest in interventions, that may prevent these interactions including vaccines. The mRNA-1273 Group members have published their preliminary report in NEJM (July 14, 2020) about the successful completion of a phase-1 study of 45 healthy adults, who received two vaccines containing stabilized perfusion of SARS CoV-2 spike protein. The vaccines seem to have induced the SARS CoV-2 immune response in all participants. These preliminary findings, support and encourage the development of such novel vaccines, as well as drugs that interfere with the host receptor and virus interaction


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