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For residents of nursing homes, it can take months to receive their first vaccinations.
New research suggests that some nursing homes in the U.S. are failing to comply with federal standards to ensure that staff are vaccinated, which puts at risk of contracting communicable diseases, such as tuberculosis, the flu and pneumonia.
In its study of 130 facilities across the country, Kaiser Health News found that 27% of providers failed to meet at least one of the three levels of vaccination requirements.
Many nursing home residents need to receive vaccinations to help protect themselves against certain diseases and to protect other residents. The Centers for Disease Control and Prevention recommends that individuals over age 50 receive flu vaccinations every year. Infants and children up to age 5 years old, pregnant women and health care workers are all encouraged to receive pneumococcal and tetanus vaccinations.
A physician must certify that the patient is eligible for a vaccination on an annual basis. Because nursing homes get federal reimbursements for these services, they’re required to comply with CDC recommendations.
Efforts to encourage more hospitals to comply with vaccination requirements for their staff met with mixed results in 2014, with about a quarter of nursing homes adopting an inoculation policy. This country’s nursing home population is older and sicker, especially compared with other hospitals.
Health experts say that getting and staying healthy is all about prevention, and residents shouldn’t have to deal with this risk of infection while they’re at a facility.
“It is a significant public health issue,” said Robert Bonow, a professor at Harvard Medical School and past president of the Infectious Diseases Society of America. “Those who are not vaccinated face the risk of contracting pertussis, tetanus and influenza, which, in many cases, can lead to death.”
One of the biggest issues facing nursing homes is a lack of staff members who have received required vaccinations.
To make sure that staff members adhere to the standards, CDC guidelines require nursing homes to have a process to process staff requests for immunizations within 10 days, said Geoffrey Wilson, an epidemiologist and former national representative of the Infectious Diseases Society of America. Most nursing homes have a team of workers dedicated to this task, but the process can be slow.
“It isn’t uncommon to have wait times of several months to get staff in compliance,” Wilson said.
To expedite the process, the agency recommends setting up a vaccination coordinator who represents the nursing home and ensures compliance. That person also serves as a “point of contact” who provides any added, missing information such as an employee’s vaccination history or medical documentation.
KHN reached out to 40 nursing homes in Massachusetts, Texas, Minnesota, Tennessee and Pennsylvania, but found that two-thirds hadn’t hired a vaccination coordinator in the past year.
In Minnesota, Harris Nursing Home, a facility that serves more than 600 people, was among the few that accepted staff requests for vaccination in the past year.
“In some nursing homes, people have gotten sick after receiving their [influenza] vaccinations,” said Yasmina Khan, the chief nursing officer at Harris Nursing Home. “It’s not necessarily because they didn’t receive their vaccines but because there’s a slow system with which to handle vaccination requests. They’re using staff or volunteers for the job instead of allowing it to be automated.”
The CDC recommends that nursing homes find a way to expedite the process of getting staff immunized by offering nurses or other staff members who’ve been vaccinated a vaccination certificate to take home with them. But this isn’t always the case.
Some nursing homes still “take the position that you have to be at fault for having a potentially deadly disease and that you are a bad nurse if you don’t get immunized,” Khan said.