- In the United States, influenza and pneumococcal infections are responsible for causing the largest number of vaccine preventable deaths.
- Ninety-percent of these deaths are in the elderly population.
- Vaccines are under-utilized in spite of being safe, cost effective and clinically effective.
- Flu vaccine is safe, 40%-50% effective in preventing hospitalization, and 80% effective in preventing death.
- Pneumococcal vaccination is 75% effective in preventing invasive disease (bacteremia).
- Billing records show that very few patients admitted to the hospital with a high risk diagnosis are given immunization during their hospital stay.
- Forty-nine percent of those who die of pneumococcal disease had been hospitalized in the previous three to five years.
- Computer assisted prompts reminding the doctor to order vaccines improve infection rates.
- Automatic process: Place a field on the face sheet for vaccination. If no vaccination, the nurse completes an assessment. If no restrictions, the pharmacy writes a prescription. The nurse gives the vaccination.
Long Term Care:
- Those facilities that implement standing orders for vaccination have much higher rates of vaccination than those facilities that require individual doctor's orders.
- Medicare does not require individual doctor's orders for influenza or pneumococcal vaccinations.
- Residents that receive both vaccinations have a 30% decrease in mortality.
- As of 2005, the MDS will have a field for vaccination. The pneumococcal vaccination rates will be a quality indicator.
- ACIP recommends vaccination if the history of pneumococcal vaccination is unknown. In the future there may be a vaccination registry.
- The myth that it is unsafe to immunize the immunosuppressed patient is untrue...it is recommended.
- There is liability in not vaccinating because it is becoming the standard of care.