According to the CDC, “Influenza causes an estimated average of greater than 200,000 hospitalizations” and as many as 49,000 deaths annually in the United States. The CDC recommends healthcare personnel receive routine annual influenza vaccination and in Maryland there are five Maryland nursing homes with staff flu vaccination rates of 25 percent or less in 2012, according to the Maryland Health Care Commission (MHCC).
The CDC reports that health care personnel are “exposed to patients with influenza in the workplace and are thus at risk of occupationally acquired influenza and of transmitting influenza to patients and other healthcare personnel.”
According to the CDC, influenza outbreaks in hospitals and long-term care facilities have been associated with low vaccination rates among healthcare personnel. The Maryland Department of Health and Mental Hygiene (DHMH) research suggests that health care workers can be a key source of institutional outbreaks, contributing to increased morbidity and mortality among vulnerable patients.
Data supplied by the MHCC indicates the five Maryland nursing homes with 25 percent or less of staff receiving flu vaccinations in 2012 are Heritage Health and Harbor Rehabilitation in Anne Arundel County; Manor Care of Dulaney, Ridgeway Manor Nursing and Rehabilitation Center and Genesis Elder Care Randallstown Center in Baltimore County; and Vantage House Retirement Community in Howard County.
In fact there were 38 nursing homes with staff flu vaccination participation rates of less than 50 percent in 2012. According to Carol Christmyer with the MHCC, last year was considered a moderately severe year for flu among the elderly. Even with that low flu vaccination rate among staff Christmyer said, “Overall the percentage rate increased 8% in 2012 over 2011.”
When Christmyer’s department becomes aware of a nursing home with a low flu vaccination percentage among staff, they respond by sending emails to the nursing home stressing how important it is for the staff to have a vaccination.
They arranged for a webinar two years ago for nursing home staff to hear a speaker talk about flu vaccinations and their importance after they saw how low the percentage rates were.
”The MHCC has no requirement for flu vaccinations of nursing home staff,” said Christmyer, but the Maryland Department of Health and Mental Hygiene issues requirements to nursing homes under the Annotated Code of Maryland §18-404 (2011).
It states that the institution “shall immunize employees and residents against the influenza virus and that prior to immunizing the institution must obtain written consent to administer the immunization.” There are circumstances under which a vaccination is not required, according to §18-404.
“A resident or employee is not required to receive a vaccine under this section if the vaccine is medically contraindicated for the resident or employee or the vaccine is against the resident's or employee's religious beliefs."
What is the likelihood that 50 percent or more of the healthcare workers in the 38 lowest rated nursing homes in Maryland are not required to have a vaccination because of one or the other of these exemption rules?