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Underutilization of pneumococcal vaccine in nursing homes in Washington state: report of a serotype-specific outbreak and a survey
Underutilization of pneumococcal vaccine in nursing homes in Washington state: report of a serotype-specific outbreak and a survey
- Source :
- American Journal of Medicine. Feb, 1993, Vol. 94 Issue 2, p149, 4 p.
- Publication Year :
- 1993
-
Abstract
- PURPOSES: To describe an outbreak of pneumococcal disease in a Washington state nursing home and to report a survey or pneumococcal vaccine utilization in Washington nursing homes. PATIENTS AND METHODS: Outbreak Data were collected from nursing home residents' records. Nasopharyngeal cultures were obtained from residents and staff. Survey. Fifty-four randomly selected Washington nursing homes were surveyed about pneumecoccal vaccine utilization and policies. RESULT: Outbreak, Three confirmed and 4 possible cases of pneumococcal disease occurred over 9 days among 94 residents; 5 patients (71%) died. Cases were identified among 6 of 42 residents on 1 wing, compared with 1 of 52 on the other 2 wings (relative risk 7.4, 95% confidence interval 1.0, 398d5). Streptococcus pneumoniae seretype 9V was cultured from the blood of 3 confirmed case-patients and the nasopharynx of 2 of 73 resident& Only 7 % of residents had received pneumococcal vaccine, including one case-patient who had received 14-valent vaccine without serotype 9V. Survey. Only 22% of residents were reported to have received pneumococcal vaccine; vaccination status was unknown for 66 %. Physician discretion determined pneumococcal vaccination in 49 (91% ) nursing homes; 9 (17%) had a written policy. Two major barriers to pneumococcal vaecination were cited: low priority among physicians (43%) and difficulty in determining residents' vaccine history (37%). CONCLUSIONS: A pneumecoccal disease outbreak among undervaccinated nursing home residents probably resulted from person-to-persen transmission. Pneumecoccal vaccine appears to be underutilized in Washington state nursing homes.
Details
- ISSN :
- 00029343
- Volume :
- 94
- Issue :
- 2
- Database :
- Gale General OneFile
- Journal :
- American Journal of Medicine
- Publication Type :
- Periodical
- Accession number :
- edsgcl.13432816