Nursing home resident and facility characteristics associated with pneumococcal vaccination: National nursing home survey, 1995-1999

OBJECTIVES: To assess Advisory Committee for Immunization Practices recommendations for the pneumococcal vaccine in nursing home residents using national surveys to examine factors associated with vaccination. DESIGN: Cross-sectional national sample surveys of nursing homes and nursing home residents with a two-stage probability design, stratified on size and Medicare and Medicaid certification status. SETTING: U.S. nursing homes during 1995, 1997, and 1999. PARTICIPANTS: Six current residents were randomly selected from each facility (n = approximately 8,000 each year). MEASUREMENTS: Residents' pneumococcal vaccination status was obtained by asking the facility respondent for each resident: "Has [the resident] EVER had a pneumococcal vaccine, that is a pneumonia vaccination?" Vaccination status was coded as yes, no, and unknown. RESULTS: The proportion of residents aged 65 and older that received pneumococcal vaccination increased significantly, from 23.6% in 1995 to 28.2% in 1997 to 37.4% in 1999 (P<.001). The proportion of residents in homes with pneumococcal immunization programs increased significantly, from 65.2% in 1995 to 88.9% in 1999. CONCLUSION: The proportion of nursing home residents aged 65 and older receiving the pneumococcal vaccine increased significantly from 1995 to 1999. Residents living in nursing homes with programs for pneumococcal immunizations were significantly more likely to be vaccinated.