Immunization

In post-acute and long-term care (PALTC) settings, ensuring that older adults receive appropriate immunizations is paramount. As the immune system undergoes changes with age, coupled with the prevalence of chronic conditions among this population, older adults become more susceptible to various infectious diseases. Immunizations play a pivotal role in reducing the risk of infections, their associated morbidities, and potential outbreaks in communal living environments.

Key Vaccinations for the PALTC Population

• Influenza Vaccine: Annual influenza vaccination is essential given the high morbidity and mortality associated with influenza in older adults. Different formulations, such as high-dose or adjuvanted vaccines offer enhanced efficacy for older adults.
• Pneumococcal Vaccines: Both PCV13 and PPSV23 protect against pneumococcal diseases. The CDC provides guidelines on their sequential administration for optimal protection.
• Herpes Zoster Vaccine: Shingles can be particularly severe in older adults. The recombinant zoster vaccine (RZV) is recommended over the live zoster vaccine due to superior efficacy and duration of protection.
• Tetanus, Diphtheria, Pertussis (Tdap) Vaccine: A one-time dose of Tdap, followed by Td boosters every 10 years, ensures continued protection against these diseases.
• COVID-19 Vaccines: Given the severe implications of COVID-19 among older adults, COVID-19 vaccination, with subsequent booster doses as recommended, is a pivotal component of preventive care in PALTC settings.
• Respiratory Syncytial Virus (RSV) Vaccine:  This long-awaited vaccine can help protect older adults from serious illness due to RSV. The CDC recommends that adults 60 years and older may receive a single dose of RSV vaccine, based on discussions between the patient and health care provider.  

Strategies to Optimize Vaccination Rates

• Vaccination Campaigns: Regularly scheduled vaccination clinics within the facility can streamline the process and ensure higher coverage.
• Educational Initiatives: For both healthcare professionals and residents, understanding the benefits, safety, and potential side effects of vaccines can mitigate hesitancy.  
• Record Keeping & Tracking: Maintaining an updated immunization registry for each resident ensures that they receive vaccines timely and prevents unnecessary re-vaccinations.
• Collaboration: Engaging with local public health departments can provide insights into any emerging infectious threats and associated vaccination recommendations.
• Adverse Event Monitoring: Monitoring and reporting any post-vaccination adverse events not only ensures patient safety but also contributes to the broader pharmacovigilance network.