[Vaccination against influenza in nursing homes in Brussels]

The aims is to measure the immunization rate against influenza in nursing homes in Brussels, to identify the methodologic problems of a survey in this type of population, to analyse the predictors of vaccine administration and to make recommendations for increasing vaccine coverage. On February 1, 1989, there were 339 nursing homes (14,095 beds) in Brussels. These nursing homes were stratified according to their size and administrative status. One home in eight was selected at random as well as two residents in three in each home. The study population included 1,165 residents in 44 nursing homes; their mean age was 81 years. The determinants of vaccine administration were analysed by logistic regression according to Donabedian's model of supply and demand. Vaccine coverage was estimated at 69%; an optimistic estimate since 20 of the homes contacted refused to participate and there are reasons to believe that the immunization rate was low in this group. Among the 781 residents able to respond, only 10% had requested to be immunized. The vaccine had been offered to 67% of that group. Factors predicting vaccine administration were the legal status of the nursing homes, the ambulatory status of the resident, knowledge of the vaccine, a history of prior vaccination, a favorable opinion about the vaccine effectiveness, safety and usefulness. Neither age nor the existence of a chronic condition were significant predictors.