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Published on: June 11, 2012
Facility-Level Access Drives Disparities in Influenza and Pneumococcal Vaccination in Long-Term Care Facilities in
Zofia Gniadek1, Estera Jachowicz-Matczak1, Cezary Kapturkiewicz1
1Department of Infection Control and Mycology, Faculty of Medicine, Jagiellonian University Medical College, 31-121 Kraków, Poland.
Background:
Vaccinations prevent severe respiratory infections in older adults, yet uptake in Polish long-term care facilities (LTCFs) remains poorly characterized. We assessed influenza and pneumococcal vaccination coverage and factors associated with uptake, including the influence of local government financing.
Methods:
In this prospective observational study (January-June 2022), residents aged ≥65 years from eight LTCFs in southern Poland (four public, four private) were evaluated. Clinical data and geriatric assessments (Barthel Index, ADL, FRAIL-NH) were obtained from medical records and questionnaires. Comparative analyses were limited to residents living in facilities where vaccination activities were implemented and for whom complete data were available.
Results:
Overall, 429 residents were assessed: 136 (31.7%) received influenza vaccination and 77 (17.9%) received pneumococcal vaccination. Three of the eight LTCFs administered neither influenza nor pneumococcal vaccines, highlighting a facility-level access gap. For individual-level comparisons, 260 residents with complete data from LTCFs offering vaccination were analyzed (245 for pneumococcal outcomes). Influenza vaccination was not associated with most comorbidities or functional measures, but was more common among residents with dementia. Pneumococcal vaccine recipients were younger, had better functional status, and exhibited a lower burden of comorbidities than unvaccinated residents, suggesting preferential vaccination of fitter individuals. Municipality-level data showed low uptake of publicly funded pneumococcal programs (6.1% in Kraków; 3.6% in Wilkowice).
Conclusions:
Vaccination coverage among LTCF residents was low and strongly influenced by structural access at the facility level. Simplifying costs, reducing out-of-pocket costs and addressing potential age-related biases are essential to improving equitable immunization in Polish LTCFs.
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