[Low vaccination coverage against influenza in elderly hospitalized in France]. / Faible taux de couverture vaccinale contre la grippe des sujets âgés hospitalisés en France.

PURPOSE: Annual influenza epidemics is still a major cause of illness and mortality especially in the elderly. Annual vaccination is the most effective way to prevent disease and reduce hospitalizations and deaths related to influenza in the elderly population. In France, there are few data available about vaccination coverage of elderly at risk for influenza. The aim of the study was to measure the influenza vaccination coverage and assess traceability in the elderly (≥ 75 years old) admitted to hospital. METHODS: In participating French hospitals, each patient aged 75 years or more, hospitalized in acute units of internal medicine, geriatric and infectious disease, was included in a multicentric point prevalence survey. RESULTS: Between April and May 2011, 63 departments of 28 hospitals participated and 903 patients were included (mean age of included patients: 85 years): 82% were previously living at home and 13% were institutionalized. Most of them had multiple diseases (77%) and 21% were admitted for a respiratory disease: 58% were vaccinated against influenza. A back-up for traceability was identified in 53% of cases. Patient refusal may be a common determinant of non-vaccination, as well as non-proposal by the attending physician. The vaccination rate did not differ according to usual living place including accommodation facilities in geriatric. CONCLUSION: Coverage for influenza vaccination is low in hospitalized elderly patients and traceability is insufficient. This vaccine, noncompliance mostly linked to the refusal of patients, is a worrisome public health problem, on which physicians and hospital staff in charge, as well as institutions, should turn attention toward a multi-professional preventive strategy against the morbidity risk of this infectious disease.

Streptococcus pneumoniae vaccinal coverage in hospitalized elderly patients in France.

BACKGROUND: In France, there is little data on vaccinal coverage in elderly people at risk for invasive pneumococcal infections (IPI). OBJECTIVE: The study objective was to assess the pneumococcal vaccination coverage and traceability in hospitalized elderly people (>75 years of age). METHOD: A multicentric point prevalence survey was made on volunteers over 75 years of age, hospitalized in internal medicine, geriatrics, and infectious diseases units. RESULTS: Nine hundred and three patients in 63 units of 28 hospitals were included (mean 85 years of age) in the study between April and May 2011. Ten percent (93/903) were vaccinated against the pneumococcus. Thirty-eight percent of the patients had at least one risk factor for IPI and 20.5% of these had been vaccinated. There was a traceability back-up in 59% of the cases. Vaccination was not considered by the hospital for 83% of patients with IPI risk factor but not vaccinated (task delegated to the family physician in 50% of the cases). CONCLUSION: Vaccination coverage against the pneumococcus in France is very low in hospitalized patients over 75 years of age even though more than one out of three presents at least one risk factor for IPI. The rate of traceability is also poor. Hospitalization should be an opportunity to offer pneumococcal vaccination to elderly patients at risk for IPI in France because of unclear recommendations for elderly individuals and lack of political will to improve vaccination coverage.