Massachusetts Department of Public Health (MDPH)
Division of Epidemiology and Immunization

Long Term Care Facilities Should Plan to Purchase Seasonal Influenza Vaccine Now for the 2010-11 Influenza Season to Avoid the Risk of Vaccine Being in Short Supply

The Centers for Medicaid and Medicare Services (CMS) require nursing homes to offer all residents seasonal influenza and pneumococcal vaccines and to document the results. Vaccinate each resident unless medically contraindicated, the resident or legal representative refuses, or there is a vaccine shortage.

The Massachusetts Department of Public Health requires that long term care facilities (LCTF) offer all employees annual vaccination against the seasonal influenza virus and also provide employees with information about the risks and benefits of the vaccine. http://www.mass.gov/Eeohhs2/docs/dph/quality/hcq_circular_letters/ltc_facilities_0611468.pdf.

Plan to purchase seasonal influenza vaccine for employees and residents:
Unfortunately, MDPH is not able to supply seasonal influenza vaccine for employees or residents of LTCFs for the 2010-2011 season. Facilities should plan to purchase influenza vaccine from pharmaceutical distributors or the manufacturers in January and February to avoid the vaccine being sold out prior to the vaccination period. The National Vaccine Influenza Summit maintains a list of distributors with flu vaccine for sale, which will be updated every other week throughout the season. To access this information, go to: http://www.preventinfluenza.org/ivats/.

Medicare reimbursement rates for the cost of administering influenza and pneumococcal vaccine are $25.21 in Metro Boston and $22.41 out side of Metro Boston. Reimbursement for the cost of influenza vaccine for the 2009-2010 season is $11.00 or more, depending on the formulation used. For more information on Medicare reimbursement for vaccination, go to http://www.cms.hhs.gov/AdultImmunizations/02_Providerresources.asp#TopOfPage.

February 2010

LTCF residents should receive seasonal influenza vaccination, and should be vaccinated against 2009 H1N1. There is ample supply of H1N1 vaccine in Massachusetts. To order H1N1 vaccine, go to http://www.mass.gov/flu/h1n1reporting, or call the H1N1 Vaccine Help Desk at 617-983-6898.

During October and November 2009, CDC received reports of 2009 H1N1 outbreaks in LTCFs in Colorado, Maine, and New York. This report summarizes the three outbreaks, which involved facilities primarily housing older patients. These outbreaks illustrate that, despite the lower risk for infection with 2009 H1N1 among persons aged ≥65 years compared with seasonal influenza, 2009 H1N1 outbreaks still can occur in LTCFs. These outbreaks also underscore the importance of respiratory illness surveillance and recommended infection-control procedures in LTCFs. All health-care personnel should be vaccinated against seasonal influenza and 2009 H1N1.

The Commonwealth of Massachusetts
Executive Office of Health and Human Services
Department of Public Health
Bureau of Health Care Safety and Quality

EMERGENCY REGULATIONS AUTHORIZING ADMINISTRATION OF VACCINE
BY DESIGNATED HEALTH CARE PROFESSIONALS
September 4, 2009

ATTACHMENT A (draft)

ATTACHMENT B (draft)
Massachusetts Department of Public Health DRAFT Guidelines Authorizing Pharmacists, Dentists and Certified EMT-Paramedics to Administer Immunization Vaccines Against Seasonal Influenza and Pandemic Influenza A H1N1 2009

(All of these are PDF documents)