Mandatory flu shots for nursing home patients

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US to require flu shots for nursing home patients

Fri Aug 12, 2005 7:53 PM BST

 

By Susan Heavey

 

WASHINGTON (Reuters) - U.S. nursing homes must vaccinate all their

patients against the flu and pneumonia starting this fall or risk

being kicked out of the Medicare and Medicaid programs under a new

plan made public on Friday.

 

The proposal, which has not yet been finalized, would ensure that the

most vulnerable elderly receive their flu shots but could raise

questions about how many doses will remain as Americans head into the

2005-2006 flu season with only two U.S.-approved vaccine makers.

 

Influenza kills about 36,000 Americans and hospitalizes 200,000 each

year. People 65 and older are among the most vulnerable to the flu,

especially those in the close quarters of nursing homes where germs

can spread more easily.

 

" Vaccines against these diseases are effective in preventing

hospitalizations and death, " Mark McClellan, head of the agency that

runs the U.S. insurance programs for the elderly, disabled or poor,

said in a statement. " However, many at-risk people are not getting the

vaccines they need. "

 

There are between 1.6 million and 2 million residents in approximately

18,000 nursing homes, according to various U.S. government estimates.

 

In order to keep receiving Medicare and Medicaid payments, nursing

homes would have to vaccinate each patient unless he or she or their

family refused " for medical reasons, " it said.

 

If the Centers for Disease Control and Prevention (CDC) declares

another shortage, states could have the option not to cite the violation.

 

Last year, officials said elderly patients should have first access to

flu shots after one of two U.S. flu vaccine makers -- Chiron Corp. --

lost its license and could not deliver 48 million doses, which were

half the anticipated supply. Despite initial confusion and long lines,

the season ended with a surplus of unused vaccines.

 

U.S. health officials have said Chiron is making progress in fixing

its problems, but it is not clear if the firm will be able to rejoin

Sanofi-Aventis unit Sanofi-Pasteur on the U.S. market this year.

 

GlaxoSmithKline is seeking approval to sell its version of the vaccine

in the United States but no decision had been announced. MedImmune

Inc. makes a nasal spray vaccine.

 

Medicare officials said they came up with the nursing home rule after

hearing from the CDC and two industry groups -- the American

Association of Homes and Services for the Aging and the American

Health Care Association.

 

Only 65 percent of nursing home residents received flu shots,

according to one 1999 survey. Officials said they want to raise that

figure to 90 percent.

 

To help encourage more shots, Medicare officials in January said they

would pay $18 for each vaccination on top of the cost of the actual

dose, up from $8. Medicaid reimbursements vary state-to-state.

 

Nursing homes must also give pneumonia vaccine to patients who have

never had it, officials said. Only 38 percent of elderly patients had

received them, the 1999 survey found.

 

Medicare's statement, dated August 11 and posted online on Friday,

also said the homes should give flu shots to their workers.

 

The proposed rule is open for public comments for 15 days. Medicare

spokeswoman Mary Kahn said she expected the final rule to be

implemented soon after.