425 No evidence for benefits of influenza vaccine in institutional healthcare workers

July 01, 2014

PEARLS 425, March 2014, written by Brian R McAvoy

Clinical question
How effective is influenza vaccination of healthcare workers on the incidence of laboratory-proven influenza, pneumonia, death from pneumonia and admission to hospital for respiratory illness in those aged 60 years or older resident in long-term care institutions (LTCIs)?

Bottom line
There was no effect of vaccination on laboratory-proven influenza, respiratory tract infections, admissions to hospital for respiratory illness or deaths due to respiratory illness. This review did not find information on co-interventions with healthcare worker vaccination: hand-washing, face masks, early detection of laboratory-proven influenza, quarantine, avoiding new admissions, prompt use of antivirals, restricting visitors and asking healthcare workers with influenza or influenza-like illness not to work.

Caveat
The principal sources of bias in the studies related to attrition and blinding. The studies did not report on adverse events.

Context
Older individuals in LTCIs at risk of influenza may be infected by their healthcare workers. There are no accurate data on rates of laboratory-proven influenza in healthcare workers. Vaccinating healthcare workers against influenza may reduce infections acquired from this source.

Cochrane Systematic Review
Thomas RE at al. Influenza vaccination for healthcare workers who care for people aged 60 or older living in long-term care institutions. Cochrane Reviews, 2013, Issue 7. Art. No.: CD005187.DOI: 10.1002/14651858. CD005187.pub4. This review contains 3 studies involving 5896 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.