Inducing Herd Immunity against Seasonal Influenza in Long-Term Care Facilities through Employee Vaccination Coverage: A Transmission Dynamics Model

Abstract EN

Introduction.

Vaccinating healthcare workers (HCWs) in long-term care facilities (LTCFs) may effectively induce herd immunity and protect residents against influenza-related morbidity and mortality.

We used influenza surveillance data from all LTCFs in New Mexico to validate a transmission dynamics model developed to investigate herd immunity induction.

Material and Methods.

We adjusted a previously published transmission dynamics model and used surveillance data from an active system among 76 LTCFs in New Mexico during 2006-2007 for model validation.

We used a deterministic compartmental model with a stochastic component for transmission between residents and HCWs in each facility in order to simulate the random variation expected in such populations.

Results.

When outbreaks were defined as a dichotomous variable, our model predicted that herd immunity could be induced.

When defined as an attack rate, the model demonstrated a curvilinear trend, but insufficiently strong to induce herd immunity.

The model was sensitive to changes in the contact parameter β but was robust to changes in the visitor contact probability.

Conclusions.

These results further elucidate previous studies’ findings that herd immunity may not be induced by vaccinating HCWs in LTCFs; however, increased influenza vaccination coverage among HCWs reduces the probability of influenza infection among residents.