Evidence remains lacking that vaccinating healthcare workers prevents influenza in elderly residents in long-term care.

Seasonal infl uenza remains a major cause of morbidity and mortality, especially in the elderly.1 Elderly residents of long-term care facilities are especially susceptible because of their frailty, increased age and the presence of multiple comorbidities. Health care workers (HCWs) can introduce infl uenza into health care settings, as a signifi cant number of HCWs (10 to 30%) are infected with infl uenza each winter2 3 and most of them continue to work, despite infection (approximately 50 to 80% of those infected).4 5 The USA Advisory Committee on Immunisation Practices recommends infl uenza vaccination to HCWs because of their contact with those at risk of complications from infl uenza.6 Despite these recommendations, only 36% of HCWs in the United States are vaccinated against infl uenza annually.7 Other previous studies demonstrate a range of immunization rates for overseas doctors from 38% to 82%.8 9