Clin Infect Dis 2004; 39:45964. BMC Geriatr. ACIP recommends that HCP be prioritized in the earliest phase of COVID-19 vaccination. (https://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm). COVID-19 vaccines can help keep you from getting seriously ill if you do get COVID-19. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Resident and staff vaccination data from assisted living and other LTC settings may be monitored by your state. Changing gloves and gowns after each resident encounter and performing hand hygiene. For purposes of entry into the United States, vaccines accepted will include FDA approved or authorized and WHO Emergency Use Listing vaccines. You can review and change the way we collect information below. Older adults with COVID-19 may not always manifest fever or respiratory symptoms. 1, New SARS-CoV-2 infection identified in HCP or nursing home-onset infection in a resident should prompt additional testing in the facility.1. Having preapproved orders from physicians or plans to obtain orders for antiviral medications on short notice can substantially expedite administration of antiviral medications. To receive weekly email updates about Seasonal Flu, enter your email address: We take your privacy seriously. According to requirements, each resident is to be vaccinated unless contraindicated medically, the resident or legal representative refuses vaccination, or the vaccine is not available because of shortage. Guidance for Fully Vaccinated Residents of Assisted Living Facilities Fully vaccinated residents of assisted living facilities may follow the CDC's recommendations for individuals who have been fully immunized against COVID-19 as described below: Fully vaccinated residents can gather with other fully vaccinated residents without masks Determining influenza virus type or subtype of influenza A virus can help inform antiviral therapy decisions. It is important to protect people who are disproportionately affected by COVID-19especially residents in long-term care (LTC) settings. Residents in the facility who develop symptoms of acute illness consistent with influenza or COVID-19 should be moved to a single room, if available, or remain in current room, pending results of viral testing. Healthcare personnel who have occupational exposures can be counseled about the early signs and symptoms of influenza and advised to contact their health-care provider immediately for evaluation and possible early initiation of antiviral treatment if clinical signs or symptoms develop. Avoid new admissions or transfers to wards with symptomatic residents. MMWR 2011:60(RR07);1-45, Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization PracticesUnited States, 202223 Influenza Season [523 KB, 32 pages], Seasonal Influenza Vaccination Resources for Health Professionals, Interim Guidance for Routine and Influenza Immunization Services During the COVID-19 Pandemic, Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza, Influenza Antiviral Medications: Summary for Clinicians, Information for Clinicians on Influenza Virus Testing, Influenza virus testing in investigational outbreaks in institutional or other closed settings, Information on Rapid Molecular Assays, RT-PCR, and other Molecular Assays for Diagnosis of Influenza Virus Infection, Healthcare-associated infections and long-term care settings, Prevention Strategies for Seasonal Influenza in Healthcare Settings, CDC. The Centers for Disease Control and Prevention (CDC), the Centers for Medicare & Medicaid Services (CMS), and the Administration for Community Living are working together to assist long-term care settings in providing access to COVID-19 vaccines and, where recommended, boosters. The Centers for Medicare & Medicaid Services (CMS) and CDC continue to . The following influenza tests are recommended: molecular assays, including rapid molecular assays, other molecular tests, or reverse transcription polymerase chain reaction (RT-PCR). These considerations will be updated as additional information becomes available. Emerg Themes Epidemiol 2014; 11:13. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Influenza can be introduced into a long-term care facility by newly admitted residents, healthcare personnel and by visitors. When asked what the CDC announcement meant for the tens of thousands of people who live in nursing homes and assisted living facilities in New Jersey, Persichilli noted the federal government's . 1. Four influenza antiviral drugs approved by the U.S. Food and Drug Administration are recommended for treatment of uncomplicated influenza in the United States: neuraminidase inhibitors: oral oseltamivir (available as a generic version or under the trade name Tamiflu), as a pill or suspension; zanamivir (trade name Relenza), available as an inhaled powder using a disk inhaler device; and intravenous peramivir (trade name Rapivab); and a cap-dependent endonuclease inhibitor: baloxavir marboxil (trade name Xofluza) available as a tablet. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Childs A, Zullo AR, Joyce NR et al. COVID-19 vaccines do not guarantee complete immunity to the virus. Below are resources to support nursing homes, assisted living facilities, and adult day services with new requirements for visitation, testing, vaccination, and service delivery. Saving Lives, Protecting People, symptoms of influenza and COVID-19 are similar, healthcare-associated infection program in your state health department, National Institutes of Health COVID-19 Treatment Guidelines Panel, latest recommendations on treatment of nonhospitalized persons with mild-to-moderate COVID-19, Therapeutic Management of Nonhospitalized Adults With COVID-19, Medicare Monoclonal Antibody COVID-19 Infusion Program Instruction, https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html, https://www.cdc.gov/coronavirus/2019-nCoV/lab/guidelines-clinical-specimens.html, https://www.cdc.gov/flu/professionals/diagnosis/table-flu-covid19-detection.html, https://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/vitro-diagnostics-euas#individual-molecular, https://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/vitro-diagnostics-euas#individual-antigenhttps://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/vitro-diagnostics-euas#individual-antigen, https://www.cdc.gov/flu/professionals/diagnosis/table-nucleic-acid-detection.html, https://www.cdc.gov/flu/professionals/diagnosis/table-ridt.html, https://www.cdc.gov/infectioncontrol/guidelines/isolation/appendix/type-duration-precautions.html, https://academic.oup.com/cid/article/68/6/895/5369363, https://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm, https://www.cdc.gov/flu/highrisk/index.htm, https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html, https://www.covid19treatmentguidelines.nih.gov/special-populations/influenza/, https://www.atsjournals.org/doi/10.1164/rccm.201908-1581ST, https://www.cdc.gov/flu/professionals/infectioncontrol/ltc-facility-guidance.htm, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases (NCIRD), Reconstruction of the 1918 Influenza Pandemic Virus, 2022-2023 Preliminary In-Season Burden Estimate, Who is at Higher Risk of Flu Complications, Flu and COVID-19 Vaccine Coadministration, Who Should & Who Should NOT Get Vaccinated, Live Attenuated Influenza Vaccine (LAIV)/Nasal Spray Vaccine, Selecting Viruses for the Seasonal Influenza Vaccine, Flu Vaccine and People with Egg Allergies, Frequently Asked Questions on Vaccine Supply, Historical Reference of Vaccine Doses Distributed, Investigating Respiratory Viruses in the Acutely Ill (IVY), Respiratory Virus Transmission Network (RVTN), Randomized Assessment of Influenza Vaccine Efficacy Network (RAIVEN), Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN), How Vaccine Effectiveness and Efficacy are Measured, What People with a Staph Infection Should Know about Flu, Resources for Hosting a Vaccination Clinic, Overview of Influenza Surveillance in the United States, Influenza Hospitalization Surveillance Network (FluSurv-NET), Weekly U.S. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. These cookies may also be used for advertising purposes by these third parties. You can review and change the way we collect information below. C) For adult patients with suspected community-acquired pneumonia who do not require hospitalization, see antibiotic treatment recommendations from the American Thoracic Society-Infectious Diseases Society of America Adult Community-acquired Pneumonia Guidelines.13 Influenza Other Respir Viruses 2014; 8:7482. People who are moderately or severely immunocompromised have different recommendations for COVID-19 vaccines. Managers and staff of long-term care settings, including skilled nursing facilities, adult care homes, family care homes, mental health group homes, and intermediate care facilities for individuals with intellectual disabilities, should review the resources and guidance to ensure they have the latest information in how to prepare and . Additionally, all staff should wear a face covering at all times. C. Indoor Visitation Administer each injection in a different injection site. If unable to move a resident, he or she could remain in the current room with measures in place to reduce transmission to roommates (e.g., optimizing ventilation, antiviral chemoprophylaxis). LA-HAN Update on the Availability of the State and Commercial COVID-19 Testing. Cookies used to make website functionality more relevant to you. Viral culture should be performed at a public health laboratory if additional information on influenza viruses, such as influenza A virus subtype, antigenic characterization to compare with influenza vaccine strains, or antiviral resistance data, are needed. However, the CDC recommends that any resident who must leave the community wear a facemask for the duration of their outing. All information these cookies collect is aggregated and therefore anonymous. C) Residents with symptoms of acute respiratory illness who are determined to have neither SARS-CoV-2 infection nor influenza should be cared for using Standard Precautions and any additional Transmission-Based Precautions based on their suspected or confirmed diagnosis.8, A) Prescribe antiviral treatment as soon as possible if influenza testing is positive OR prescribe empiric antiviral treatment based upon a clinical suspicion of influenza while test results are pending for symptomatic residents.9-12. These cookies may also be used for advertising purposes by these third parties. CDC twenty four seven. Residents receiving antiviral medications who do not respond to treatment or who become sick with influenza after starting chemoprophylaxis might have an infection with an antiviral-resistant influenza virus. Some states may have regulations in place . Specific recommendations are highlighted below. Saving Lives, Protecting People, Given new evidence on the B.1.617.2 (Delta) variant, CDC has updated the, The White House announced that vaccines will be required for international travelers coming into the United States, with an effective date of November 8, 2021. For purposes of entry into the United States, vaccines accepted will include FDA approved or authorized and WHO Emergency Use Listing vaccines. For newly vaccinated individuals with exposure, antiviral chemoprophylaxis can be considered for up to 2 weeks following inactivated influenza vaccination until vaccine-induced immunity is acquired. Zanamivir should be used when persons require chemoprophylaxis as a result of exposure to influenza virus strains that are suspected or known to be oseltamivir-resistant. Given the predominance of women of child-bearing potential among the healthcare workforce, a substantial number of HCP are estimated to be pregnant or breastfeeding at any given time. The previous CMS guidelines, issued in September 2020 and largely adopted by the states, recommended allowing indoor visits if a facility has been case-free for 14 days and is located in a county with a positivity rate on coronavirus tests of less than 10 percent. J Am Geriatr Soc 2002; 50:60816. If resident movement or transport is necessary, have the resident wear a facemask (e.g., surgical or procedure mask), if possible. Deaths, which bottomed at about 60 in June . Persons receiving antiviral chemoprophylaxis should not receive live attenuated influenza virus vaccine (LAIV), and persons receiving LAIV should not receive antiviral treatment or chemoprophylaxis until 14 days after LAIV administration. Specific recommendations are highlighted below. Baloxavir is not recommended for pregnant women, severely immunosuppressed persons, those with severe disease, or hospitalized influenza patients. Additional Information for Community Congregate Living Settings (e.g., Group Homes, Assisted Living), Management of COVID-19 in Homeless Service Sites and Correctional and Detention Facilities, Centers for Disease Control and Prevention. However, in settings where the initial vaccine supply is insufficient to vaccinate residents of all LTCFs, sub-prioritization of vaccine doses may be necessary. For the latest information on influenza vaccination, see. They help us to know which pages are the most and least popular and see how visitors move around the site. Background. Based on greater reactogenicity observed following the second vaccine dose in phase I/II clinical trials, staggering considerations may be more important following the second dose. Thank you for taking the time to confirm your preferences. A)Obtain respiratory specimens for influenza and SARS-CoV-2 testing2. Most COVID-19 deaths occur in people older than 65. You will be subject to the destination website's privacy policy when you follow the link. Additionally, CDC has developed guidance to implement facility-wide testing in nursing homes and updated the interim testing guidance to integrate testing with other core prevention strategies. J Hosp Infect 2008; 68:837. The facility should encourage all individuals to be up to date with all recommended COVID-19 vaccine doses, based upon the latest recommendations. Guidance for Long-Term Care Providers and Facilities. All information these cookies collect is aggregated and therefore anonymous. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Oseltamivir prophylaxis in controlling influenza outbreak in nursing homes: a comparison between three different approaches. COVID-19 Vaccines for Long-term Care Residents, Safe, Easy, Free, and Nearby COVID-19 Vaccination, Centers for Disease Control and Prevention. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Cookies used to make website functionality more relevant to you. MMWR 2010:59(03):74-77. Use of antiviral drugs for chemoprophylaxis of influenza is a key component of influenza outbreak control in institutions that house residents at higher risk of influenza complications. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Quality Improvement Organizationsexternal icon. G) Encourage residents and HCP to remain up to date with recommended COVID-19 vaccine doses. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Have symptomatic residents stay in their own rooms as much as possible, including restricting them from common activities, and have their meals served in their rooms when possible. Visitation Guidance: CMS is issuing new guidance for visitation in nursing homes during the COVID-19 PHE. Wearing gloves if hand contact with respiratory secretions or potentially contaminated surfaces is anticipated. While highly effective, antiviral chemoprophylaxis is not 100% effective in preventing influenza illness. The following practices should be considered when SARS-CoV-2 and Influenza viruses are found to be co-circulating based upon local public health surveillance data and testing at local healthcare facilities. Commun Dis Intell Q Rep 2004; 28:396400. While the incidence and timing of post-vaccination symptoms will be further informed by phase III clinical trial data, strategies are needed to mitigate possible HCP absenteeism and resulting personnel shortages due to the occurrence of these symptoms. Home health agencies. If your loved one is not able to ask questions or otherwise communicate with the LTC staff, heres what to know about consent for getting a COVID-19 vaccine: COVID-19 vaccines are free of charge to all people living in the U.S., regardless of their immigration or health insurance status. If a private room is not available, place (cohort) residents suspected of having influenza residents with one another; Wear a facemask (e.g., surgical or procedure mask) upon entering the residents room. Please see Recommendations of the Advisory Committee on Immunization Practices United States, 2022-2023 Season [523 KB, 32 pages] for the latest information regarding recommended influenza vaccines. PLoS One 2012; 7:e46509. Please contact CDC-INFO at 800-232-4636 for additional support. B) Residents confirmed with influenza only should be placed in a single room, if available, or housed with other residents with only influenza. Older adults and other long-term care residents, including those who are medically fragile and those with neurological or neurocognitive conditions, may manifest atypical signs and symptoms of influenza virus infection (e.g., behavior change), and may not have fever. COVID-19 vaccines are safeand effectiveespecially against becoming seriously ill, being hospitalized and dyingand very important for older adults. CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. Please see Antiviral Drugs: Information for Healthcare Professionals for the current summary of recommendations for clinical practice regarding the use of influenza antiviral medications. This guidance applies at all large facilities - nursing, assisted living and residential care. COVID-19 vaccines are safe and effective especially against becoming seriously ill, being hospitalized and dyingand very important for older adults.