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8 Influenza Vaccination Rates Among Staff at Long Term Care Facilities and Hospitals


Description | Specific Indicators | Corresponding OPHS Outcome | Corresponding National Indicators | Data Sources |  Alternative Data Sources | ICD Codes | Analysis Check List | Method of Calculation |  Basic Categories | Indicator Comments | Cross-References to Other Sections | References | Acknowledgements | Changes Made 
Proportion of staff at LTC facilities and hospitals who have been vaccinated for the current influenza season by the date specified in the MOHLTC reporting requirements.
Specific Indicators
  • Influenza vaccine coverage among staff in long-term care facilities
  • Influenza vaccine coverage among staff in hospitals

Corresponding Outcome from the Ontario Public Health Standards(OPHS):

The Ontario Public Health Standards (OPHS) establish requirements for the fundamental public health programs and services carried out by boards of health, which include assessment and surveillance, health promotion and policy development, disease and injury prevention, and health protection. The OPHS consist of one Foundational Standard and 13 Program Standards that articulate broad societal goals that result from the activities undertaken by boards of health and many others, including community partners, non-governmental organizations, and governmental bodies. These results have been expressed in terms of two levels of outcomes: societal outcomes and board of health outcomes. Societal outcomes entail changes in health status, organizations, systems, norms, policies, environments, and practices and result from the work of many sectors of society, including boards of health, for the improvement of the overall health of the population. Board of health outcomes are the results of endeavours by boards of health and often focus on changes in awareness, knowledge, attitudes, skills, practices, environments, and policies. Boards of health are accountable for these outcomes. The standards also outline the requirements that boards of health must implement to achieve the stated results.

Link to OPHS

Outcomes Related to this Indicator

  • Societal Outcomes (Vaccine Preventable Diseases): Target coverage rates for vaccine preventable diseases are achieved;  There is increased health care provider knowledge of immunization;
  • Board of Health Outcomes (Vaccine Preventable Diseases): Target coverage rates for provincially funded immunizations are achieved; 

Corresponding Health Indicator(s) from Statistics Canada and CIHI

  • None 

Data Sources
Numerator: Number of staff in Long-term care facility or hospital who have been vaccinated against influenza for the current influenza season by the date specified in the MOHTLC reporting requirements
Denominator: Number of staff at long-term care facility or hospital on the reporting date
Original source: Public Health Unit
Distributed by: Public Health Unit
Suggested citation (see Data Citation Notes):
Long-Term Care Facility Vaccination Data [years], Date Collected: [date]
Alternative Data Sources
Data Sources: Rapid Risk Factor Surveillance System (RRFSS):

  • RRFSS Questions:
    I1A: Since September 20XX, have you had a flu shot?
    I2: Have you EVER had a pneumonia vaccination?
    WP3: Are you an EMPLOYEE, STUDENT OR VOLUNTEER in a health care facility such as a hospital, a doctor's, dentist's or chiropractor's office, or any other health care facility?

Analy sis Check List

  • For RRFSS data: Before releasing and/or publishing these data, users should first determine the number of sampled respondents who contributed to the calculation of the estimate. If this unweighted number is less than 30, the weighted estimate should not be released regardless of the estimate's coefficient of variation (C.V.). For unweighted estimates of 30 or more, users should determine the C.V. of the rounded weighted estimate and follow the guidelines below:
    • Acceptable (C.V. of 0.0 - 16.5) Weighted estimates can be considered for general unrestricted release. Requires no special notation.
    • Marginal (C.V. of 16.6 - 33.3) Weighted estimates can be considered for general unrestricted release but should be accompanied by a warning cautioning of high sampling variability.
    • Unacceptable (C.V. greater than 33.3) Statistics Canada recommends not releasing estimates of unacceptable quality. However, if the user chooses to do so then estimates should be flagged and the following warning should accompany the estimates: "The user is advised that . . .(specify the data) . . . do not meet Statistics Canada's quality standards for this statistical program. Conclusions based on these data will be unreliable and most likely invalid". These data and any consequent findings should not be published. If the user chooses to publish these data or findings, then this disclaimer must be published with the data.
  • For RRFSS analysis, questions may be asked seasonally and weights may need to be recalculated to reflect this.

Method of Calculation

Number of staff in that facility who have been vaccinated against influenza for the current influenza season by the date specified in the MOHLTC reporting requirements.

    x 100

Total number of staff in that facility at the reporting date

Basic Categories

  • Geographic areas: public health unit

Indicator Comments

  • The influenza surveillance season starts on September 1 and ends on August 31 every year
  • High levels of immunization rates result in “herd immunity” whereby unimmunized persons are protected because the chances of an infected person coming in contact with a susceptible person is very low.
  • Vaccination against influenza is an annual event.
  • There is a decreased risk to residents / patients if health care workers are immunized.
  • National objectives include 95% influenza vaccination coverage of staff of long-term care facilities who have extensive contact with residents.
  • Typically, influenza vaccination coverage information is collected manually for staff working in hospitals, home for the aged and nursing homes. Depending on the health unit, coverage rates may also be collected for staff working in retirement homes. There is no indication as to whether the health care worker works with high-risk individuals. The coverage rates will not include health care workers working in other facilities or in other positions (such as VON) or those working in other facilities where data is not routinely collected.
  • Given the possible variation among who data was collected for and date of collection between facilities/hospitals and Public Health Units, use caution when comparing rates. The definition of a health care worker according to RRFSS is very broad.

Cross-References to Other Sections

  • None


  • Evans AS, Brachman PS. Bacterial Infections in Humans: Epidemiology and Control. Springer, 1998.
  • Heymann DL. Control of Communicable Diseases Manual. American Public Health Association, 2004.
  • Pohani G. Summary Report of the 2000/2001 Ontario Influenza Season. PHERO, Volume 12(11), December 22, 2001; 330-340.
  • Pohani G, Henry B, Nsubuga J. Summary Report of the 1999/2000 Ontario Influenza Season. PHERO, Volume 11(7), July and August 2000;136-149.
  • National Advisory Committee on Immunization. Canadian Immunization Guide, Seventh Edition, 2006. Ottawa, ON: Public Health Agency of Canada, 2006. Available at
  • Public Health Agency of Canada. CCDR 2006;32S3:1-44. Canadian National Report on Immunization, 2006. Available at:
  • Public Health Agency of Canada. Final Report of Outcomes from the National Consensus Conference for Vaccine-Preventable Diseases in Canada. CCDR 2007;33S3:1-56. Available at:


Lead Author(s)

Katherine Haimes , Ottawa Public Health
Stephanie Wolfe, Simcoe Muskoka District Health Unit

Contributing Author(s)

Core Indicators Infectious Disease Subgroup

CIWG Reviewers

Core Indicators Infectious Disease Subgroup

External Reviewers

Effie Gournis, Toronto Public Health
Rachel Savage, Ontario Agency for Health Protection and Promotion

Changes Made


Type of Review

(Formal or Adhoc)

Changes made by


January, 2009


Infectious Disease subgroup

  • Changed name from "Influenza Vaccination Rates Among Health Care Workers"
June 13, 2011 Ad hoc

Sherri Deamond on behalf of CIWG

  •  Added acknowledgments section
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