Vaccination of health care workers (HCWs) is recommended as a strategy for preventing influenza in elderly patients in long-term care.

However, there have been no controlled studies to show whether this approach is effective.

During the winter of 1994-1995,1059 patients in 12 geriatric medical long-term-care sites, randomized for vaccination of HCWs, were studied.

In hospitals where HCWs were offered vaccination, 653 (61%) of 1078 were vaccinated.

Vaccination of HCWs was associated with reductions in total patient mortality from 17% to 10% (odds ratio [OR], 0.56 ; 95% confidence interval [CI], 0.40-0.80) and in influenza-like illness (OR, 0.57 ; 95% CI, 0.34-0.94).

Vaccination of patients was not associated with significant effects on mortality (OR, 1.15 ; 95% CI, 0.81-1.64).

Results of this study support recommendations for vaccination against influenza of HCWs in long-term geriatric care.

Vaccination of frail elderly long-term-care patients may not give clinically worthwhile benefits.