Code of Maryland RegulationsRecommendations for Long Term Care Facilities
Recent outbreaks of pneumococcal pneumonia in long term care facilities in the United States, including Maryland, have reinforced the need for pneumococcal vaccination in populations at risk of complications of Streptococcus pneumoniae. Several points are worth noting:
Therefore, prevention through proper immunization with pneumococcal vaccine is critical. The Advisory Committee on Immunization Practices (ACIP) recommends that the vaccine be administered to all persons 65 years or older and to any individual at increased risk of getting pneumococcal disease. ACIP recommendations for the use of pneumococcal vaccine can be found in the MMWR, Volume 38, No. 5, p. 64-68, 1989 (Attachment 5).
II. Code of Maryland Regulations
Code of Maryland Regulations (COMAR) 10.06.01.12-1 Pneumococcal Disease requires that residents of long term care facilities be vaccinated with pneumococcal vaccine. Residents' physicians shall educate the individual or the individual's legal guardian on the availability of the vaccine and administer the vaccine to a consenting individual who has no contraindications. The physician may refer the individual to another health care provider to administer the vaccine. Facilities are not the group that must comply with this regulation; the regulation requires the attending physician to educate and administer or refer the resident for pneumococcal immunization.
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Code of Maryland Regulations (COMAR) 10.06.01.12-1 Pneumococcal Disease requires the following: .
A. There is no control of a case or contacts.
B. Vaccination of an Individual at Risk.
III. Recommendations for Long Term Care Facilities
Maryland's local health departments, the Epidemiology and Disease Control Program (410-767-6677) and the Licensing and Certification Administration (410-764-2770) of the Department of Health and Mental Hygiene are ready to provide consultation and assistance as needed.
We hope that these recommendations and materials will be helpful in your efforts to ensure that your attending physicians comply with the requirements of Code of Maryland Regulations 10.06.01.12-1 or in establishing policies of your own.
Download Attachment 2 in PDF formatDownload Sample letter
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