The California Department of Health has issued an All Facilities Letter outlining recommendations for the prevention and control of influenza in long-term care facilities. The letter emphasizes the importance of annual influenza vaccinations for healthcare workers, particularly in long-term care facilities where elderly residents are at high risk of developing serious complications. Facilities are encouraged to provide vaccines to healthcare workers and adopt approaches that maximize immunization rates. The letter also highlights the requirement for general acute care hospitals to offer onsite influenza vaccinations to all employees at no cost, and for employees to either be vaccinated or declare in writing that they have declined the vaccination. Additionally, facilities must institute respiratory hygiene and cough etiquette protocols, develop and implement procedures for the isolation of patients with influenza, and adopt a seasonal influenza plan. The proposed California Division of Occupational Safety and Health (Cal/OSHA) Aerosol Transmissible Diseases Standard would make the provision of influenza vaccine and use of a declination form mandatory in all health care facilities.

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