Influenza vaccination rates and informed consent in Dutch nursing homes: survey of nursing home physicians.

Influenza is a major cause of morbidity and mortality among residents of nursing homes. Many nursing homes therefore aim at high vaccination rates. To meet this aim some homes use tacit consent policies, in which the vaccine is given unless residents or their proxies state that they do not want it. Such policies deviate from standard (express) consent procedures, which require that vaccination occurs only if the resident or his or her proxy gives consent. Is this deviation from standard informed consent procedures justified? We explored consent procedures and vaccination rates in Dutch nursing homes to determine the effects of current practice.