Coordinating Vaccination for Older People in Home-Based and Residential Long-Term Care in Viet Nam: Clinical Eligibility, Informed Choice and Reliable Follow-Up

Coordinating Vaccination for Older People in Home-Based and Residential Long-Term Care in Viet Nam: Clinical Eligibility, Informed Choice and Reliable Follow-Up

An older woman living in a residential care facility is approaching her next routine medical review. Her daughter remembers that she received an influenza vaccine the previous year but cannot find the record. The facility has documentation of an earlier COVID-19 vaccination, although nobody is certain whether she received additional doses elsewhere. The woman also has several chronic conditions and has recently become less mobile.

The care coordinator wants to help her access appropriate preventive healthcare. Several questions arise. Which vaccinations should be considered? Who can verify her history and assess whether a particular vaccine is suitable? How should she participate in the decision? If vaccination is arranged, who will confirm that it was completed and ensure that any necessary follow-up is addressed?

The recent change in her mobility may also require clinical attention in its own right, regardless of whether vaccination is being considered.

The facility can help coordinate access to healthcare, but deciding which vaccines are clinically appropriate and delivering vaccination services require qualified professionals and legally compliant arrangements.

Similar situations arise in home-based care. A family may be unsure whether an older relative is up to date with relevant vaccinations. A visiting care worker may notice an appointment reminder without knowing who is responsible for following it up. Someone with limited mobility may wish to receive vaccination but find it difficult to reach an appropriate healthcare provider.

In many cases, the difficulty is not vaccine availability alone. It is the sequence of decisions and practical arrangements needed to connect the person with suitable preventive healthcare.

For organizations supporting older people in Viet Nam, vaccination coordination offers an opportunity to improve access to preventive services while respecting professional boundaries. Doing this responsibly requires accurate information, individualized clinical assessment, informed choice, appropriate service arrangements, and reliable follow-up.

The objective is not to turn residential facilities or home-care organizations into vaccination providers. It is to help older people access qualified healthcare without unnecessary barriers, confusion about responsibilities, or loss of personal choice.

Why Vaccination Matters in Older-Person Care

Vaccination is an established preventive healthcare intervention that can reduce the risk of certain infectious diseases and, depending on the vaccine and individual circumstances, their serious complications.

Older adults may face increased risks from some vaccine-preventable infections because of age-related changes in immune function, chronic conditions, frailty, or other individual factors. An illness that causes relatively limited symptoms in one person may lead to hospitalization, loss of functional independence, or serious complications in another.

These concerns are particularly relevant for people living with cardiovascular or respiratory disease, diabetes, kidney disease, or other conditions that may complicate recovery from infection.

However, age alone does not determine which vaccines should be administered.

Clinical eligibility depends on the specific vaccine, previous immunization history, underlying health conditions, current recommendations, product authorization, and other relevant considerations. Vaccination should therefore be approached through individualized professional assessment rather than an assumption that every older person needs the same schedule.

Long-term care settings introduce practical challenges. Some residents rely on others to arrange appointments, locate records, or communicate with healthcare professionals. Others receive care from several providers whose information systems may not be connected.

People receiving support at home may encounter similar difficulties, especially when mobility limitations, transportation needs, or family circumstances make healthcare visits difficult.

The challenge is often whether the person can move through the necessary steps: identifying a possible need, obtaining professional advice, making an informed decision, accessing an appropriate vaccination service, and completing any recommended follow-up.

The World Health Organization's December 2025 update of Immunization in Practice reinforces a life-course approach to vaccination. It recognizes the importance of immunization not only during childhood but also throughout adulthood and older age.

For long-term care organizations, this supports treating vaccination as part of access to preventive healthcare while maintaining a clear distinction between service coordination and clinical practice.

Vaccination Coordination Is Different From Providing Vaccination

A residential facility or home-care provider can contribute to vaccination access without administering vaccines.

Care workers may help older people locate existing records, identify questions for a healthcare professional, arrange transportation, communicate appointment details, or obtain information about authorized vaccination services.

A residential organization may also coordinate with an external vaccination establishment to help residents access services that are clinically appropriate and legally available.

These activities differ from clinical assessment and vaccination itself.

Determining whether a vaccine is indicated, evaluating contraindications and precautions, selecting an appropriate product, conducting pre-vaccination screening, administering the vaccine, and managing clinical complications require qualified professionals operating within the applicable legal and professional framework.

This distinction matters in Viet Nam because residential and home-based care services may operate under different legal classifications, staffing arrangements, and professional capabilities.

A social assistance facility does not automatically become an authorized vaccination establishment because it provides accommodation or personal care to older people. Similarly, internal training does not independently authorize a non-clinical care worker to administer vaccines or undertake other regulated clinical activities.

The responsibilities of a care organization should reflect the services it lawfully provides and the coordination tasks it has agreed to perform.

Clear boundaries allow organizations to improve access without creating uncertainty about who is responsible for clinical decisions, vaccination procedures, or the management of complications.

Clinical Eligibility Must Be Assessed Individually

Before vaccination, an appropriately qualified healthcare professional should determine whether the proposed vaccine is suitable for the individual.

Relevant considerations may include the person's age, previous vaccination history, chronic medical conditions, immune status, allergies, reactions to earlier doses, current illness, and other vaccine-specific factors.

Different vaccines have different indications, contraindications, precautions, dosing schedules, and requirements for additional doses.

Vaccines against influenza, COVID-19, pneumococcal disease, shingles, and respiratory syncytial virus are among those considered in international older-adult immunization guidance.

However, recommendations, age thresholds, authorized products, availability, and funding arrangements differ between countries and can change over time.

A vaccine recommended or publicly funded in Australia or the United States should not automatically be described as clinically indicated, available, free, or mandatory for every older person in Viet Nam.

Care organizations should not combine foreign vaccination schedules to create their own recommendations.

Instead, they should support access to a qualified vaccination provider who can evaluate the individual under current Vietnamese requirements, applicable professional guidance, relevant product information, and the person's circumstances.

For someone with complex medical conditions, communication with their treating clinician may also be appropriate.

Chronic illness does not necessarily prevent vaccination. Many people with chronic conditions may benefit from appropriate preventive interventions, but the decision requires individualized assessment.

The residential or home-care provider can help ensure that relevant information reaches the professional making the clinical decision. It should not independently determine eligibility or decide which vaccine must be administered.

Incomplete Vaccination Records Require Careful Verification

Older people may have received vaccines from several providers over many years.

Some have personal vaccination books or electronic records. Others may have been vaccinated through hospitals, community health facilities, private vaccination centers, or public health campaigns.

The information available to a family or care organization may therefore be incomplete.

An absent record does not prove that vaccination never occurred. Equally, a family member's recollection may not provide enough detail to establish which product was administered, when it was given, or whether further vaccination is necessary.

When the history is uncertain, the qualified vaccination provider should determine the appropriate approach using available records, professional guidance, and the individual's circumstances.

Care workers should distinguish verified information from reported or uncertain history.

For example, a daughter's recollection that her mother received an injection last year may be useful information to investigate. It should not automatically be entered as a confirmed vaccination event.

This distinction is particularly important when recommendations depend on the number, timing, or type of previous doses.

Viet Nam's Circular No. 13/2026/TT-BYT includes provisions concerning the management of vaccination information through the national immunization information system.

Vaccination establishments have responsibilities for recording and updating relevant information in accordance with applicable requirements.

A residential facility may maintain selected internal records to support coordination, but those records do not replace the official documentation and reporting responsibilities of an authorized vaccination establishment.

When discrepancies arise, the care organization can help the older person contact the appropriate vaccination provider for clarification.

The purpose is to establish a dependable basis for clinical decisions rather than create another incomplete record that may later be mistaken for verified information.

Informed Choice and Consent Must Remain Central

Vaccination decisions should be based on relevant information, professional advice, and a meaningful opportunity to make an informed choice.

An older person may want to understand why a vaccine is being considered, what benefits can reasonably be expected, which risks or side effects are relevant, and whether further doses may be necessary.

Some individuals may have concerns because of previous vaccination experiences. Others may be uncertain about changing recommendations or the differences between vaccine products.

These questions deserve respectful attention.

Care organizations can help residents and families obtain reliable information and appropriate professional counseling, but they should not pressure people to accept vaccination simply to improve an organizational performance indicator.

A healthcare recommendation and the person's decision are related but distinct.

Individuals should have an appropriate opportunity to ask questions, consider the information, and participate in decisions affecting their health.

Communication may need to be adapted for hearing or vision impairment, limited health literacy, language differences, or cognitive difficulties.

Written information can be helpful, but providing a document does not by itself establish informed understanding.

Family members may support discussions, particularly when they know the person's medical history or communication preferences. However, their involvement does not automatically replace the older person's rights or the consent requirements applicable to vaccination.

The responsible healthcare provider must obtain and document the necessary consent in accordance with Vietnamese law and relevant professional requirements.

An internal consent form maintained by a residential facility should not be treated as a substitute for those requirements.

Cognitive Impairment Does Not Automatically Remove Decision-Making Rights

Some older people receiving long-term care live with dementia or other conditions affecting cognition.

These conditions may make vaccination discussions more challenging, but they do not automatically establish that someone lacks the legal capacity to make healthcare decisions.

A person with cognitive impairment may still understand a proposed intervention when information is presented simply, at an appropriate time, and with suitable support.

The person should be involved in the discussion to the extent appropriate to their abilities and circumstances.

Where legal representation is necessary, the responsible healthcare provider must establish the relevant authority and follow applicable Vietnamese law.

Being an adult child, relative, emergency contact, or person responsible for payment does not automatically confer unrestricted authority to consent to medical interventions on another adult's behalf.

Organizations should distinguish a person's need for communication support from legal restrictions on decision-making capacity.

The objective is to preserve meaningful participation while ensuring that vaccination decisions and consent are handled through appropriate clinical and legal processes.

Respecting a Decision to Decline or Defer Vaccination

An older person may decide not to receive a recommended vaccine or may wish to postpone the decision.

Their reasons may include concerns about adverse reactions, previous experiences, uncertainty about the expected benefit, personal beliefs, or a desire for additional information.

A refusal should not automatically be interpreted as ignorance or non-cooperation.

Appropriate professional counseling may help clarify questions or address misunderstandings. However, counseling should not become coercion.

Providers should not use threats, unnecessary restrictions, or withdrawal of unrelated care services to pressure someone into accepting voluntary vaccination.

Where vaccination is legally compulsory for a defined disease, population, or circumstance, the applicable legal requirements and directions of competent authorities must be considered separately.

Vietnamese law distinguishes compulsory and voluntary vaccination. The inclusion of a disease in a compulsory vaccination framework does not necessarily mean that every older adult must receive a vaccine against that disease.

The relevant target population and legal circumstances must be established.

A decision to decline or defer vaccination should be documented appropriately by the responsible provider. Any necessary communication with the care organization should respect the individual's rights and applicable information-sharing requirements.

Someone who initially declines vaccination may later wish to reconsider. Providing access to further professional advice can be appropriate, but repeated approaches should respect the person's preferences and avoid unnecessary pressure.

For residential and home-care organizations, the priority is to ensure that people can make informed decisions, not to obtain agreement at any cost.

Improving Access for People Receiving Care at Home

Older people receiving home-based care may face practical barriers to attending vaccination appointments.

Some have limited mobility, need assistance leaving the house, or depend on relatives who are unavailable during ordinary working hours. Others require transportation arrangements, mobility aids, or support throughout a healthcare visit.

Home-care organizations can help identify these barriers and coordinate appropriate assistance within their agreed responsibilities.

This may include helping someone contact an authorized vaccination establishment, explain their mobility or communication needs, arrange suitable transport, or obtain information about available services.

Where an appropriately qualified vaccination provider offers a legally compliant home-based or mobile service, the care organization may help coordinate access.

However, the availability of a visiting healthcare professional or home-care worker does not automatically establish that vaccination can lawfully be performed in a private home.

The vaccination provider must meet the requirements applicable to its service, including professional personnel, vaccine handling, cold-chain management, equipment, emergency preparedness, and other relevant conditions.

A home-care organization should not independently purchase, transport, store, prepare, or administer vaccines beyond its lawful authority.

Where home vaccination is unavailable or unsuitable, the organization may help explore other safe and lawful ways for the older person to access an appropriate service.

Improving access should not require compromising vaccination safety or professional accountability.

Organizing Vaccination in Residential Long-Term Care

Residential facilities may be able to coordinate vaccination appointments for several residents who wish to receive appropriate vaccines.

This can reduce practical barriers for people who would otherwise need separate journeys to vaccination establishments.

However, organizing an on-site session involves more than inviting a healthcare professional to bring vaccines into the facility.

The activity must be arranged through an appropriately qualified and authorized vaccination provider under the applicable legal and technical requirements.

Responsibilities should be clarified before the session.

The vaccination establishment is responsible for the clinical and technical activities within its scope, including pre-vaccination assessment, consent, vaccine handling, administration, required observation, emergency preparedness, and documentation.

The residential facility may support communication, appointment scheduling, mobility assistance, access arrangements, and preparation of suitable space where agreed.

It should not assume that these coordination activities authorize the facility to perform functions reserved for the vaccination provider.

The care environment must also be suitable for the proposed activity.

An available room does not necessarily meet the requirements for an authorized vaccination session. Similarly, an individual healthcare professional's qualifications do not replace the organizational, equipment, and procedural conditions applicable to the service.

Where a suitable on-site arrangement cannot be established, the facility should consider other lawful ways to help residents obtain vaccination.

The central consideration is whether the service can be delivered appropriately and safely, not simply whether it would be convenient to hold the session onsite.

Preparing Residents Without Taking Over Clinical Screening

Good preparation can make vaccination appointments easier to organize and help residents participate meaningfully.

Before a planned appointment, the care organization may assist with gathering available vaccination records, identifying communication or mobility needs, and making relevant health information available through an appropriately authorized process.

Staff should distinguish verified information from observations or reports that have not been clinically assessed.

They should not independently decide that a particular medical condition is a contraindication or that a resident is fit to receive a vaccine.

However, care workers may communicate observations relevant to the qualified professional's assessment.

For example, staff may know that a resident has recently been unwell, experienced a significant change in health, or previously reported symptoms after vaccination.

The vaccination provider should determine whether these circumstances require further assessment, precautions, or changes to the proposed plan.

Preparation should also include practical arrangements following the appointment.

Residents may need assistance returning to their rooms, communicating discomfort, or contacting healthcare professionals if concerns arise.

The care organization should understand the observation instructions provided by the vaccination team and ensure that routine activities do not interfere with the required immediate post-vaccination observation.

Preparation helps the clinical process run smoothly, but it does not replace professional screening or judgment.

Post-Vaccination Observation and Adverse Events

Vaccination safety does not end when a dose has been administered.

Viet Nam's Circular No. 13/2026/TT-BYT, effective July 1, 2026, establishes requirements for vaccination activities at fixed vaccination establishments and mobile vaccination sites.

Article 12 requires appropriate pre-vaccination screening, administration according to professional guidance, and observation of the vaccinated person at the vaccination site for at least 30 minutes.

It also requires instructions for continued observation for at least 24 hours afterward.

These requirements are important when coordinating vaccination for people who depend on residential or home-based support.

The vaccination provider must ensure that the applicable clinical procedures and instructions are followed.

The care organization should understand what assistance it has agreed to provide after the person returns to its care.

A resident may need help communicating discomfort, recognizing that something feels unusual, or contacting a healthcare professional. Someone with cognitive impairment or communication difficulties may be unable to describe symptoms clearly.

Care workers should understand the information supplied by the vaccination team and know how to obtain appropriate assistance when concerns arise.

However, supporting observation within an agreed care role is different from providing clinical assessment or treatment.

For people receiving intermittent home-care visits or living alone, arrangements for continued observation deserve particular attention. Occasional visits should not be assumed to provide the same level of support as continuous supervision.

Vaccines may cause adverse reactions, although their types, frequency, and severity vary by product and individual circumstances.

Some reactions are expected and temporary. Others may require medical assessment or emergency care.

An important distinction is that an adverse event following immunization is not necessarily caused by vaccination.

An abnormal health event occurring after vaccination may have another explanation. Determining whether a serious event is causally associated with a vaccine may require professional evaluation and formal investigation.

Care workers should not make unsupported conclusions about causation.

Their immediate role is to recognize concerning changes, seek appropriate assistance, and communicate relevant observations accurately.

Severe breathing difficulty, collapse, or other potentially life-threatening symptoms require urgent medical attention. In Viet Nam, emergency medical services can be contacted through 115.

Seeking help should not be delayed while staff attempt to determine whether symptoms were caused by vaccination.

Vaccination establishments and relevant healthcare authorities have reporting, surveillance, and investigation responsibilities under the applicable framework.

Care organizations should know how to communicate concerns to the vaccination provider and cooperate with lawful reporting or investigation where necessary.

Internal incident documentation may help, but it does not replace the professional and statutory responsibilities of the authorized providers or authorities.

Confirming Vaccination and Completing Follow-Up

After an appointment, a care coordinator may receive information that an older person attended a vaccination session.

Attendance alone does not establish which vaccine was administered or whether the intended dose was completed.

Before updating internal records, the organization should seek appropriate confirmation.

The authorized vaccination establishment remains responsible for official documentation and information reporting associated with the service.

A residential or home-care provider may retain selected verified details necessary for coordination, subject to applicable privacy requirements.

This may include the confirmed vaccination date, relevant product information, the responsible provider, and instructions concerning further appointments.

If vaccination was deferred, declined, or not completed, the record should accurately reflect that outcome.

It is useful to distinguish between verified vaccination, confirmed non-vaccination, unknown status, and deferred vaccination.

Treating an unverified record as proof that a dose was administered can create a safety problem. Treating every missing record as proof that vaccination did not occur can lead to unnecessary repeat appointments.

Some vaccine schedules involve multiple doses or periodic reassessment.

The exact timing depends on the product, previous vaccination history, current recommendations, and individual circumstances.

Care organizations should not independently calculate or modify clinical vaccination schedules.

They can, however, help ensure that recommended follow-up appointments are not forgotten.

Where a vaccination provider recommends another dose, the care organization should clarify who has agreed to arrange the next appointment.

A reminder is not evidence that the person attended, and a scheduled dose is not evidence that vaccination occurred.

If an appointment is missed or cannot proceed, the responsible vaccination provider should be contacted for guidance rather than allowing non-clinical staff to redesign the schedule.

Reliable follow-up depends on confirmation of what happened, not simply documentation of what was planned.

Explaining Costs and Avoiding Unsupported Promises

Vaccination costs can influence whether an older person can access a recommended service.

Some vaccination activities are supported through public programs, while others involve voluntary services funded by individuals or families.

Eligibility, available products, public funding, and applicable charges differ according to the vaccine and program.

Care organizations should not promise that every vaccine recommended internationally is available free of charge in Viet Nam.

Likewise, the inclusion of a disease in a compulsory vaccination framework does not establish that all older adults must receive vaccination against that disease.

The relevant target population and circumstances must be considered.

Where the care organization helps arrange a paid vaccination service, the financial arrangements should be communicated clearly.

Residents and families should understand whether the service is included in an existing care agreement, charged by an external vaccination provider, or involves a separate lawful coordination charge.

Financial information should support informed choice.

A voluntary service should not be presented as legally mandatory without the relevant legal basis.

Where affordability, accessibility, or transportation creates a barrier, the care organization may help the individual explore available lawful options.

Equitable access means recognizing practical disadvantages without promising services or funding that cannot be guaranteed.

Vaccination for People With Complex Care Needs

Some older people receiving long-term care live with substantial frailty, multiple chronic conditions, advanced dementia, or serious life-limiting illness.

These circumstances may affect the expected benefits, timing, precautions, and appropriateness of vaccination.

However, no single diagnosis or level of dependency should automatically determine the outcome for every individual.

The responsible healthcare professional should consider the person's clinical circumstances, relevant evidence, current recommendations, and authorized vaccine products.

The person's preferences and goals of care should also be part of appropriate discussions.

For someone receiving palliative care, vaccination may or may not be suitable depending on the situation.

The decision should not be based solely on a palliative care designation or an assumption that preventive healthcare is always unnecessary.

Equally, vaccination should not become an organizational target that overrides individual clinical considerations.

The care provider's contribution is to facilitate appropriate professional discussion and support the agreed plan within its responsibilities.

A person-centered approach keeps preventive healthcare accessible without treating all older people as clinically identical.

Protecting Vaccination-Related Personal Information

Vaccination records contain personal health information.

Residential facilities and home-care organizations may need selected details to coordinate appointments, communicate with vaccination providers, or support follow-up.

However, collecting information for care coordination does not justify unrestricted access, use, retention, or disclosure.

Viet Nam's Law on Personal Data Protection No. 91/2025/QH15 and Government Decree No. 356/2025/ND-CP both took effect on January 1, 2026.

These instruments establish relevant requirements for lawful processing and protection of personal data.

Care organizations should consider the legal basis for processing vaccination information, who may access it, how records are protected, and what consent or other legal requirements apply.

A family member responsible for payment does not automatically have unrestricted access to the older person's health information.

Similarly, staff should not circulate lists of residents' vaccination decisions through uncontrolled messaging groups, personal accounts, or shared devices.

Where electronic systems are used, appropriate security and access controls should be maintained.

The national immunization information system has separate legal and professional operating requirements. An internal spreadsheet maintained by a residential facility does not replace the information reporting responsibilities of an authorized vaccination establishment.

Good coordination requires necessary information to reach the appropriate people without exposing residents to unnecessary disclosure.

Understanding Viet Nam's Vaccination Framework in 2026

Viet Nam's principal legislative framework for disease prevention and vaccination changed on July 1, 2026.

The Law on Disease Prevention No. 114/2025/QH15 was enacted on December 10, 2025, and took effect on July 1, 2026, replacing the previous Law on Prevention and Control of Infectious Diseases No. 03/2007/QH12.

Article 22 establishes the legal distinction between compulsory and voluntary vaccination.

Compulsory vaccination applies according to the diseases, target populations, and circumstances established by law and relevant implementing provisions, including vaccination undertaken for outbreak control where applicable.

Voluntary vaccination concerns vaccination outside those compulsory categories.

This distinction is especially important when discussing vaccination for older people.

A clinical recommendation, a care facility's internal policy, and a legal vaccination requirement are not interchangeable.

Government Decree No. 165/2026/ND-CP, issued May 15, 2026, and effective July 1, 2026, provides detailed provisions and measures for implementing the Law on Disease Prevention, including requirements relevant to vaccination establishments and activities.

Ministry of Health Circular No. 13/2026/TT-BYT, issued May 16, 2026, and effective July 1, 2026, regulates vaccination activities.

The Circular addresses compulsory vaccination lists, vaccination organization, management of vaccination recipients, vaccine handling, professional procedures, information reporting, and surveillance of adverse events following immunization.

Article 12 establishes requirements for vaccination at fixed establishments and mobile vaccination sites, including pre-vaccination screening, vaccine administration, observation, and documentation.

Article 25 addresses the responsibilities of vaccination establishments, including compliance with professional and technical requirements, vaccination information management, reporting, and cooperation with relevant adverse-event investigation activities.

These obligations must be interpreted according to the legal status and activities of the organization involved.

A residential care facility that helps residents access vaccination should not automatically be treated as having the same professional or reporting responsibilities as an authorized vaccination establishment.

Where a care organization wishes to host or facilitate vaccination onsite or in a person's home, the arrangement must be assessed against the applicable requirements for the vaccination provider, location, personnel, equipment, vaccine management, and service delivery.

The Law on Medical Examination and Treatment No. 15/2023/QH15 and its implementing regulations may also be relevant where regulated healthcare activities are involved.

The Law on Older Persons and applicable personal data protection legislation remain relevant to residents' rights, representation, communication, and information management.

A further regulatory change is approaching for social assistance facilities.

Government Decree No. 395/2026/ND-CP on the operation and management of social assistance facilities was issued October 23, 2026, and is scheduled to take effect December 7, 2026.

As of November 3, 2026, the decree has been issued but is not yet in force.

Organizations within its defined scope should prepare for the applicable requirements while continuing to comply with the legal framework currently in effect.

The decree should not be interpreted as independently authorizing residential or home-care organizations to perform vaccination activities without meeting specialized legal requirements.

The distinction between facilitating access to healthcare and delivering a regulated clinical service must remain clear.

What Recent International Research Tells Us

Research published in 2026 offers useful examples of how vaccination coordination can be improved in residential long-term care.

In February 2026, McGregor and colleagues published a study in Vaccines evaluating a tailored quality improvement intervention in residential aged care facilities in Sydney, Australia.

The intervention included resources to support consent processes, vaccination planning, and tracking.

Researchers compared vaccination records at two points approximately 14 months apart using information from the Australian Immunisation Register.

Of 6,964 residents initially listed, 5,153 remained identifiable in the register at follow-up and were included in the analysis.

Recorded vaccination coverage increased for shingles by 23.4 percentage points, pneumococcal vaccination by 14.2 percentage points, and influenza by 10.9 percentage points.

COVID-19 vaccination coverage declined by 7.4 percentage points when assessed using the study's six-month reporting interval.

These different outcomes illustrate that an operational improvement initiative does not necessarily produce uniform results across vaccines.

The study also highlighted problems with vaccination documentation. Among staff who completed the process evaluation survey, some reported discrepancies between facility records and the national register, including vaccination encounters that external providers had not entered.

Because the evaluation used a nonrandomized pre–post design, the observed changes cannot be attributed solely to the intervention.

A second study by Sobczyk and colleagues, published in the September 2026 issue of the Journal of the American Medical Directors Association, examined an immunization quality improvement project involving 21 long-term care facilities across nine US states.

Seventeen facilities improved vaccination coverage for at least one vaccine, while five improved coverage for four or more vaccines.

The project identified recurring difficulties involving incomplete immunization information, limited staff capacity, workforce turnover, and vaccine hesitancy or resistance.

Improvement activities focused on monitoring coverage, integrating vaccination into routine care processes, and strengthening organizational support.

Both studies were conducted in healthcare systems with funding, regulatory, professional, and information arrangements that differ from those in Viet Nam.

Their findings should not be used to predict that identical interventions would produce the same results locally.

Nevertheless, they provide useful evidence that vaccination access is influenced by more than the availability of vaccines. Information quality, consent processes, appointments, staff capacity, communication with external providers, and reliable follow-up all matter.

For Vietnamese long-term care organizations, the most relevant lesson is to examine these operational processes rather than assume that issuing reminders or arranging occasional vaccination sessions will be sufficient.

Measuring Coordination Without Creating Pressure

Organizations may wish to evaluate whether their vaccination coordination efforts improve access to preventive healthcare.

However, vaccination coverage alone is not a sufficient measure of service quality.

A single percentage of vaccinated residents may conceal differences in clinical eligibility, incomplete records, access barriers, and individual decisions.

A more meaningful approach distinguishes confirmed vaccination status from information that remains uncertain.

It may also examine whether older people who wish to discuss vaccination can access a qualified professional, whether recommended and accepted vaccination can be arranged, and whether completed appointments are appropriately confirmed.

Reasons for non-completion matter.

A person who declined vaccination after an informed discussion should not be grouped indiscriminately with someone who wanted vaccination but could not obtain an appointment.

Likewise, a person for whom a particular vaccine was clinically inappropriate should not be treated as an organizational failure to achieve coverage.

Quality measurement should respect informed decisions and professional clinical judgment.

Care organizations may review whether staff understand their roles, whether agreed follow-up tasks are completed, and whether discrepancies in vaccination records are addressed.

The findings should be interpreted in light of the population served.

Facilities supporting residents with complex health conditions, substantial mobility limitations, or different access to vaccination services may not be directly comparable.

A higher vaccination rate does not automatically establish better care if consent, clinical eligibility, or documentation has been handled poorly.

The purpose of measurement is to understand whether people can make informed choices and access appropriate services without avoidable barriers.

Making Vaccination Coordination Part of Everyday Care

Home-based and residential long-term care services in Viet Nam vary considerably in size, legal classification, professional staffing, and relationships with healthcare providers.

Some residential facilities have established arrangements with licensed healthcare or vaccination establishments. Others rely on residents, families, and external clinics to organize preventive healthcare.

Home-care organizations may visit older people for limited periods and have little involvement in clinical decision-making.

These differences should shape the coordination process.

For a small home-care provider, the most appropriate contribution may be helping an older person obtain reliable information, contact a vaccination establishment, communicate mobility needs, and attend an agreed appointment.

A residential facility may coordinate access for several residents while maintaining individual assessment, consent, and record arrangements.

However, the organization should not assume that every resident wishes to participate in a group vaccination session or that every vaccine can appropriately be administered onsite.

Clinical eligibility, informed choice, professional authority, and service capacity must remain central.

A practical coordination process should make clear who is responsible for obtaining verified information, communicating with the vaccination provider, arranging appointments, supporting access, and following up on agreed tasks.

Responsibilities should remain within each party's lawful and professional scope.

For smaller organizations, a designated coordinator and a controlled record of outstanding actions may be sufficient.

Larger providers may benefit from structured referral processes, established agreements with vaccination establishments, and secure electronic information systems.

The system should be proportionate to the organization's actual role and resources.

Management should review recurring barriers and determine whether organizational changes could improve access.

Staff should not be assessed solely on the proportion of residents who agree to vaccination.

A more appropriate expectation is that employees provide accurate information within their competence, respect residents' rights, coordinate agreed services reliably, and recognize matters requiring professional intervention.

International frameworks can support this work.

WHO's updated Immunization in Practice guidance addresses life-course vaccination, service planning, safe delivery, community engagement, monitoring, and reducing missed opportunities.

NSW Health's April 2026 vaccination risk-assessment resources for residential aged care residents provide another example of structured consideration of clinical eligibility, information, consent, and follow-up.

ISO 25557:2026, Ageing Societies — Care Quality for Older Persons at Home and in Care Facilities, offers broader principles for person-centered care, preventive support, coordination between health and social care, and organizational accountability.

These resources should be interpreted according to their intended purposes. They do not establish a universal vaccination schedule for Viet Nam, authorize unlicensed vaccination activities, or replace national legal requirements.

From Vaccine Availability to Reliable Preventive Care

Vaccination is an important component of preventive healthcare, but access depends on more than whether a vaccine is available.

An older person may need help understanding whether vaccination should be considered, locating previous records, contacting a qualified provider, making an informed decision, or completing an agreed follow-up appointment.

These steps may involve several people and organizations.

When responsibilities are unclear, an opportunity for preventive care can be missed even when appropriate services exist.

For older people, good coordination should mean access to reliable information, appropriate clinical advice, meaningful choice, and practical support when needed.

For families and caregivers, it should mean understanding whom to contact and which arrangements have been agreed upon.

For care organizations, it should mean knowing their responsibilities and professional limits while maintaining dependable communication with qualified vaccination providers.

The objective is not to vaccinate every resident indiscriminately or transform non-medical care organizations into vaccination establishments.

It is to establish a reliable pathway through which vaccination can be considered, chosen, delivered by authorized professionals when appropriate, and followed up safely.

As Viet Nam's population ages and long-term care services develop, improving the connection between preventive healthcare and everyday care can contribute to safer and more coordinated services.

Ultimately, the quality of vaccination coordination should not be judged solely by the number of doses administered.

It should be reflected in whether older people receive accurate information, retain meaningful choice, overcome avoidable access barriers, and receive appropriate follow-up when vaccination is clinically suitable and agreed.

That is what makes vaccination coordination part of high-quality, person-centered long-term care.

Key References and Regulatory Context

National Assembly of Viet Nam. (2025). Law on Disease Prevention No. 114/2025/QH15. Enacted December 10, 2025; effective July 1, 2026. Particularly Articles 21–23 concerning vaccination, eligibility for access, and compulsory and voluntary vaccination arrangements.

Government of Viet Nam. (2026). Decree No. 165/2026/ND-CP Detailing and Guiding the Implementation of Certain Provisions of the Law on Disease Prevention. Issued May 15, 2026; effective July 1, 2026.

Ministry of Health, Viet Nam. (2026). Circular No. 13/2026/TT-BYT on Vaccination Activities. Issued May 16, 2026; effective July 1, 2026. Particularly Articles 10–15 and 25 concerning vaccination recipient information, vaccination procedures, adverse-event surveillance, reporting, and vaccination establishment responsibilities.

National Assembly of Viet Nam. (2023). Law on Medical Examination and Treatment No. 15/2023/QH15, as amended, and applicable implementing regulations.

National Assembly of Viet Nam. (2009). Law on Older Persons No. 39/2009/QH12, as amended.

Government of Viet Nam. (2017). Decree No. 103/2017/ND-CP on the Establishment, Organization, Operation, Dissolution and Management of Social Assistance Facilities, as amended and applicable.

Government of Viet Nam. (2026). Decree No. 395/2026/ND-CP on the Operation and Management of Social Assistance Facilities. Issued October 23, 2026; scheduled to take effect December 7, 2026.

National Assembly of Viet Nam. (2025). Law on Personal Data Protection No. 91/2025/QH15. Effective January 1, 2026.

Government of Viet Nam. (2025). Decree No. 356/2025/ND-CP Detailing Certain Articles and Measures for Implementation of the Law on Personal Data Protection. Effective January 1, 2026.

World Health Organization. (2025). Immunization in Practice: A Practical Guide for Health Staff. Updated December 8, 2025.

World Health Organization. WHO Recommendations for Routine Immunization — Summary Tables. Relevant current and vaccine-specific recommendations should be consulted according to their publication and update dates.

McGregor, C., Tillman, L., Maude, L., Chee, K., Swift, C., et al. (2026). Evaluating a Tailored Quality Improvement Intervention to Improve Vaccination Coverage in Sydney Residential Aged Care Facilities. Vaccines, 14(2), 171. DOI: 10.3390/vaccines14020171.

Sobczyk, E. A., Schultz, E. M., Casey, D. M., Roney, H. L., Davis, R. C., & Fiebelkorn, A. P. (2026). Lessons Learned From an Immunization Quality Improvement Project Focused on Residents Living in Long-Term Care Settings, United States, 2022 to 2024. Journal of the American Medical Directors Association, 27(9), 106362. DOI: 10.1016/j.jamda.2026.106362.

NSW Health. (2026). Vaccination Risk Assessment for Residential Aged Care Home Residents. Updated April 30, 2026.

Australian Government Department of Health, Disability and Ageing. (2025). Strengthened Aged Care Quality Standards. Effective November 1, 2025, within the applicable Australian aged care framework.

International Organization for Standardization. (2026). ISO 25557:2026 — Ageing Societies — Care Quality for Older Persons at Home and in Care Facilities.

About Healthy Longevity Vietnam

Healthy Longevity Vietnam (HLVN) is an independent initiative focused on advancing quality, safety, and implementation in age-friendly, integrated, and long-term care for older people in Viet Nam. Through evidence-informed approaches, quality improvement, measurement, and collaboration, HLVN supports healthcare and care organizations in developing safer, more coordinated, and person-centered care across settings.

Disclaimer

This article is intended for general educational, preventive healthcare awareness, quality improvement, and organizational development purposes. It does not constitute individualized medical advice, a vaccination recommendation for a particular person, clinical screening guidance, authorization to administer vaccines, legal advice, an official regulatory interpretation, or a mandatory national standard for long-term care in Viet Nam.

Vaccination eligibility, product selection, contraindications, precautions, timing, dosing schedules, consent, pre-vaccination screening, vaccine administration, post-vaccination observation, and management of adverse events must follow applicable Vietnamese law, current professional guidance, relevant product authorization and instructions, and assessment by appropriately qualified healthcare professionals.

The distinction between compulsory and voluntary vaccination must be understood under the relevant provisions of Vietnamese law. No vaccine discussed in this article should be assumed to be mandatory, clinically indicated, authorized, available, or publicly funded for every older person in Viet Nam.

Home-based and residential care providers must distinguish their responsibilities for communication, access arrangements, service coordination, and agreed support from the clinical and regulatory responsibilities of authorized vaccination establishments and healthcare professionals.

Providing long-term care does not automatically authorize an organization to purchase, transport, store, prepare, or administer vaccines outside its lawful scope.

Informed consent and the involvement of family members or legally authorized representatives must comply with applicable legal and professional requirements. Age, frailty, disability, or a diagnosis of dementia does not automatically determine a person's legal decision-making capacity.

An adverse event occurring after vaccination is not necessarily caused by vaccination. Serious or potentially life-threatening symptoms require timely medical assessment or emergency assistance. Applicable professional reporting and investigation obligations remain with the responsible authorized providers and authorities.

Vaccination-related personal information must be processed and shared in accordance with applicable Vietnamese confidentiality and personal data protection requirements.

Government Decree No. 395/2026/ND-CP was issued on October 23, 2026, and is scheduled to take effect on December 7, 2026. It must not be treated as already effective on the review date of this article or as independently authorizing vaccination activities by social assistance facilities.

International research, vaccination guidance, standards, and foreign regulatory examples are presented as reference points. They do not replace Vietnamese law or automatically establish clinical recommendations, legal permissions, consent rules, or reporting obligations for providers operating in Viet Nam.

Organizations should develop locally appropriate vaccination coordination arrangements in consultation with qualified healthcare, preventive medicine, vaccination, long-term care, quality management, and legal professionals, and seek clarification from competent authorities where necessary.

Information and regulatory context reviewed as of November 3, 2026.