Updated Interim Influenza Vaccination Recommendations

2004-05

 

On October 5, 2004, Chiron Corporation announced that the company could not provide vaccine for distribution in the United States for the 2004-2005 influenza season. At that time, CDC, in coordination with the Advisory Committee on Immunization Practices (ACIP), issued interim recommendations to direct available inactivated influenza vaccine to persons in certain priority groups.  The primary goal of the recommendations by CDC and ACIP is to reduce the risk for complications from influenza among persons who are most vulnerable.  This year the reduced national supply of inactivated influenza vaccine led CDC to issue interim influenza vaccination recommendations that were more restrictive than usual.  The recommendations issued on October 5, 2004 included all children aged 6–23 months; adults aged 65 years and older; persons aged 2–64 years with underlying chronic medical conditions; all women who will be pregnant during the influenza season; residents of nursing homes and long-term care facilities; children aged 6 months–18 years on chronic aspirin therapy; health-care workers involved in direct patient care; and out-of-home caregivers and household contacts of children aged <6 months.

 

Since the interim recommendations were issued, the influenza vaccine supply and demand situation has continued to evolve in the United States so that some, but not all, local areas appear to have adequate supplies to meet the demand for vaccine from those in the interim priority groups.  This has resulted in unused vaccine in some areas of the country.

 

Influenza disease activity in the United States has remained relatively low but is expected to increase during the weeks ahead.  In addition, influenza vaccination coverage among this season’s interim priority groups is lower than it has been in recent influenza seasons.  Given these considerations, CDC recommends that aggressive efforts should continue to reach unvaccinated persons in high risk priority groups and use available vaccine to vaccinate such persons.  Adequate time remains for persons in these priority groups to receive the benefits of vaccination before influenza begins to widely circulate in most communities.  CDC will continue to allocate available vaccine to reach these priority groups. 

 

In addition to these ongoing activities, in coordination with ACIP, CDC is issuing updated interim recommendations for influenza vaccination during the 2004-05 season.  If the locally available supply is sufficient to meet the local demand for vaccine from persons in priority groups identified on October 5, 2004, the interim recommendations for that area may be expanded to allow vaccination of persons in the following categories:

 

·      Out-of-home caregivers and household contacts of persons in high-risk groups (e.g., persons aged ≥ 65 years; persons with chronic conditions such as diabetes, heart or lung disease, or weakened immune systems because of illness or medication; and children aged < 2 years); and

·      All adults aged 50-64 years.

 

Decisions to expand priority groups are left to the discretion of state and local health departments. Vaccine providers and health departments with vaccine should aggressively reach out to vaccinate persons in the priority groups established October 5.  These persons include those at highest risk for complications from influenza and health-care professionals caring for persons at high risk, and should remain a focus even where vaccine supplies are sufficient to support expansion to other groups.

 

These recommendations were formally approved by ACIP on December 17, 2004, to take effect on January 3, 2005.  Implementation is being delayed to allow extra time for vaccine to reach high priority groups and to allow time for state and local health departments to prepare for increased requests for vaccine.

 

The ACIP also passed a resolution for the Vaccines for Children (VFC) program that expands the groups of eligible children to receive VFC influenza vaccine to include VFC-eligible children who are household contacts of persons in high-risk groups. This expansion of VFC is effective immediately.

 

A more detailed description of the updated interim influenza vaccination recommendations adopted by ACIP on December 17, 2004 can be found at http://www.cdc.gov/mmwr/

 

To find CDC communication resources for use by state and local health departments and clinicians to encourage vaccination and other related prevention activities, please see:

·      http://www.cdc.gov/flu/professionals/vaccination/

o  Resource for health care providers and other public health professionals about the current status of 2004-2005 flu vaccine.

·      http://www.cdc.gov/flu/weekly/fluactivity.htm

o  Weekly updates on flu activity in the United States.

·      http://www.cdc.gov/flu/professionals/patiented.htm

o  CDC resources for patient education, including the Flu Gallery and the Flu Toolkit. Resources are updated with new material as the flu season evolves.