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Weekly Report

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October 10 - October 16, 2004

Volume 1, Issue 132

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Interim Influenza Vaccination Recommendations: 2004-05

On October 5, 2004, CDC was notified by Chiron Corporation that none of its influenza vaccine (Fluvirin®) would be available for distribution in the United States for the 2004-05 influenza season. The company indicated that the Medicines and Healthcare Products Regulatory Agency (MHRA) in the United Kingdom, where Chiron's Fluvirin vaccine is produced, has suspended the company's license to manufacture Fluvirin vaccine in its Liverpool facility for 3 months, preventing any release of this vaccine for this influenza season. This action will reduce by approximately one half the expected supply of trivalent inactivated vaccine (flu shot) available in the United States for the 2004-05 influenza season.

The remaining supply of influenza vaccine expected to be available in the United States this season is nearly 54 million doses of Fluzone® (inactivated flu shot) manufactured by Aventis Pasteur, Inc. Of these doses, approximately 30 million doses already have been distributed by the manufacturer. In addition, approximately 1.1 million doses of live attenuated influenza vaccine (LAIV/FluMist®) manufactured by MedImmune will be available this season.

Because of this urgent situation, CDC, in coordination with its Advisory Committee for Immunization Practices (ACIP), is issuing interim recommendations for influenza vaccination during the 2004-05 season. These interim recommendations were formally recommended by ACIP on October 5, 2004, and take precedence over earlier recommendations.

Priority Groups for Influenza Vaccination

The following priority groups for vaccination with inactivated influenza vaccine this season are considered to be of equal importance and are:

  • 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.

Other Vaccination Recommendations

Persons in priority groups identified above should be encouraged to search locally for vaccine if their regular health-care provider does not have vaccine available. Intranasally administered, live, attenuated influenza vaccine, if available, should be encouraged for healthy persons who are aged 5-49 years and are not pregnant, including health-care workers (except those who care for severely immunocompromised patients in special care units) and persons caring for children aged < 6 months. Certain children aged < 9 years require 2 doses of vaccine if they have not previously been vaccinated. All children at high risk for complications from influenza, including those aged 6-23 months, who present for vaccination, should be vaccinated with a first or second dose, depending on vaccination status. However, doses should not be held in reserve to ensure that 2 doses will be available. Instead, available vaccine should be used to vaccinate persons in priority groups on a first-come, first-serve basis.

Vaccination of Persons in Nonpriority Groups

Persons who are not included in one of the priority groups described above should be informed about the urgent vaccine supply situation and asked to forego or defer vaccination.

Persons Who Should Not Receive Influenza Vaccine

Persons in the following groups should not receive influenza vaccine before talking with their doctor:

  • persons with a severe allergy (i.e., anaphylactic allergic reaction) to hens' eggs and
  • persons who previously had onset of Guillain-Barr� syndrome during the 6 weeks after receiving influenza vaccine.

For more information, visit www.cdc.gov/flu, or call the National Immunization Hotline at (800) 232-2522 (English), (800) 232-0233 (espa�ol), or (800) 243-7889 (TTY).


HHS Secretary Tommy G. Thompson, CDC Director Dr. Julie L. Gerberding, NIH National Institute of Allergy and Infectious Diseases Director Dr. Anthony S. Fauci and FDA Center for Biologics Evaluation and Research Director Dr. Jesse L. Goodman respond to the temporary delay in the Fall 2004 release of influenza vaccine. HHS Photo by Chris Smith

HHS Secretary Tommy G. Thompson, CDC Director Dr. Julie L. Gerberding, NIH National Institute of Allergy and Infectious Diseases Director Dr. Anthony S. Fauci and FDA Center for Biologics Evaluation and Research Director Dr. Jesse L. Goodman respond to the temporary delay in the Fall 2004 release of influenza vaccine. HHS Photo by Chris Smith


HEALTHY HABITS

HHS and OPM Announce Launch of HealthierFeds Physical Activity Challenge to Urges Federal Workforce to Get Moving for Health

HHS Secretary Tommy G. Thompson and Office of Personnel Management (OPM) Director Kay Coles James launched on Wednesday the HealthierFeds Physical Activity Challenge, the first government-wide effort to encourage federal employees to get moving for health. Employees may sign up online at http://www.healthierfeds.gov

"America needs to get healthier and federal employees need to set the pace," Secretary Thompson said. "We're spreading the message of prevention and we need to lead by example. I challenge everyone within the government to make physical activity a part of their daily lives. Encourage each other, compete against other offices, but most importantly have fun and get healthy."

The goal for HealthierFeds participants is to meet daily physical activity goals of 30 minutes a day, five days a week, for six weeks. Participants can choose from a list of more than 100 activities and log their activity online in increments as small as five minutes. The HealthierFeds Physical Activity Challenge will utilize the President's Challenge, a program of the President's Council on Physical Fitness and Sports (PCPFS).

Regular physical activity substantially reduces the mortality risk related to coronary heart disease, the nation's leading cause of death, and decreases the risk for stroke, colon cancer, diabetes and high blood pressure.

Employees can sign up online at www.healthierfeds.gov and use the Web site to log their physical activities for six weeks. HealthierFeds Physical Activity Challenge is part of Steps to a HealthierUS, a bold new initiative from the U.S. Department of Health and Human Services (HHS) that advances President George W. Bush's HealthierUS goal of helping Americans live longer, better and healthier lives.

Lynne Swann, PCPFS Chairman motivates federal government employees to join the HealthierFeds Physical Activity Challenge. Secretary Thompson, Director James, and Executive Director of PCPFS, Melissa Johnson look on. HHS Photo by Chris Smith

Lynne Swann, PCPFS Chairman motivates federal government employees to join the HealthierFeds Physical Activity Challenge. Secretary Thompson, Director James, and Executive Director of PCPFS, Melissa Johnson look on. HHS Photo by Chris Smith



science in the news

Stopping Germs at Home, Work and School

The main way that illnesses like colds and flu are spread is from person to person in respiratory droplets of coughs and sneezes. This is called "droplet spread." This can happen when droplets from a cough or sneeze of an infected person move through the air and are deposited on the mouth or nose of people nearby. Sometimes germs also can be spread when a person touches respiratory droplets from another person on a surface like a desk and then touches his or her own eyes, mouth or nose before washing their hands. We know that some viruses and bacteria can live 2 hours or longer on surfaces like cafeteria tables, doorknobs, and desks.

How to Stop the Spread of Germs

In a nutshell: take care to

  • Cover your mouth and nose
  • Clean your hands often
  • Remind your children to practice healthy habits, too

Cover your mouth and nose when coughing or sneezing

Cough or sneeze into a tissue and then throw it away. Cover your cough or sneeze if you do not have a tissue. Then, clean your hands, and do so every time you cough or sneeze.

The "Happy Birthday" song helps keep your hands clean

Not exactly. Yet we recommend that when you wash your hands -- with soap and warm water -- that you wash for 15 to 20 seconds. That's about the same time it takes to sing the �Happy Birthday� song twice!

Alcohol-Based Hand Wipes and Gel Sanitizers Work Too

When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers may be used. You can find them in most supermarkets and drugstores. If using gel, rub your hands until the gel is dry. The gel doesn't need water to work; the alcohol in it kills the germs on your hands.

Remind children to practice healthy habits too, because germs spread, especially at school. The flu has caused high rates of absenteeism among students and staff in our country's 119,000 schools. Influenza is not the only respiratory infection of concern in schools -- nearly 22 million schools days are lost each year to the common cold alone. However, when children practice healthy habits, they miss fewer days of school.

What are other steps that can be taken to prevent the flu?

There are other good health habits that can help prevent the flu. These are:

  • Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.
  • If possible, stay home from work, school, and errands when you are sick. You will help prevent others from catching your illness.
  • Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick
  • .
  • Washing your hands often will help protect you from germs.
  • Avoid touching your eyes, nose or mouth. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.
  • Also, antiviral medications may be used to prevent the flu.


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Medicare Minute

Medicare Advantage Plans Expand Coverage to Seniors, Lower Costs for Enrollees

HHS Secretary Tommy G. Thompson announced on Wednesday that Medicare Advantage plans were seeking to expand coverage to 1.6 million additional seniors and persons with disabilities, while also lowering their premium and out of pocket covered services costs by an average of 10 percent and providing more benefits -- evidence that the new Medicare Modernization law is a successful investment in seniors and their access to better health care benefits.

Secretary Thompson said that 35 Medicare Advantage plans had made new applications to provide coverage and 22 had applied for expansion of service areas. If approved this translates into 1.6 million additional Medicare beneficiaries living in 93 counties and 11 states who will have access to Medicare Advantage plans. This expansion is on top of the nearly 5 million Medicare beneficiaries enrolled in Medicare Advantage plans who will continue to receive high quality care at affordable costs in 2005.

In addition to an overall expansion of coverage areas, initial analysis show that plan premiums and cost sharing for Medicare-covered services are declining on average by 10 percent, while plans continue to provide more benefits not covered by fee-for-service Medicare, including drugs, dental, vision and preventive and wellness services, providing average savings of about $23 per month.

"The new Medicare Modernization law is expanding access to health care for seniors and lowering their costs," Secretary Thompson said. "We made an investment in seniors and it is paying off with greater access to health care at more affordable costs. Under President Bush's leadership, we are reversing a trend of seniors losing access to Medicare Advantage plans each year to an environment where plans are expanding coverage and lowering costs."

The expansion of Medicare Advantage plans to provide more health care access to seniors represents a significant shift from years of plans dropping out of the Medicare Advantage program and reducing seniors' access to coverage.

"The steps Congress and the Administration have taken to stabilize the Medicare Advantage program are keeping costs down for Medicare beneficiaries," Centers for Medicare & Medicaid Services Administrator (CMS) Mark B. McClellan, M.D., Ph.D. said. "With a turnaround in the availability of health plans that provide coordinated care in Medicare, we expect that many more Medicare beneficiaries will have access to the savings in Medicare Advantage plans in 2005, on our way to even broader availability of less costly, comprehensive coverage in 2006."

CMS will post the plan benefits and premiums on www.medicare.gov on Oct. 19. The same information will be available by calling 1-800-MEDICARE and is currently being mailed as part of the Medicare & You 2005 handbook that should be arriving in beneficiaries' homes within the next couple of weeks.

Because of hurricane activity, beneficiaries in Florida will begin to receive their Medicare & You 2005 handbooks the first week of November and be able to see updated information on www.medicare.gov at that time as well. Beneficiaries in Florida also have an extended open enrollment period that ends Jan. 31, 2005.



Secretary Thompson's Public Schedule
  • Sunday, October 10, 2004
    • Secretary Thompson is in Mexico attending the inauguration of the Border Bi-national Health Week with Mexican President Vicente Fox.
  • Monday, October 11, 2004
    • Secretary Thompson will be attending the Border Health Commission Meeting in Noqales, Arizona



Last revised: October 12, 2004

For any questions or comments, please call 202-690-6887 or e-mail Wendy.Riemann@hhs.gov

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