Flu Season 2004-05
Influenza Vaccine Bulletin #1
Flu Season 2004-2005
March 26, 2004

Topics
Influenza Vaccine Supply and Production
Vaccine Distribution and Administration
Vaccine Communications and Resources
Miscellaneous Information

version of this bulletin

The National Immunization Program (NIP) of the Centers for Disease Control and Prevention (CDC) publishes and distributes periodic
bulletins to update partners about recent developments related to
the production, distribution, and administration of influenza
vaccine. All recipients of this bulletin are encouraged to distribute
each issue widely to colleagues, members and constituents.

2004-2005 Influenza Vaccine Strains
The Vaccines and Related Biological Products Advisory Committee (VRBPAC) of the Food and Drug Administration (FDA) met on February 18-19, and March 17, 2004 to determine the influenza vaccine formulation for the United States during the upcoming season. The formulation includes one virus from last year’s vaccine [A/New Caledonia/20/99 (H1N1)-like] and two new viruses [A/Fujian/411/2002 (H3N2-like) and B/Shanghai/361/2002-like]. For the A/Fujian component, manufacturers may use A/Wyoming/3/2003 (H3N2) or A/Kumamoto/102/2002 (H3N2). An available alternate for the B/Shanghai component is B/Jilin/20/2003.

Projection for 2004-2005 Influenza Vaccine Supply
Based on early projections, the three manufacturers anticipate total influenza vaccine production of between 90 and 100 million doses. A more precise estimate will be available later in the production cycle once the companies have some experience working with the new viruses and can begin to quantify yields. Total production in 2003 was 86.9 million doses.

Place orders for influenza vaccine
Healthcare providers should place influenza vaccine orders now if they have not already done so. Distributors began taking orders in December of 2003.

Additional information on sources of vaccine can be found at www.hidanetwork.com/govtrelations/flulinks.asp, a service provided by the Health Industry Distributors Association.

Distribution Totals for the 2003-04 Influenza Season
During the 2003-04 influenza vaccination campaign, manufacturers distributed approximately 83.1 million doses of vaccine, about the same as in 2002-03.

Changes to Recommendations for the 2004-05 Influenza Season
On February 24-25, 2004, the Advisory Committee on Immunization Practices (ACIP) met in Atlanta to consider updates to its annual influenza vaccine recommendations. The updated version for 2004-05 will be published in the Morbidity Mortality Weekly Report in late April or early May 2004. Among the changes are the following:

• Influenza vaccine is now routinely recommended for all infants and children ages 6-23 months.
    
• Influenza vaccine has been covered by the Vaccine for Children (VFC) Program since March 1, 2003. The following groups of VFC-eligible children can now receive influenza vaccine through the VFC Program: all infants and children ages 6-23 months and children and adolescents 2-18 years of age who have risk factors or are household contacts of people with risk factors.
     
• All women who will be pregnant at any time during influenza season should be vaccinated.
    
• The guidance for use of the live attenuated influenza vaccine (FluMist) versus inactivated vaccine among healthcare workers and other contacts of high risk persons will be narrowed to recommend that the inactivated influenza vaccine is preferred only for persons who have close contact with severely immunosuppressed persons (e.g., patients with hematopoietic stem cell transplants) during those periods in which the immunosuppressed person requires care in a protective environment. There is no preference for inactivated influenza vaccine use by contacts of persons with lesser degrees of immunosuppression or other high risk conditions (e.g., persons with diabetes mellitus, persons with asthma taking corticosteroids, or persons infected with human immunodeficiency virus).

The length of time that persons vaccinated with live attenuated vaccine are recommended to avoid contact with severely immunosuppressed persons is changed to 7 days from 21 days after vaccination.

Update on Medicare Payment for Influenza Vaccine Purchase and Administration

• Based on Medicare’s 2004 Physician Fee Schedule, the average payment rate for administration of influenza vaccine to Medicare beneficiaries has increased from $7.72 to $8.21 per dose. Rates vary by locale and range from $5.68 to $13.72. Once these rates are posted on the CMS website, the Influenza Vaccine Bulletin will provide a link to the information so that people wishing to determine payment rates for their respective locales may do so.
    
• The Medicare payment rate for influenza vaccine has not yet been determined but is expected to be similar to last year’s $9.95 per dose. (The payment for vaccine is in addition to payment for its administration.)

Cost for Influenza Vaccine
The prices for influenza vaccine this year are expected to be similar to, if not the same as, last year. Purchasers should check with their regular sources of vaccine to determine exact prices. The least expensive price per dose will be for the 10-dose vial presentation while product packaged in pre-filled syringes will be more expensive.

Latest Influenza Vaccine Coverage Data
From the 2002 National Health Interview Survey, coverage level data for selected groups targeted for influenza vaccine are as shown below.

Selected Group	Percentage Coverage
Ages 18-49	23
Ages 50-64	44
Ages 50-64	34
Ages 65 and older	64
Pregnant Women	12
Healthcare Providers	38
Household Contacts	18

Resource Materials

• "Influenza Immunization Among Health Care Workers”.
  A call for action, published by The National Foundation for Infectious Diseases, suggests a comprehensive approach is essential to improve influenza vaccination rates among health care workers.
  
  You may download the entire Call to Action at www.nfid.org/publications/calltoaction.pdf
    
• Review recently published Morbidity and Mortality Weekly Reports (MMWRs) related to influenza by clicking on the following links:
    
  • “Recommended Childhood and Adolescent Immunization Schedule—United States, January-June 2004” MMWR January 16, 2004; 53(1)
    www.cdc.gov/mmwr/pdf/wk/mm5301-Immunization.pdf
      
  • “Racial/Ethnic Disparities in Influenza and Pneumococcal Vaccination Levels in Persons Aged ? 65 Years—United States, 1989-2001” MMWR October 10, 2003; 52(40):958
    www.cdc.gov/mmwr/PDF/wk/mm5240.pdf
       
  • “Notice to Readers: Recommended Adult Immunization Schedule—United States, 2003-2004” MMWR October 10, 2003; 52(40):965.
    www.cdc.gov/mmwr/PDF/wk/mm5240.pdf
       
• The National Immunization Program (NIP) at CDC collected qualitative data on beliefs, behaviors, and barriers that cause low influenza and pneumococcal immunization rates among older African-American and Hispanic populations. You may review the entire report at www.cdc.gov/nip/Flu/flu_qualresearch.htm
    
• Review strategies for increasing influenza vaccination rates by visiting www.cdc.gov/flu/professionals/vaccination/vaxratestrategies.htm on CDC’s web site for the National Immunization Program.
    
• Reference previous bulletins at www.cdc.gov/flu/professionals/flubulletin.htm
    
• Visit the Flu Gallery to download and print influenza-related health education materials at  www.cdc.gov/flu/professionals/flugallery/index.htm on CDC’s website.

Upcoming Events

Event	Location	2004 Date(s)
National Influenza Vaccine Summit	Atlanta, GA	April 13-14
National Infant Immunization Week (NIIW)	National	April 25-May 1
National Immunization Conference (NIC)	Nashville, TN Gaylord Opryland Hotel	May 11-14
National Vaccine Advisory Committee (NVAC) meeting	Washington, DC	June 1-2
Advisory Committee on Immunization Practices (ACIP)	Atlanta, GA	June 23-24
National Immunization Awareness Month (NIAM)	National	August
National Adult Immunization Awareness Week (NAIAW)	National	September 24- October 2

This page last modified on March 26, 2004