| Flu
Season 2004-05
Influenza Vaccine Bulletin
#3
Flu Season 2004-2005
September 24, 2004
Topics
Influenza Vaccine Supply and Production
Vaccine
Distribution and Administration
Vaccine Communications and Resources
Upcoming
Events
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.
| Influenza
Vaccine Supply and Production |
2004-2005
Influenza Vaccine Production Update
About 100 million doses of influenza vaccine will be available
this year in the United States. Chiron has reported a delay in
their vaccine delivery schedule. They expect to distribute about
46-48 million total Fluvirin® doses this year plus 2 million
doses to CDC stockpile. While vaccine will begin to be shipped
in October, Chiron has stated that there will be no prioritization
of shipments to distributors once vaccine is released for shipment.
Aventis Pasteur has already shipped some vaccine, reports no delays
in vaccine delivery, and expects to deliver about 20 million doses
in September and the remaining 32 million doses in October. MedImmune
expects to deliver all of its approximate 1.5 million doses of
preservative-free intranasal influenza vaccine (FluMistTM ) in
October. More information is available at www.ama-assn.org/ama/pub/article/1826-8817.html.
Orders for Influenza Vaccine
By now, healthcare providers should have placed influenza vaccine
orders for administration in the fall of 2004. If orders have
not been placed and regular sources of vaccine are booked, healthcare
providers are encouraged to get on a waiting list. Last year,
sporadic cases of influenza were reported throughout the summer,
with widespread activity in several states in November and in
most states during December. Because increased demand for vaccine
is anticipated, healthcare providers who care for Medicare beneficiaries
and others at high risk for complications from influenza must
prepare for the upcoming influenza season immediately.
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.
Influenza
Vaccine Contracts
For 2004, the Centers for Disease Control and Prevention (CDC)
has contracted for a maximum quantity of 8 million doses, up from
4.8 million in 2003. This vaccine may be purchased by state and
local immunization programs with VFC, 317 or state or local funds
for persons of all ages.
On July 30, 2004, CDC signed a contract with MedImmune Vaccines
Inc. for a maximum purchase of 500,000 doses of live, intranasal
influenza virus vaccine, FluMistTM. The vaccine is supplied in packs
containing 10 pre-filled single-dose, 0.5mL sprayers (0.25 per nostril).
This vaccine is indicated for healthy persons five through 49 years
of age. To maintain potency, the vaccine must be stored continuously
at or below -15o C (+5o F). Purchasers intending to store the vaccine
in frost-free freezers must also receive and use a FluMist FreezeBox
supplied by the manufacturer.
VFC
Influenza Vaccine Stockpile
CDC has legislative authority through the Vaccines for Children
(VFC) program to purchase influenza vaccine for a national stockpile
program for children through 18 years of age. Influenza vaccine
is being stockpiled by the CDC to ensure sufficient supply in
case of a shortage like the one experienced this past winter.
4.5 million doses will be purchased for the stockpile this year.
Stockpiled vaccine may be made available directly to state immunization
programs through the VFC program without additional cost to the
programs, or manufacturers may “borrow against” the
stockpile for non-VFC populations. Influenza vaccine for non-VFC
populations will not be free of cost to vaccine providers.
| Influenza
Vaccine Distribution and Administration |
2004
Influenza Vaccination Recommendations of the Advisory Committee
on Immunization Practices (ACIP)
Recommendations have been broadened to protect more people from
influenza. The Centers for Disease Control and Prevention (CDC)
has adopted the following new recommendations beginning with the
2004-05 season.
- Children
6 months to 23 months of age should be vaccinated annually
against influenza.
- Household
contacts and out-of-home caregivers of children 0 to 23 months
of age should be vaccinated annually to prevent these contacts
from infecting young children with influenza.
Other
changes from last year’s recommendations include the composition
of the influenza vaccine for the 2004-2005 season and clarification
about the use of live, attenuated influenza vaccine in healthcare
workers and close contacts of severely immunosuppressed persons.
In addition, women who will be pregnant during the influenza season
are recommended for vaccination at any stage of pregnancy.
Review
the ACIP Recommendations at www.cdc.gov/mmwr/pdf/rr/rr5306.pdf.
Medicare Payment for Influenza Vaccine Purchase and Administration
Medicare
payment rates for influenza vaccine and its administration will
be posted by late September by the Centers for Medicare and Medicaid
Services (CMS) at www.cms.hhs.gov/medlearn/refimmu.asp.
MedImmune
Modifies Marketing Strategy for FluMist™
MedImmune
selected Henry Schein as its exclusive U.S. distributor of FluMist™
for the upcoming influenza season. MedImmune will oversee all
sales and marketing activities with special emphasis on pediatricians
and pharmacies. In addition to selling FluMist™, Henry Schein
will respond to customer product inquiries, process returns, and
promote the product through marketing initiatives to primary care
physicians. Distribution of FluMist™ will be handled through MedImmune's
distribution center in Louisville, Kentucky, a regulated facility
that maintains the FluMist™ cold chain.
MedImmune
has significantly reduced the price of FluMist™ for the
2004–2005 flu season.
Prioritization of Influenza Vaccine to High Risk Patients
As
the United States influenza vaccine supply is expected to be adequate
by October, at present CDC does not envision any need for tiered
vaccination recommendations for this upcoming season. Thus, no
prioritization of vaccine for those at higher risk of complications
from influenza is recommended; however, strong recommendations
to immunize those at high risk of complications from influenza
continue.
For additional information, visit www.cdc.gov/mmwr/preview/mmwrhtml/mm5337a7.htm.
| Influenza
Vaccine Communications & Resources |
Meeting
Summary-Advisory Committee on Immunization Practices (ACIP)
The ACIP met on June 23-24, 2004. Their agenda included discussions
about influenza vaccine supply, influenza surveillance (see the
update on influenza activity published in the MMWR on July 2,
referenced below under Resource Materials), influenza vaccine
effectiveness (new data now published in the MMWR on August 13;
see reference below), a report on the Influenza Vaccine Summit
meeting in April, 2004, the priming dose of influenza vaccine
for children less than 9 years of age, vaccination of health care
workers, and pandemic influenza preparedness. The meeting minutes
will be available at www.cdc.gov/nip/ACIP/minutes.htm
later this year.
Resource
Materials
- “Improving
Influenza Vaccination Rates in Health Care Workers: Strategies
to Increase Protection for Workers and Patients”
This 21-page monograph, released by the National Foundation for
Infectious Diseases (NFID), is an all-inclusive report that includes
detailed information about influenza immunization rates among
healthcare workers and provides strategies healthcare institutions
can use to improve annual influenza immunization rates among employees.
You may download the entire Call to Action at
www.nfid.org/publications/hcwmonograph.pdf.
-
“Kids Need Flu Vaccine, Too!”
Now available online is the National Foundation for Infectious
Diseases (NFID) Kids Need Flu Vaccine, Too! practice resources
program at www.nfid.org. (Click
on the image at the top, right side of the screen.) Features include
helpful information and educational materials for conducting pediatric
influenza immunization programs.
- Review
and print influenza Vaccine Information Statements.
- Review
recently published Morbidity and Mortality Weekly Reports
(MMWRs) related to influenza by clicking on the following
links.
- “Assessment
of the Effectiveness of the 2003-04 Influenza Vaccine Among
Children and Adults” MMWR August 13, 2004; 53
(31):707-710, www.cdc.gov/mmwr/pdf/wk/mm5331.pdf
- “Update:
Influenza Activity-United States and Worldwide, 2003-04 Season,
and Composition of the 2004-05 Influenza Vaccine”
MMWR July 2, 2004; 53(25):547-574, www.cdc.gov/mmwr/PDF/wk/mm5325.pdf
- “Prevention
and Control of Influenza: Recommendations of the Advisory Committee
on Immunization Practices (ACIP)” MMWR May 28,
2004; 53(RR-06):1, www.cdc.gov/mmwr/pdf/rr/rr5306.pdf
- 2004-05
Influenza campaign materials are now available online.
Visit the Flu Gallery on the CDC Flu website
to download and print influenza-related patient and provider education
materials at www.cdc.gov/flu/professionals/flugallery/index.htm.
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