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Influenza Immunization
WHAT IS THE PUBLIC HEALTH ISSUE?
About 36,000 deaths and 114,000 hospitalizations per year in the United
States are the result of influenza infections. These infections occur in all
age groups, but deaths occur most frequently among persons aged 65 years or
older. In 2003, an unusually early onset of severe influenza outbreaks
resulted in strong consumer demand for influenza vaccine. This demand
exceeded that seen in previous flu seasons. In prior years, the supply of
influenza vaccine was generally sufficient to meet demands. However, demand
in 2003 remained high well into December, when flu vaccination clinics are
typically winding down.
Production of influenza vaccines is a complex process that requires many
steps, including selection of suitable vaccine viruses, reproduction of
these viruses in eggs, and testing to ensure the safety and purity of the
vaccine. Recommendations for strains to be included in U.S. vaccines are
based on year-round surveillance. Typically, these recommendations are
released in February for vaccines that will be used in the following season.
WHAT HAS CDC ACCOMPLISHED?
During the 2003 influenza season, contracts were developed to deliver
additional vaccine to state and local health departments to alleviate spot
shortages reported. Work with the vaccine manufacturers, distributors,
healthcare providers, and state and local public health departments was
performed to redistribute vaccine wherever possible. Communication was
extensively initiated throughout the year to advise partners and others
about developments related to the production, distribution, and
administration of influenza vaccine; provider and patient educational
materials to encourage timely vaccination of high-risk groups were revised;
and CDC participated in media events to highlight the benefits of influenza
vaccination. These communications relied upon strengthened influenza disease
surveillance, resulting in the systematic dissemination of information to
characterize the degree and extent of influenza disease.
Ongoing influenza programs continued to work on making influenza
vaccinations more broadly available. During 2003, CDC updated immunization
recommendations and developed education materials for the new nasal-spray,
FluMist, Live Attenuated Influenza Vaccine, licensed in 2003. Also, CDC and
the Centers for Medicare and Medicaid Services completed a 3-year program to
promote and evaluate the use of standing orders of vaccines in nursing
homes. Initial data showed that standing orders are both more effective and
more cost-effective than other available methods for immunizing nursing home
residents against influenza and pneumococcal diseases.
WHAT ARE THE NEXT STEPS?
CDC will continue to work with other federal agencies, state and local
health departments, and private and community partners to facilitate
communication and collaboration about influenza vaccine supply and
distribution; develop strategies to improve annual immunization coverage
among high-risk populations; and encourage providers to extend vaccination
efforts into December and beyond where needed. Improving physician and
institutional practices will lead to increased vaccination coverage among
adolescents and adults. Efforts are also underway to address the unique
supply issues associated with a seasonal vaccine that changes annually. CDC
will continue to plan, prepare, and exercise responses to the eventual
occurrence of an influenza pandemic.
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last reviewed January 2004
Centers for Disease Control and Prevention
Programs In Brief
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