The influenza vaccine shortage has prompted a substantial revision of the NIH influenza immunization program. NIH purchased its flu vaccine supply this year from Aventis Pasteur and has already received its first shipment of 6,000 doses. The status of shipment of the remaining 4,000 doses that were ordered (initially scheduled to arrive in late October) is uncertain.

The modified NIH program will first vaccinate health care providers and next will offer vaccine to others on the CDC priority list.

Occupational Medical Service staff will continue to visit the clinical patient care areas on a rotating basis to administer vaccine. A new schedule for vaccination in these patient care areas has been posted on the NIH web site and throughout Bldg. 10. If you are a patient care provider or someone who comes in contact with CC patients as a result of your job and you would like to be immunized, contact the leadership of the clinical care area where you work to determine when staff from OMS will be in that area. Then make arrangements to report to that area during that time to be vaccinated. The number of doses available is limited, so make arrangements immediately. Call the Hospital Epidemiology Service (301/496-2209) to discuss problems or issues you may have with this revised schedule.

If you are an NIH employee who is not a health care provider but have a condition that you believe places you on the CDC priority list for vaccination, call OMS (301/496-4411) to place your name on a list of potential priority list vaccinees. More guidance about immunization will be provided during the first or second week of November after the health care provider program is completed.

Because of the limited supply of influenza vaccine, health care workers and others should pay special attention this year to what CDC has termed "respiratory etiquette." If an employee develops symptoms suggestive of influenza at home, he/she should take sick leave to avoid spreading the illness to other staff or patients. If symptoms develop while the individual is working, he/she should report first to her/his supervisor and then to OMS, who can obtain appropriate specimens and begin rapid diagnostic testing, as well. Health care workers should avoid spreading infection to others by limiting contact with patients, other staff and visitors and by washing their hands or using the alcohol-based hand hygiene product after contact with respiratory secretions. Health care workers should always follow the tenets of respiratory etiquette (i.e., cover mouths when coughing or sneezing, careful hand hygiene after contact with respiratory secretions, etc.). Although hand hygiene is a key hospital infection control strategy at all times, during the respiratory virus season (from October through February) health care professionals should pay meticulous attention to hand hygiene. If influenza is diagnosed in a health care worker or patient, the Clinical Center's Hospital Epidemiology Service should be immediately notified. The CC Microbiology Service has the ability to make the diagnosis of influenza rapidly. If you suspect that one of your patients may have influenza, contact the Infectious Diseases consultative service and order influenza cultures from the microbiology service.