CDC: Flu vaccine as important to receive as to give

Health officials warn that the upcoming flu season could be severe.

By Stephanie Stapleton, amednews staff. Oct. 13, 2003.

Physician, vaccinate thyself.

That is one of the messages the Centers for Disease Control and Prevention hopes to convey as part of a recently launched influenza vaccination campaign.

What's in it?
Pneumonia vaccine urged for ill, elderly
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The CDC reports that 85.5 million vaccine doses will be available early in the season, allowing the tiered vaccination approach that prioritized the flu shots for those at highest risk to be abandoned. As a result, health officials are encouraging people to get immunized as soon as possible. Health professionals are no exception. Studies show that only 38% of doctors, nurses and other health workers receive the annual flu shot.

This percentage is "an alarmingly low number," especially in the context of the CDC recommendations, said AMA President Donald J. Palmisano, MD, during a recent Washington, D.C., briefing by the National Foundation for Infectious Diseases and the National Coalition for Adult Immunization. "The AMA message to the 60% or more of those who are unvaccinated is to protect yourself and your patients by getting the vaccine."

The risk physicians face is twofold. First, they have an almost constantly high level of exposure. "Health care professionals are on the front line with at-risk patients in hospitals, nursing homes and medical offices," said Dr. Palmisano. And without the shot, health workers can transmit the bug to patients in their care. "These patients are often fragile."

Additionally, low vaccination levels among health professionals during a flu outbreak would translate into a real threat of having limited staff available to care for sudden patient increases.

85.5 million doses of flu vaccine will be available early in the season.

That's why a special emphasis this year will be placed on reaching this population, according to CDC Director Julie Gerberding, MD, MPH."It's no secret how to prevent the flu: Get vaccinated," added Dr. Palmisano.

He advises physicians to schedule their own immunization to make sure they get it. The vaccine should also be free in their workplaces. Its benefits should be touted. And health care employers should embrace these ideas.

The bottom line: "Flu bad. Vaccine good. Get it now," he said. All practices and hospitals should plan to have enough vaccine on hand to meet needs, and all physicians should purchase vaccine now to be prepared, he added.

Bracing for a virulent bug

Influenza still kills approximately 36,000 Americans and results in the hospitalization of more than 114,000 per year, according to CDC statistics.

"It is simply unacceptable that such a large number of people continue to die and suffer as a result of influenza," said Dr. Gerberding.

38% of health professionals get annual flu shots.

For the 2000-2001 season, the estimated vaccination coverage among adults 18 to 64 years old with high-risk conditions was 29%, substantially lower than the 60% objective established by Healthy People 2010. Among people ages 50 to 64 and those younger than 50 with chronic medical conditions, only 41% and 21%, respectively, were vaccinated against influenza.

"Clinicians really need to reach out to patients and put the problem in terms that are black and white," said Dr. Gerberding.

Upcoming months may be marked by a stronger than usual flu bug. The season drawing to a close in Australia and New Zealand featured an especially virulent virus that is headed our way, said Dr. Gerberding. Typically, longer flu seasons and more severe cases are linked to AH3 strains, which predominated in the recent Australian experience, explained Nancy Cox, PhD, chief of the influenza branch at CDC's National Center for Infectious Diseases.

Health officials are also concerned that mild flu seasons during the past two years might result in public complacency. Additionally, recent delays and confusion surrounding vaccine delivery may also have taken a toll.

This year, the CDC recommends flu shots for all healthy individuals younger than 50 and anyone who wishes to decrease his or her risk of influenza infection.

Patients at risk for developing serious influenza-related complications especially should be vaccinated. These include the elderly; adults and children with chronic diseases such as asthma and diabetes; and pregnant women who will be in their second or third trimester of pregnancy during the influenza season.

Vaccination is still recommended for those 50 to 65 years old, household contacts of at-risk individuals and health care workers who care for at-risk patients.

The CDC now encourages vaccination for healthy children 6 to 23 months old. These children are considered at increased risk for influenza-related hospitalizations. Children younger than 9 years receiving influenza vaccine for the first time require two doses, one month apart.

Health officials also urged immunization against pneumococcal disease for people 65 or older and for younger people with chronic medical conditions.

ADDITIONAL INFORMATION:

What's in it?

Each year a new flu vaccine is formulated to protect against the flu strains experts expect to crop up. The 2003-2004 influenza vaccine protects against the following viruses:

A/Moscow/10/99-like (H3N2)
A/New Caledonia/20/99-like (H1N1)
B/Hong Kong/330/01-like

Source: Centers for Disease Control and Prevention

Pneumonia vaccine urged for ill, elderly

The Centers for Disease Control and Prevention recommends the pneumococcal vaccine for all people older than 65 -- especially those in long-term or chronic care facilities. Still, gaps in coverage persist. For instance, CDC data indicate:

Each year in the United States there are 175,000 hospitalized cases of pneumococcal pneumonia.
There are more than 50,000 cases of bacteremia and 3,000 to 6,000 cases of meningitis annually.
Invasive pneumococcal disease causes more than 6,000 deaths annually, making it responsible for the highest rates of death among the elderly and patients who have underlying medical conditions.
More than half of these cases involve adults for whom pneumococcal vaccination is recommended.
In recent years, pneumococcal strains resistant to one or more commonly used antibiotics have emerged. The emergence of resistant strains places further emphasis on the need for prevention through vaccination.

The vaccine is also recommended for everyone 2 or older with chronic conditions such as diabetes, heart, kidney, liver or lung (excluding asthma) disease, or alcoholism. Patients whose immune systems have been weakened by such conditions as cancer or HIV infection should be vaccinated. So should those without a functioning spleen or with sickle cell disease.

Weblink

Centers for Disease Control and Prevention national flu vaccine program resources (www.cdc.gov/nip/flu/gallery.htm)

Information from the National Influenza Summit 2003, co-sponsored by the AMA and Centers of Disease Control and Prevention (www.ama-assn.org/go/2003influenzasummit)