Letters to the Editor - Dec. 1, 2008

Thanksgiving should not mark the close of influenza vaccine season

Regarding "The never-ending story: Flu vaccine season goes year-round (Article, Oct. 6): Yes, thankfully we have a large and secure supply of influenza vaccine, but its value is greatly diminished unless we ramp up efforts to get it into the arms or noses of those who need it. One way to do that is to overcome the perception among physicians and the public that getting vaccinated is strictly an autumn event.

As the article says, physicians are vaccinating at full tilt in October and November, whereas after Thanksgiving it's much more of a dribble. But the influenza season goes on well past Thanksgiving; in fact, it usually peaks about two to three months after we've digested the last of our leftover turkey. There are up to 30 million or more U.S. cases of influenza after the new year annually.

Since it only takes about two weeks to develop immunity after vaccination, the medical relevance of vaccinating in December, January or later is clear. And with over 260 million Americans recommended to get the vaccine every year, there is also a practical need to vaccinate for a longer period. It is not feasible to vaccinate 85% of our population, including every child 6 months and older, as recommended in the brief October-November window.

The Centers for Disease Control and Prevention understands this and encourages vaccination throughout the season. Indeed, National Influenza Vaccination Week will be Dec. 8-14 this year, underscoring the importance of vaccinating past our self-imposed November deadline.

The National Foundation for Infectious Diseases also understands the need and recently sponsored a supplement to the American Journal of Medicine, which discusses this shift in thinking about the influenza vaccination window. The supplement includes new data showing that 25 million people at high risk for influenza complications visit doctors an average of 2.2 times each year between November and February but do not get vaccinated.

As health care providers, we need to take the lead to increase immunization rates by offering vaccines at every opportunity throughout the entire influenza season.

--William Schaffner, MD, Nashville, Tenn.

Editor's note: Dr. Schaffner is professor and chair of the Dept. of Preventive Medicine at Vanderbilt University and president-elect of the National Foundation for Infectious Diseases.

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