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250 June 6, 2001
CONTENTS OF THIS ISSUE
- CDC's National Immunization Program issues influenza
- CDC publishes MMWR issue on HIV/AIDS
- CDC seeks proposals for primary care physician
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June 6, 2001
CDC'S NATIONAL IMMUNIZATION PROGRAM ISSUES INFLUENZA VACCINE BULLETIN
On May 29, 2001, the National Immunization Program of the Centers for Disease Control and Prevention (CDC) issued the
first in a series of influenza vaccine bulletins designed to update health professionals on the production,
distribution, and administration of influenza vaccine for the 2001-2002 influenza season. The bulletin is reprinted below in its
INFLUENZA VACCINE BULLETIN #1 MAY 29, 2001
The National Immunization Program (NIP) of the Centers for Disease Control and Prevention (CDC) is publishing and
distributing a periodic bulletin to update partners about recent developments related to the production,
distribution and administration of influenza vaccine for the 2001-2002 influenza season. All recipients of this bulletin are
encouraged to distribute each issue widely to colleagues, members and constituents.
INFLUENZA VACCINE SUPPLY/PRODUCTION
Influenza vaccine manufacturers periodically update their influenza vaccine production projections.
At different points in the production process, influenza
vaccine manufacturers project how much influenza vaccine they are going to produce. Completion of
various steps in the manufacturing process provides data that allow the projections to be refined over time. Although still
relatively early in the process, all three companies recently provided updated projections which
suggest that this year's production may at least approximate last year's. Nevertheless, officials at FDA caution that the projections
assume that no difficulties are encountered during the remainder of production. They stress
that the final yields cannot be known until production is completed.
INFLUENZA VACCINE DISTRIBUTION
Annual contingency planning for the possibility of an influenza vaccine production delay or shortfall is
Each year, as new influenza viruses emerge, influenza vaccine manufacturers must produce a new vaccine containing
one or more viruses that differ from the previous year's formulation. Because of the challenges these emergent
viruses pose to the vaccine manufacturers and the FDA, and the many other uncertainties inherent in influenza vaccine
production, definitive information about annual influenza vaccine production usually will
not be available until late summer or early fall. Thus, CDC recommends that all
organizations and institutions involved in distributing and administering influenza vaccine annually develop contingency
plans. These plans should address problems that would result should a shortfall in vaccine production or
a delay in vaccine distribution occur. CDC has asked State health departments to develop plans that include, among other
elements, communication with partners and voluntary reallocation of vaccine where
needed. The plans will ensure that in the event of a shortfall, vaccine could be
targeted to high-risk patients and if distribution of vaccine is delayed, all
providers could at least begin their vaccination efforts in their high-risk patients.
A delay in vaccine distribution may impact different providers differently. Providers with high-risk patients
should order vaccine now.
Because influenza vaccine is newly produced for each influenza season, numerous factors may affect each
manufacturer's vaccine production and distribution. If some manufacturers are delayed in getting their vaccine to their
customers, uneven distribution of the vaccine will result with providers who
ordered from one manufacturer possibly receiving vaccine later than providers who ordered from
another. Further, providers who order late may receive vaccine late. Providers who order from third party
distributors will be dependent upon which manufacturer is supplying that distributor.
If a vaccine shortfall or delay in distribution occurs, mass vaccination clinics
should follow the recommendations of the Advisory Committee on Immunization Practices (ACIP) and
CDC's "Best Practices."
An important change in the ACIP recommendations is to extend the optimal time for vaccinating high-risk individuals from
mid-November to the end of November, but realize that immunization attempts should continue into
January if necessary. For a copy of the entire ACIP influenza recommendations, please refer to the Resources section at
the bottom of this bulletin. A copy of CDC's "Best Practices" is also attached.
INFLUENZA VACCINE COMMUNICATIONS
As the season progresses and more information is obtained regarding influenza vaccine issues, CDC will provide that
information at its website at http://www.cdc.gov/nip/issues/flu
ACIP influenza recommendations:
BEST PRACTICES FOR MASS INFLUENZA VACCINATION CAMPAIGNS: ENSURING THAT PERSONS AT HIGH RISK AND THEIR HOUSEHOLD
CONTACTS ARE VACCINATED
- Develop liaisons with community groups representing the
elderly and those with chronic diseases (e.g., offer incentives for groups to attend
clinics, ask for volunteers to help promote and run clinics).
- Share information about vaccine availability with other
clinics/facilities providing flu vaccine in your community. Inform clients about other
locations where vaccine is available.
- Schedule and publicize special "senior clinics" when only
elderly or other high-risk patients will be accepted.
- Schedule flu vaccine delivery during daytime hours when
the elderly, and other high-risk patients, have less need to compete with younger,
healthy clients for a place in line at the vaccination location.
- Workplace sites can offer vaccination to elderly and
chronically ill employees and relatives of persons in the workplace.
- Promote the campaign by publishing "public service"
announcements in local media stressing a commitment to first serve the high-risk population
and asking healthy people to cooperate by waiting for availability of vaccine. Include
up-to-date information about expected availability of more vaccine and about flu activity (or lack thereof) in the
- Share vaccine with other providers (e.g., hospitals,
nursing homes, physicians) who see high-risk patients.
AT THE VACCINATION LOCATION . . .
- Establish criteria for identifying high-risk individuals
and those living with them, and ensure that they receive top priority.
- Develop a brief questionnaire or checklist to enable
prospective vaccinees to determine their risk status, and encourage those not at high
risk to return in December or later.
- Post notices (or personnel) asking healthy people to defer
their flu shots so high-risk people can be protected with available vaccine. Give people
the opportunity to defer before they have started to wait in line.
- Establish "express lanes" for elderly and high-risk
patients to reduce the amount of time they have to stand in line to receive the vaccine.
- Offer incentives for non-high-risk patients who accept a
"rain check" to return at a later date for their shots.
- Keep customers informed. Post notices informing clients of
hours of flu vaccine clinics and of the need to vaccinate high-risk patients first.
Assure them (if appropriate) that additional shipments of vaccine are
expected. Post information about other locations where vaccine is available.
To obtain a camera-ready copy (PDF format) of "Best Practices for Mass Influenza Vaccination Campaigns," go to: http://www.immunize.org/cdc/cdcflu2.pdf
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June 6, 2001
CDC PUBLISHES MMWR ISSUE ON HIV/AIDS
The June 1, 2001, issue of "Morbidity and Mortality Weekly Report" (MMWR), published by CDC, is devoted to "new reports
on the epidemiologic features and impact of HIV/AIDS on communities in the United States and in other
countries." The issue includes the following stories:
First Report of AIDS:
HIV and AIDS--United States, 1981-2000:
The Global HIV and AIDS Epidemic, 2001:
HIV Incidence among Young Men Who Have Sex with Men--Seven U.S. Cities, 1994-2000:
Notice to Readers: The 20th Year of AIDS: A Time to Re-Energize Prevention:
A compilation of notable MMWR reports on HIV and AIDS is available at
AIDS video commentary and report summaries are available on the CDC website. Video clips include interviews with
participants in CDC's first AIDS investigations and reports. Go to:
HOW TO OBTAIN A FREE ELECTRONIC SUBSCRIPTION TO THE MMWR:
To obtain a free electronic subscription to the "Morbidity and Mortality Weekly
Report" (MMWR), visit CDC's MMWR website at: http://www.cdc.gov/mmwr
Select "Free MMWR Subscription" from the menu at the left of the screen. Once
you have submitted the required information, weekly issues of the MMWR and all new ACIP statements (published as MMWR's
"Recommendations and Reports") will arrive automatically by e-mail.
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June 6, 2001
CDC SEEKS PROPOSALS FOR PRIMARY CARE PHYSICIAN IMMUNIZATION SURVEY
CDC is seeking proposals to obtain longitudinal and nationally representative
data on the attitudes and practices of pediatricians, family physicians, and
their patients regarding vaccination.
Data will be used to characterize rates and types of concerns regarding safety of childhood vaccinations and
measure provider and parent confidence in the safety of vaccines; identify parents' questions and concerns about
alleged side effects; and assess patient education methods and materials used in childhood immunizations.
The project involves developing a collection instrument, collecting and analyzing data, and preparing various
reports. Period of performance is 48 months.
More information, including the request for proposals (RFP), is available online at:
For further information, contact Wanda Allison at CDC by telephone at (770)
488-2645 or by email at WAllison@cdc.gov