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Issue Number 184            August 29, 2000


  1. UPDATE: CDC says, "Plan now: Expect flu vaccine supply delays and possible shortages"
  2. Oops! We erred in the price listed for Michigan's immunization modules described in IAC EXPRESS #183


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August 25, 2000

The Centers for Disease Control and Prevention (CDC) has released the following announcement:


Influenza vaccine manufacturers have told FDA and CDC to expect delays in flu vaccine shipments this flu season. In addition, the possibility of a U.S. shortage of influenza vaccine for the 2000-01 season continues to be a concern. CDC is urging all health care providers who provide flu vaccines to their patients to consider ways to ensure their high risk patients receive vaccination if a severe vaccine shortfall were to occur. CDC also encourages delaying adult mass influenza vaccination campaigns to November (usually recommended for October through mid-November) to diminish the possibility that these campaigns will need to be cancelled because vaccine is not available.

The amount of vaccine available is complicated by two important factors: 1) the yield for this year's influenza vaccine A(H3N2) component appears to be lower than expected which limits the supply that can be developed in time for this flu season and, 2) other manufacturing issues. The total amount of vaccine available for the influenza season is uncertain at this time. Because of this uncertainty, CDC urges health care providers to develop contingency plans to ensure their high risk patients receive flu vaccine. Both FDA and CDC are actively working with manufacturers to determine how much and when vaccine will be available.

Regardless of the overall availability of vaccine this flu season, CDC emphasizes that health care providers should vaccinate persons at highest risk of death from influenza and the health care workers who take care of them.

In the United States, 70 to 76 million persons (approximately 35 million persons aged 65 years or older; 33 to 39 million persons less than 65 years of age with high-risk medical conditions; and 2 million pregnant women) are at high risk for serious complications from influenza infections, including hospitalizations and deaths. For every age group, people with chronic medical conditions are at higher risk. However, healthy 50 to 64 year olds are not at any greater risk than healthy adults less than 50.

Currently, four antiviral drugs are approved by FDA to treat acute, uncomplicated influenza. Two of the drugs are also approved for use in preventing influenza. However, these drugs are not a general substitute for influenza vaccine and should not be used as such. The annual use of influenza vaccine is the primary means for minimizing adverse outcomes from influenza virus infections.

Influenza Vaccine Recommendations for the 2000-01 Influenza Season Only

Annual vaccination against influenza is the best way to reduce hospitalizations and deaths from influenza complications. These infections result in approximately 20,000 deaths and 110,000 hospitalizations per year in the United States.

  • Organized influenza vaccination campaigns should be delayed. Health-care providers, health organizations, commercial companies, and other organizations planning organized influenza vaccination campaigns for the 2000-01 influenza season should delay vaccination campaigns until November. The purpose of this recommendation is to minimize cancellations of vaccine campaigns and wastage of vaccine doses resulting from such cancellations.
  • Influenza vaccination of persons at high risk for complications from influenza and their close contacts should proceed routinely during regular health-care visits. Routine influenza vaccination activities in clinics, offices, hospitals, nursing homes, and other health-care settings (especially vaccination of persons at high risk for complications from influenza, health-care staff, and other persons in close contact with persons at high risk for complications from influenza) should proceed as normal with available vaccine. This is particularly important for young children at high risk who are receiving influenza vaccination for the first time and who require two doses of vaccine.
  • Providers should develop specific contingency plans for an influenza vaccine shortage. All influenza vaccine providers, including health-care systems and organizers of vaccination campaigns, should develop a provider-specific contingency plan to maximize vaccination of high-risk persons and health-care workers. These plans should be available for implementation if a vaccine shortage develops.
  • Influenza vaccine should be offered to unvaccinated persons throughout the influenza season. Each season, many people who should be vaccinated have not received vaccine by November. For these people, influenza vaccine administered about November can still provide substantial protective benefits within 10 to 14 days after vaccination. In many years, influenza activity does not peak until after December.
  • Minimizing influenza vaccine waste is particularly important. Influenza vaccine purchasers should not place duplicate orders with multiple companies. This should minimize the amount of vaccine that is returned to a manufacturer and discarded.
  • In 2000, the Advisory Committee on Immunization Practices (ACIP) broadened its influenza vaccine recommendations to include all persons 50-64 years. There is no change in this recommendation at this time. However, if a vaccine shortage materializes, then it would be appropriate to vaccinate persons with high-risk conditions in this age group rather than the entire age group. Healthy persons in the 50-64 year old age group are at lower risk for serious complications than persons in this age group with underlying high-risk medical conditions.
  • Vaccine providers should keep in mind that pneumococcal vaccine is recommended for many of the same people for whom influenza vaccine is indicated. Use of pneumococcal vaccine could reduce some of the bacterial complications of influenza infection.
  • There are no new recommendations for the use of influenza antiviral drugs. Even if an influenza vaccine shortage develops, CDC does not support their routine and widespread use to prevent influenza because this is an untested and expensive strategy that could result in large numbers of persons experiencing adverse effects.
  • This fall a CDC website will provide information on where to obtain additional influenza vaccine supplies. In addition, local or state health departments may also have information on vaccine availability in local areas.

CDC Website for more information:

CDC Media Relations phone number: (404) 639-3286

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August 29, 2000

IAC EXPRESS #183 published the incorrect price for the immunization curricula for health providers and their office staff. The modules, developed by the Michigan Department of Community Health and Michigan State University, cost $30 each (rather than $10).

For more information about the modules and their content, call Nancy Fasano, Michigan Department of Community Health, at (517) 335-9423.

To request an order form, call the Health Promotion Program at Michigan State University at (517) 353-2596.

About IZ Express

IZ Express is supported in part by Grant No. 1NH23IP922654 from CDC’s National Center for Immunization and Respiratory Diseases. Its contents are solely the responsibility of and do not necessarily represent the official views of CDC.

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Editorial Information

  • Editor-in-Chief
    Kelly L. Moore, MD, MPH
  • Managing Editor
    John D. Grabenstein, RPh, PhD
  • Associate Editor
    Sharon G. Humiston, MD, MPH
  • Writer/Publication Coordinator
    Taryn Chapman, MS
    Courtnay Londo, MA
  • Style and Copy Editor
    Marian Deegan, JD
  • Web Edition Managers
    Arkady Shakhnovich
    Jermaine Royes
  • Contributing Writer
    Laurel H. Wood, MPA
  • Technical Reviewer
    Kayla Ohlde

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