Issue
Number 483
October 6, 2004
CONTENTS OF THIS ISSUE
- CDC releases ACIP's interim influenza vaccine
recommendations for the 2004-05 influenza season
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October 6, 2004
CDC RELEASES ACIP'S INTERIM INFLUENZA VACCINE RECOMMENDATIONS FOR THE
2004-05 INFLUENZA SEASON
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The Centers for Disease Control and Prevention (CDC) published "Interim
Influenza Vaccination Recommendations, 2004-05 Influenza Season" in the
October 5 issue of "MMWR Dispatch."CDC publishes the web-based "MMWR
Dispatch" only for the immediate release of important public health
information. The article will be published in a print issue of Morbidity and
Mortality Weekly Report (MMWR) in the future.
CDC's Advisory Committee on Immunization Practices (ACIP) developed the
interim recommendations in response to Chiron Corporation's announcement
that its trivalent inactivated influenza vaccine will not be available in
the United States for the 2004-05 influenza season. The interim
recommendations delineate priority groups for receiving influenza vaccine in
light of the upcoming vaccine shortage. They take precedence over ACIP's
earlier recommendations. The chief differences between the interim
recommendations and earlier recommendations with regard to priority
populations for vaccination are three:
- The interim recommendations include
persons age >=65 years as a priority population for influenza vaccination.
Earlier recommendations included persons >=50 years.
- The interim recommendations include
persons age 2-64 years with underlying chronic medical conditions as a
priority population for influenza vaccination. Earlier recommendations
included persons age 2-49 years with underlying chronic medical
conditions.
- The interim recommendations include
persons who can transmit influenza to certain high-risk groups (i.e.,
health care workers involved in direct patient care; out-of-home
caregivers and household contacts of children age <6 months) as priority
populations for influenza vaccination. Earlier recommendations included a
much broader group of health care workers (e.g., all physicians, nurses,
and others in hospital and outpatient-care settings), as well as household
contacts and out-of-home caregivers of all persons in groups at high risk,
including children 0-23 months of age.
The October 5 "MMWR Dispatch" is reprinted
below in its entirety. Following the article are additional sources of
information about Chiron's announcement and the interim recommendations, as
well as a link to ACIP's previous influenza vaccine recommendations, dated
May 28, 2004.
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On October 5, 2004, CDC was notified by Chiron Corporation that none of its
influenza vaccine (Fluvirin) would be available for distribution in the
United States for the 2004–05 influenza season. The company indicated that
the Medicines and Healthcare Products Regulatory Agency (MHRA) in the United
Kingdom, where Chiron's Fluvirin vaccine is produced, has suspended the
company's license to manufacture Fluvirin vaccine in its Liverpool facility
for 3 months, preventing any release of the vaccine for this influenza
season. This action will reduce by approximately one half the expected
supply of trivalent inactivated vaccine (flu shot) available in the United
States for the 2004–05 influenza season.
The remaining supply of influenza vaccine expected to be available in the
United States this season is approximately 54 million doses of Fluzone
(inactivated flu shot) manufactured by Aventis Pasteur, Inc. Of these doses,
approximately 30 million doses already have been distributed by the
manufacturer. In addition, approximately 1.1 million doses of live
attenuated influenza vaccine (LAIV/FluMist) manufactured by MedImmune will
be available this season.
Because of this urgent situation, CDC, in coordination with its Advisory
Committee for Immunization Practices (ACIP), is issuing interim
recommendations for influenza vaccination during the 2004–05 season. These
interim recommendations were formally recommended by ACIP on October 5 and
take precedence over earlier recommendations.
Priority Groups for Influenza Vaccination
The following priority groups for vaccination with inactivated influenza
vaccine this season are considered to be of equal importance and are:
- all children aged 6–23 months;
- adults aged >=65 years;
- persons aged 2–64 years with underlying
chronic medical conditions;
- all women who will be pregnant during
the influenza season;
- residents of nursing homes and long-term
care facilities;
- children aged 6 months–18 years on
chronic aspirin therapy;
- health-care workers involved in direct
patient care; and
- out-of-home caregivers and household
contacts of children aged <6 months.
Other Vaccination Recommendations
- Persons in priority groups identified
above should be encouraged to search locally for vaccine if their
regular health care provider does not have vaccine available.
- Intranasally administered, live,
attenuated influenza vaccine, if available, should be encouraged for
healthy persons who are aged 5–49 years and are not pregnant,
including health care workers (except those who care for severely
immunocompromised patients in special care units) and persons caring
for children aged <6 months.
- Certain children aged <9 years require
2 doses of vaccine if they have not previously been vaccinated. All
children at high risk for complications from influenza, including
those aged 6–23 months, who are brought for vaccination, should be
vaccinated with a first or second dose, depending on vaccination
status. However, doses should not be held in reserve to ensure that 2
doses will be available. Instead, available vaccine should be used to
vaccinate persons in priority groups on a first-come, first-serve
basis.
Vaccination of Persons in Nonpriority Groups
Persons who are not included in one of the priority groups described above
should be informed about the urgent vaccine supply situation and asked to
forego or defer vaccination.
Persons Who Should Not Receive Influenza Vaccine
Persons in the following groups should not receive influenza vaccine before
talking with their doctor:
- persons with a severe allergy (i.e.,
anaphylactic allergic reaction) to hens' eggs and
- persons who previously had onset of
Guillain-Barré syndrome during the 6 weeks after receiving influenza
vaccine.
Additional information is available at
http://www.cdc.gov/flu or
through the CDC public response hotline, telephone (888) 246-2675 (English),
(888) 246-2857 (Español), or (866) 874-2646 (TTY).
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To access a web-text (HTML) version of the "MMWR Dispatch" for October 5,
2004, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm53d1005a1.htm
To access a ready-to-copy (PDF) version of the Dispatch, go to:
http://www.cdc.gov/mmwr/pdf/wk/mm53d1005.pdf
To access a Department of Health and Human Services news release about the
Chiron influenza vaccine, go to:
http://www.hhs.gov/news/press/2004pres/20041005.html
To access an official CDC Health Advisory about the interim influenza
recommendations, go to:
http://www.phppo.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00214
To access a CDC press release about the interim influenza recommendations,
go to:
http://www.cdc.gov/od/oc/media/pressrel/r041005.htm
To access a ready-to-print (PDF) version of "Prevention and Control of
Influenza: Recommendations of the Advisory Committee on Immunization
Practices (ACIP)," dated May 28, 2004, go to:
http://www.cdc.gov/mmwr/PDF/rr/rr5306.pdf
To access a web-text (HTML) version of the recommendations from May 28,
2004, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5306a1.htm
To receive a FREE electronic subscription to MMWR (which includes new ACIP
statements), go to:
http://www.cdc.gov/mmwr/mmwrsubscribe.html |
