CDC urges flu shots for all healthcare workers

Jul 2, 2007 (CIDRAP News) – Federal health officials released their influenza vaccine advisory Friday for the upcoming flu season, and though they did not extend the vaccine recommendations beyond current age groups, they strongly recommended vaccination of all healthcare workers and urged providers to schedule later immunization clinics.

The recommendations, published in an early-release article in Morbidity and Mortality Weekly Report, are from the Centers for Disease Control and Prevention's (CDC's) Advisory Committee on Immunization Practices (ACIP).

In effort to boost the rates of immunized healthcare workers, a group that has lagged behind desired levels, the CDC recommended that healthcare administrators consider vaccination coverage levels as a measure of patient safety quality programs. The CDC also recommends that administrators obtain signed declinations from workers who opt out of seasonal influenza vaccination for reasons other than medical contraindications.

In response to past distribution problems that have hampered vaccination clinics in the earlier part of the fall, the CDC urged providers to schedule vaccination clinics throughout the season.

"Vaccine administered in December or later, even if influenza activity has already begun, is likely to be beneficial in the majority of influenza seasons," the CDC report said.

The CDC reiterated that children aged 6 months to 8 years who have not been vaccinated previously receive two doses, on the basis of research showing that two doses are required in this age-group to optimize protection. Children in this age-group who have only one dose in their first year of vaccination should receive two doses the following year,

Also, the CDC emphasized that all people, including school-age children, who want to reduce their risk of contracting seasonal flu be vaccinated.

The report does not contain updated recommendations about the use of the live, attenuated influenza vaccine (the FluMist intranasal vaccine) for children under age 5, as many healthcare practitioners had hoped. Though a US Food and Drug Administration (FDA) advisory panel in May recommended the vaccine for use in younger children, except those with wheezing history, production problems at MedImmune's Liverpool, England, plant have delayed final FDA approval of FluMist for children younger than 5.

On May 24, the FDA sent MedImmune a warning letter after inspectors found that bulk monovalent lots contained amounts of bacteria and mold that exceeded the manufacturer's limits, according to an FDA background report.

Healthcare experts have hoped that the availability of a needle-free vaccine might boost seasonal flu vaccination rates in young children.

Curtis Allen, a CDC spokesperson, told CIDRAP News it's possible that ACIP could vote on the recommendation before October when the vaccination season starts. However, he said steps are required before the next ACIP vote: MedImmune would need to resolve the production problem before the FDA could issue its licensing recommendation to extend FluMist use in the younger age-group.

CDC. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2007. MMWR 2007 Jun 29 (early release) [Full text]

See also:

May 17 CIDRAP News article "FDA advisory panel recommends FluMist approval for young children"

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