Experts urge clinicians to extend flu-shot season

Dec 6, 2007 (CIDRAP News) – Experts from the US Centers for Disease Control and Prevention (CDC) and the National Influenza Vaccine Summit (NIVS) in a teleconference today urged clinicians to consider extending their seasonal flu vaccination efforts through March and shared strategies for immunizing more patients during office visits.

The CDC and NIVS efforts are aimed at utilizing the record number of seasonal flu vaccine doses that will be available this year. In November the CDC predicted producers would ship 132 million doses of vaccine by the end of the flu season—more than 10 million more than ever produced before in the United States. At today's teleconference, Andrew Kroger, MD, medical officer and trainer with the CDC's immunization services division, said 109.3 million doses have already been distributed.

Kroger said the influenza season is just beginning and emphasized the importance of encouraging patients to be vaccinated, even well after December. "It's a fallacy that the vaccination season is over in December. The job is not done yet," he said.

The number of confirmed influenza cases is normal for this point in the season, Kroger said.

It's too early to tell if this season's vaccine is a good match for the circulating flu strains, he said. "Lab surveillance began in October, so we don't really have a sense of that yet."

In November, John Bresee, MD, chief of epidemiology and prevention for the CDC's immunization services division, said the agency was concerned about reports from last season and the summer of possible drift in the influenza A subtype H3N2.

Andrew Eisenberg, MD, a family practice and emergency department physician from Madisonville, Tex., who has attended NIVS on behalf the Texas Medical Association, shared suggestions for boosting vaccination rates through doctors' offices. One strategy he said he has found successful is to issue standing orders for all patients to be vaccinated, except those with contraindications. "That way, the vaccination is done before the patient even sees you, and it doesn't take up the doctor's time," Eisenberg said.

When patients decline the vaccine, physicians can intervene and tell them about the importance of getting their annual flu shot, he said.

Physicians should also ensure that clinic staff members are immunized, Eisenberg said. Staff vaccination not only is useful for protecting patients and maintaining workforce productivity, but also gives staff members opportunities to debunk some myths that patients believe, such as that flu shots cause the flu, he said.

Offering the flu vaccine shouldn't always be thought of as a moneymaking proposition, Eisenberg said: "It's the right thing to do." However, physicians can avoid losing money on unused vaccine by using it early and frequently.

"Influenza is out there all year round," he said. "Keep giving it [flu vaccine] when you've got it, and give it till it's gone."

Seasonal flu vaccines can be given during preventive visits, for which payers often compensate doctors, Eisenberg said.

See also:

Nov 9 CIDRAP News story "CDC: vaccine deliveries set record, but will strains match?"

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