Report: Preparedness steps hedge against busy flu seasons

Jan 15, 2013 (CIDRAP News) - Low demand for flu vaccine in previous years could limit the supply of vaccine, leaving the nation unprepared for a year when levels are higher, according to a new analysis of flu vaccine trends and policies by Trust for America's Health (TFAH), a nonprofit health advocacy group based in Washington, D.C.

The TFAH report, posted today on its Web site, cited numbers from the US Centers for Disease Control and Prevention (CDC), which show that over the past two flu seasons fewer than half of Americans were vaccinated against flu. As of November 2012, this season's vaccine uptake was similar to the same period in 2011, about 36.5% for Americans ages 6 months and older, TFAH said, citing CDC estimates.

Jeffrey Levi, PhD, TFAH executive director, said in the report that flu is an annual threat that varies in its impact. "The problem is we let our guard down during mild seasons and then we aren't ready when a harder season hits," he said. "We need to maintain a steady defense and make annual flu vaccinations -- and the manufacture of sufficient supply -- a much higher priority every year."

Federal health officials have said the flu season started roughly a month earlier than usual and has been dominated by the H3N2 strain, which is known to cause more serious disease. High levels of flu and other viruses that circulate during the winter have placed a burden on hospital emergency departments and have led a few jurisdictions to declare public health emergencies.

Concerns about rising levels of the disease have prompted health officials in several states to renew their advice for the public to get immunized against flu, which has led to a few spot shortages of the vaccine.

Recent rigorous reviews of the flu vaccine have found that it is only about 60% effective in healthy adults, and an early CDC estimate for this season's vaccine suggests that it is 62% effective. However, health officials say until better vaccines are developed, immunization against flu with the current vaccines is still the best tool for preventing the disease.

The TFAH report, citing CDC findings for last flu season, points out that flu vaccination levels varied widely by state, with South Dakota, Massachusetts, Hawaii, Rhode Island, and Iowa as the top-ranking states for flu vaccine coverage. The five states that ranked the lowest were Florida, Montana, Alaska, Idaho, and Nevada.

TFAH's report also said this flu season shines a spotlight on other actions that could fill persistent gaps in preparedness and policy. It said Congress should reauthorize the Pandemic and All-Hazards Preparedness Act (PAHPA) to better enable the public health system to respond to health threats and give federal officials resources to invest in the development of flu-related medications and technologies.

After months of work to craft a final bill that included common ground from both the House and Senate versions, the Senate did not vote on it in the final days of the 112th Congress, which means the new Congress must start the PAHPA reauthorization process all over again.

Among 12 other actions, TFAH urged policymakers to educate the public and at-risk groups about the importance of vaccination, invest in expanded domestic flu vaccine manufacturing capacity, support the development of a universal flu vaccine, expand triage lines to relieve some of the flu burden on hospitals, and improve disaster surge capacity so that hospitals and providers are better able to handle increased loads during events such as a busy flu season.

In a related development, the American College of Physicians (ACP), which represents internists, yesterday said it has approved a policy recommendation calling for healthcare workers to be immunized against a host of diseases, including influenza; diphtheria; hepatitis B; measles, mumps, and rubella; pertussis; and varicella. The ACP said in a press release that 40,000 to 50,000 adults die from vaccine-preventable disease each year and that the vaccines could prevent the burden on patients and health workers.

The ACP said its policy exempts workers for medical reasons or religious objections.

Given the vigorous pace of flu activity this season, the ACP also urged all adults to get flu shots and to discuss the need for other immunizations with their health providers. The ACP pointed out that only 39% of adults were vaccinated against flu during the 2011-12 season.

See also:

Jan 15 TFAH report

Jan 15 TFAH press release

Jan 14 ACP statement

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