CDC launches universal flu vaccination recommendation

Jul 29, 2010 (CIDRAP News) – The US Centers for Disease Control and Prevention (CDC) today endorsed its vaccine advisory group's recommendation for universal influenza immunization, as public health groups prepare to shift gears from pushing the pandemic H1N1 vaccine to drawing the public's attention to the new seasonal flu vaccine advice.

The CDC issued a comprehensive update on seasonal flu vaccination, which includes the new universal recommendation, in an early online edition of Morbidity and Mortality Weekly Report (MMWR). In February the CDC's Advisory Committee on Immunization Practices (ACIP) recommended seasonal flu immunizations for nearly everyone except babies younger than 6 months old.

Based on literature reports on the vaccine's safety and its ability to prevent disease, the CDC has been expanding its recommendation, and by 2009 its seasonal flu vaccination recommendation covered 85% of the population.

The CDC's latest expansion includes all healthy, nonpregnant adults aged 18 to 49. The CDC said expanding the recommendation to that group helps address two problems: Flu complications can occur, even in healthy people, and many adults with underlying conditions such as diabetes and asthma don't consider themselves at increased risk.

Today's CDC recommendations also fold in ACIP's recent advice on pandemic H1N1 coverage for younger children. Children ages 6 months through 8 years who have not received at least one dose of pandemic H1N1 vaccine should receive two doses of the trivalent vaccine for the upcoming flu season, which includes the pandemic strain.

The latest recommendations also say adults age 65 and older can receive either the standard seasonal flu vaccines or the new high-dose version made by Sanofi.

Over the past several months, vaccine and communications experts at the CDC have been developing new strategies for pitching the new universal flu vaccine recommendation and have been testing them in focus groups. Yesterday they previewed the new campaign during a webinar for public health officials that was hosted by PKIDs Online (Parents of Kids with Infectious Diseases), a nonprofit pediatric health group. An archived version of the webinar is available on the group's Web site for registered users.

Richard Quartarone, a media and communication officer with the National Center for Immunization and Respiratory Diseases, told participants that vaccine manufacturers are projecting 170 million doses for the upcoming flu season, with a substantial amount available by the end of September. However, he cautioned the group that the vaccine manufacturing process can be unpredictable, and amount and delivery times can vary from early estimates.

"There's some wariness, but everything we've seen is that it will be available early when most people are interested in the vaccine," he said.

The CDC has tested drafts of its new flu vaccine communication materials in focus groups, not only to the public, but also to medical providers, Quartarone said. Research has shown that vaccine messages have the most impact when they come from sources people trust, "and healthcare providers are whom they trust the most. People trust people they know."

He said the CDC is keeping in mind the barriers that physicians face—such as supply, cost, and patient awareness—in promoting and providing flu vaccines.

The CDC is finding that healthcare workers have some of the same misperceptions about the vaccine as does the general public, Quartarone said. In an effort to boost sagging flu vaccination levels in this group, he said the CDC is rethinking its communication strategy. Some healthcare workers turn against the vaccine if they perceive that it's being pushed from above or the tactics include negative elements such as guilt or letting down the team.

A new flu vaccine approach to healthcare workers is "keeping your work at work," he said. "Protecting themselves and their patients resonated well," Quartarone added.

The main theme for the universal vaccination will be "the flu ends with U," he said, noting that messages will emphasize that everyone can prevent the flu and everyone is at risk.

Most of the CDC's new flu vaccine campaign materials will be available on its Web site by Sep 1, but CDC officials who spoke at the webinar told participants that some will be posted sooner.

See also:

Jul 29 MMWR report

PKIDSs Online Web site

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