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Although the supplement contributors each emphasize different aspects ofinfluenza immunization, all underscore the need for vaccine to be offered byhealth care providers from October through January and beyond. Therecommendation supports guidelines from the Centers for Disease Control andPrevention (CDC) and is aimed at reducing influenza-related illness and death,particularly among high-risk populations such as children, the elderly andthose with chronic conditions.
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"What we are really talking about is a paradigm shift," said WilliamSchaffner, MD, chair of the Department of Preventive Medicine at VanderbiltUniversity School of Medicine, president-elect of the National Foundation forInfectious Diseases and guest editor of the journal supplement. "As the numberof people who need to get vaccinated has been expanded by public-healthofficials, so has the time-frame for vaccination. Vaccines given later in theyear or even into the New Year are still beneficial in helping people avoidthis serious illness."
Earlier this year, the CDC expanded its recommendations for annualinfluenza immunization to include all children 6 months through 18 years ofage. The new recommendation is to take effect as soon as feasible, but nolater than the 2009-10 influenza season. The change will add about 30 millionchildren to the total number of people for whom CDC recommends annualinfluenza vaccination.
Schaffner added, "It is abundantly clear that we cannot vaccinate everyonein a two- to three-month vaccination window. Since influenza usually peaksaround February in the U.S., vaccination given in December and later continuesto be medically relevant."
In the supplement, Schaffner and Walter A. Orenstein, MD, associatedirector of Emory Vaccine Center at Emory University in Atlanta, report thereis no shortage of influenza vaccine today and predict no shortages in thefuture because more vaccine manufacturers have entered the market. The CDCestimates projected capacity for 2008-09 to be 143 to 146 million doses.Authors say the overriding issue now is to increase consumer demand forinfluenza vaccine.
In another paper, Gregory A. Poland, MD, Mayo Vaccine Research Group, MaryLowell Leary Professor of Medicine, Mayo Clinic, and David R. Johnson, MD,MPH, director, Scientific and Medical Affairs, sanofi pasteur Inc., reportthat health care providers are "missing important opportunities" to vaccinatepeople during office visits.
Based on insurance claims filed by 240,000 physicians from 2004 to 2007,the researchers found that 25 million people at high risk for complicationsfrom influenza visited doctors an average of 2.2 times each year betweenNovember and February, the usual peak of influenza season, but did not getvaccinated. The researchers urge stepped-up efforts by health care providersto take advantage of ongoing access to patients and vaccinate them startingwhen they make visits during the early fall when vaccine becomes available,and continuing throughout the influenza season.
Patricia K. Stinchfield, RN, MS, CPNP, Director of Infectious Disease,Immunology, Rheumatology and Infection Control, Children's Hospitals andClinics of Minnesota urges health ca
