Influenza — 2007/2008

Special Report by Carol Kemper, MD, FACP, Clinical Associate Professor of Medicine, Stanford University, Division of Infectious Diseases, Santa Clara Valley Medical Center. Dr. Kemper reports no financial relationship to this field of study.

Source: MMWR, www.cdc.gov/mmwr/preview/mmwrhtml/rr5606a1.htm

Guidelines for this year's influenza season are now available, with important recommendations to hospitals and clinics. The 2007/2008 trivalent vaccine contains A/Solomon Islands/ 3/2006 (H1N1-like), A/Wisconsin/ 67/2005 (H3N2-like), and B/Malaysia/ 2506/2004-like antigens. The A/Solomon Islands component, which is a recent antigenic variant of the former A/Caledonia, is a new addition to the vaccine, while the other 2 antigens remain unchanged. While H1 viruses were more common during the peak season in February 2007, H3 viruses were more frequently identified later in the season in March through May. A few Influenza B viruses were also identified.

Vaccine coverage still falls below 50% for children, health care personnel, pregnant women, and adults with risk factors for influenza complications.

The target groups for vaccination have not changed. But the ACIP is re-emphasizing the following:

  • Administration of 2 doses of vaccine to all children aged 6 months to 8 years;
  • If children received only one dose in previous years, they should receive 2 doses this year. If they received two doses last year, then one dose this year is sufficient;
  • Anyone who requests vaccine should receive it; in other words, anyone wishing to reduce their risk of influenza, even if they do not fall into a risk category, is a candidate for vaccination;

In addition, the ACIP strongly recommends:

  • Health care facilities should offer immunization clinics throughout the flu season;
  • Health care facilities should consider the level of vaccination among health care workers a patient safety quality measure.
  • Health care facilities should implement policies such that health care workers refusing vaccination shall sign a declination.