CDC Q&A on National Flu Vaccine Shortage

Live mist vaccine OK for most HCWs

In response to the national influenza vaccine shortage, the Centers for Disease Control and Prevention is providing the answers to some of the most common questions by clinicians and the public.

Question: Who should be vaccinated?

Answer: The existing flu vaccine supplies should be given to protect people who are at greatest risk from serious complications from influenza disease. Everyone in this group should seek vaccination:

Adults 65 and older

Children ages 6 months to 23 months

Adults and children 2 years of age and older with chronic lung or heart disorders including heart disease and asthma

Pregnant women

Adults and children 2 years and older with chronic metabolic diseases (including diabetes), kidney diseases, blood disorders (such as sickle cell anemia), or weakened immune systems, including people with HIV/AIDS

Children ages 6 months to 18, who take aspirin daily

Residents of nursing homes and other chronic-care facilities

Household members and out-of-home caregivers of infants younger than 6 months (Children younger than 6 months cannot be vaccinated.)

Health care workers who provide direct, hands-on care to patients

Question: Who should go without vaccination?

Answer: Healthy people 2 to 64 years of age are asked to not get vaccinated this year at all or to wait to get their vaccine after people in priority groups in their area have had a chance to be vaccinated, so that available vaccine can go to protect those at greater risk for flu complications.

Question: What else can you do to prevent the spread of flu?

Answer: There are certain good health habits that can help prevent the spread of flu.

Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.

Cover your nose and mouth with a tissue when you cough or sneeze — and dispose of the tissue afterward.

If you don’t have a tissue, cough or sneeze into your sleeve.

Wash your hands after you cough or sneeze — with soap and warm water, or an alcohol-based hand cleaner.

If you get the flu, stay home from work or school. You will help prevent others from catching your illness.

Question: What if you are in a high-risk group and your clinic has no vaccine?

Answer: Contact your local health department and ask your regular vaccine provider about other options for influenza vaccination. Health departments throughout the United States are trying to make sure that as many high-risk people as possible eventually will be able to go to either their regular vaccine provider or a flu shot clinic to get the vaccine. Some public vaccination clinics may also be posted at www.lungusa.org.

Question: How much flu vaccine will be available in the United States this season?

Answer: About 55 million flu shots will be available in the United States this season. About 1 million doses of live attenuated influenza vaccine (LAIV) will be available.

Question: Does CDC recommend using partial doses of influenza vaccine?

Answer: No. CDC does not advise using partial doses of recommended dosages of inactivated influenza vaccine (flu shot) either for people at high risk for complications from influenza or for healthy persons, including health care workers. There are no data on whether partial doses of the current 2004-05 vaccine would provide an adequate antibody response. Some studies have been done to assess the antibody response to one-half of the normal dose of inactivated influenza vaccine in healthy adults ages 18-49; however, the vaccine is not approved by the Food and Drug Administration for use at this reduced dose.

Question: What about using the new FluMist vaccine?

Answer: An alternative to the flu shot is the intra-nasally administered LAIV. If available, LAIV should be encouraged for use by healthy, nonpregnant people 5 to 49, including most health care workers, those who have contact with people in high-risk groups, such as those with lesser degrees of immunosuppression (e.g., people with diabetes, persons with asthma taking corticosteroids, people infected with HIV), and those caring for children younger than 6 months of age. The only health care workers for whom inactivated vaccine (flu shot) is preferred are those who have contact with severely immunosuppressed patients, such as bone marrow transplant recipients, who are under treatment in special isolation units.

(Editor’s note: For influenza updates, go to www.cdc.gov/flu.)