CDC changes strategy to encourage flu vaccination

4.4 million doses becoming available

The Centers for Disease Control and Prevention (CDC) has changed its strategy to help health care providers continue to vaccinate people at risk for developing serious complications of influenza.

The CDC is making this change — for this flu season and vaccine only — because it is concerned that a large number of these people still have not been vaccinated. "The big perspective here is that the flu season is not over. It may not even have peaked," said CDC director Julie Gerberding, MD, MPH. She spoke to reporters in a telebriefing in late January.

First, the CDC is emphasizing its support for local and state jurisdictions that are broadening the availability of flu vaccine to people who are not in the previously recognized priority groups. When the vaccine supply was most limited in October, these groups included:

  • all children 6 to 23 months of age;
  • adults 65 years or older;
  • people 2 to 64 years old with underlying chronic medical conditions;
  • all women who will be pregnant during the influenza season;
  • residents of nursing homes and long-term care facilities;
  • children 2 to 18 years of age on chronic aspirin therapy;
  • health care workers involved in direct patient care.
  • out-of-home caregivers and household contacts of children younger than 6 months.

On Dec. 22, 2004, the following priority groups were added:

  • out-of-home caregivers and household contacts of people in high-risk groups;
  • all adults 50 to 64 years of age.

If local areas have vaccine and can’t redistribute it, it makes sense that they open up the vaccination to anyone in those jurisdictions who would like to be vaccinated, Gerberding said.

Second, the CDC is making available the remaining 3.1 million doses of influenza vaccine in the federal government’s emergency reserve to Sanofi Pasteur. The company then will market and sell the vaccine to public and private providers. Health care providers will therefore be able to order vaccine directly from Sanofi Pasteur or a vaccine distributor rather than working through state or local health departments. Providers also will be allowed to return unused vaccine for a credit and will pay for return shipping costs only.

Finally, in states where the demand for influenza vaccine in the Vaccines for Children program (VFC) has been met, the CDC is allowing those jurisdictions to make the vaccine available for non-VFC use. There are approximately 1.3 million doses of the VFC, Gerberding reports.

Even with the 4.4 million doses of vaccine that are becoming available, the CDC is stopping short of encouraging everyone who wants a flu shot to get one.

The demand for a flu vaccine is unpredictable, Gerberding said, and it varies from group to group and area of the country to area of the country. "CDC’s broad goal in all of this is to try to make the best use of the vaccine doses that we have, and that means encouraging immunization of people who need it, and it also means using some common sense and not letting vaccine go to waste in areas where the supply is ample or even in excess."

Influenza activity in the United States had remained relatively low into December, the CDC reports, but has been steadily increasing since mid-December. As of mid-January, 24 states were reporting widespread or regional flu activity.