CDC reports enough flu shots for everyone
■ Vaccine is urged for those at high risk, but with ample supplies expected, officials say all patients can get it.
By Victoria Stagg Elliott — Posted Oct. 23, 2006
If a patient asks for an influenza vaccine, physicians should not hesitate to give it, say public health leaders.
"Get anyone who wants a flu shot their flu shot. We are not restricted by supply," said Julie L. Gerberding, MD, MPH, director of the Centers for Disease Control and Prevention. "The vaccine is here. The time is now. And let's really make this our best-ever flu season." She was speaking Oct. 4 at a National Foundation for Infectious Diseases' event launching the influenza and pneumococcal vaccination season.
Priority groups such as health care workers and those older than 65 are still the target of flu vaccination campaigns. But, after several rough years marked by shortages and delays, officials are feeling increasingly confident about the supply situation. Dr. Gerberding's advice comes because the expectation of ample vaccine that has been talked about for the past year is becoming a reality.
"Our supply is good this year, and we are optimistic, although never 100% confident, that we will ultimately deliver all of that vaccine," said Dr. Gerberding.
About 26 million doses were shipped in September. Another 50 million are expected in October. The remainder are predicted for November, December and early January 2007. About 115 million doses, including GlaxoSmithKline's FluLaval, which became the fifth available flu vaccine when it was approved by the Food and Drug Administration earlier this month, are expected before the season wraps up. This is far more than in any prior year.
"We would like to get that vaccine used to protect as many people as possible against this serious illness," said William Schaffner, MD, NFID's vice president and professor and chattir of the Dept. of Preventive Medicine at Vanderbilt University School of Medicine in Tennessee.
Myths may limit use
Significant concerns persist, however, that these supplies will not be used, in part because of long-enduring flu vaccine myths. For example, an NFID survey released at the event found that 46% of the 1,000-plus adults queried believed that the vaccine could cause the flu. About 30% think immunization is not worth receiving because it only protects against three virus strains.
"Unfortunately, public opinion is still split about the safety and effectiveness of influenza immunization," said Susan J. Rehm, MD, NFID's medical director and an infectious disease physician at the Cleveland Clinic.
Officials are particularly worried about administering vaccine that arrives in December and beyond. These shots have always presented a challenge. In fact, the NFID survey found the majority believed that December was too late to receive it.
"It's always best to get vaccinated early, but there's really no late time to get vaccinated," said Daniel B. Jernigan, MD, MPH, deputy director of CDC's influenza division.
But while there are some worries, there is also optimism that the season will not only boast more vaccine than ever before but also more people will receive it. The Healthy People 2010 goals call for 90% of those older than 65 to receive it. The actual rates are far below this level. An article in the Oct. 6 Morbidity and Mortality Weekly Report found flu vaccine coverage in this group declined from just shy of 68% in 2004 to just more than 63% in 2005. Blame was primarily placed on the significant shortfalls in supplies for the 2004-05 season.
"[Influenza] is a very important health threat, and we need to do more about it," said Dr. Gerberding. "And we need to be more aggressive about taking the steps to save lives, save hospitalization and save time."
Physicians are hoping uptake of the pneumococcal vaccine, which is often offered with the flu shot, will increase, too. Its rates in those older than 65 are also far below Healthy People 2010 goals, with the MMWR paper reporting that it hovered around 63% in both 2004 and 2005.
"Flu season is an excellent time for doctors to remind high-risk patients that, when they get their flu vaccine, they should also be vaccinated against pneumonia," said AMA President William G. Plested, III, MD, who represented the AMA at the NFID event. The AMA has long worked to stabilize vaccine supplies, and annually co-sponsors the National Influenza Vaccine Summit with the CDC.