Boost flu vaccine rates, but don’t start too early
Boost flu vaccine rates, but don’t start too early
ACIP highlights low vaccination among HCWs
Caution: Don’t begin your fall influenza vaccination campaign too early.
That is one of the new recommendations from the Advisory Committee on Immunization Practices (ACIP), a panel of experts that makes recommendations on the use of vaccines. Large-scale campaigns, particularly those that target the community as well as health care workers, may falter due to lack of availability of the vaccine, the guidelines state.1
"The optimal time to administer vaccine is generally October to mid-November," says Carolyn Buxton Bridges, MD, a medical epidemiologist in the influenza branch of the Centers for Disease Control and Prevention in Atlanta.
ACIP also has lowered the recommended age for immunization from 65 to 50 in order to capture more people with high-risk conditions. Only about 40% of people with chronic conditions in the 50-64 age range received the vaccine in 1997. Age-based recommendations may prompt more people with high-risk conditions to receive vaccines, influenza experts said.
The influenza recommendations also highlight the importance of vaccination of health care workers, who historically have a low vaccination rate. Only 34% of health care workers reported receiving the influenza vaccine in the National Health Interview Survey.
"I’m not sure they’re aware of the potential severe consequences of influenza," says Bridges. "If you transmit it to your patients, it can cause very severe illness and in some cases death."
An optimal vaccination rate in hospitals would be 80% or higher — the point at which "there is some evidence that you have benefits of herd immunity," says Bridges. In other words, if vaccination rates are high enough, transmission of the virus in the workplace drops, she says.
Some health care workers may avoid vaccination because of concern over side effects. The primary side effect is a sore arm, which can last for up to two days. But concern about other possible side effects may be based on misinformation, Bridges says. For example, the flu vaccine cannot cause influenza; it is a killed vaccine. The vaccine is considered safe at all stages of pregnancy and is actually recommended for women in their second and third trimesters, who have an increased risk of flu-related complications, Bridges says.
People who are allergic to eggs should not receive the vaccine. But epidemiologists have not been able to establish a clear link between the vaccine and increased risk of Guillain-Barré syndrome (GBS). At worst, there may be one additional case of GBS per million people vaccinated, the guidelines state.
Meanwhile, the vaccine is 70% to 90% effective in preventing influenza.
With the updated guidelines, Bridges says, "We’re hoping that people increase vaccination rates and that there will be more attention to health care worker vaccination."
(Editor’s note: The ACIP recommendations are available on the CDC Web site at www.cdc.gov/epo/ mmwr/preview/mmwrhtml/rr4903a1.htm. Employee health professionals also can download a pamphlet to educate health care workers about influenza vaccination at www.cdc.gov/ncidod/hip/guide/immune.htm.)
Reference
1. Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2000; 49(RR-03):1-38.
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