Dec. 17, 2004

UPDATE: CDC's Advisory Committee on Immunization Practices is expanding the priority groups for inactivated influenza vaccination to include adults aged 50-64 and close contacts of persons in high-risk groups will be eligible for influenza vaccination in areas where vaccine supply is sufficient to meet demand.

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On Oct. 5, 2004, the CDC was notified by Chiron Corp. that none of its influenza vaccine (Fluvirin®) would be available for distribution in the United States for the 2004–05 influenza season. The company indicated that the Medicines and Healthcare Products Regulatory Agency (MHRA) in the United Kingdom, where Chiron's Fluvirin vaccine is produced, has suspended the company's license to manufacture Fluvirin vaccine in its Liverpool facility for three months, preventing any release of this vaccine for this influenza season.

This action will reduce by approximately one-half the expected supply of trivalent inactivated vaccine (flu shot) available in the United States for the 2004–05 influenza season.

The remaining supply of influenza vaccine expected to be available in the United States this season is nearly 54 million doses of Fluzone® (inactivated flu shot) manufactured by Aventis Pasteur, Inc. Of these doses, approximately 30 million doses already have been distributed by the manufacturer. In addition, approximately 1.1 million doses of live attenuated influenza vaccine (LAIV/FluMist ®) manufactured by MedImmune will be available this season.

Because of this urgent situation, the CDC, in coordination with its Advisory Committee for Immunization Practices (ACIP), is issuing interim recommendations for influenza vaccination during the 2004–05 season. These interim recommendations were formally recommended by ACIP on October 5, 2004, and take precedence over earlier recommendations.

Priority Groups For Influenza Vaccination

The following priority groups for vaccination with inactivated influenza vaccine this season are considered to be of equal importance and are:

all children aged 6 to 23 months;
adults aged 65 years and older;
persons aged 2-64 years 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 aged 6 months to 18 years on chronic aspirin therapy;
health-care workers involved in direct patient care; and
out-of-home caregivers and household contacts of children aged under 6 months.

Other Vaccination Recommendations

People in priority groups identified above should be encouraged to search locally for vaccine if their regular health-care provider does not have vaccine available.

Intranasally administered, live, attenuated influenza vaccine, if available, should be encouraged for healthy people ages 5 to 49 and are not pregnant, including health-care workers (except those who care for severely immunocompromised patients in special care units) and persons caring for children under 6 months old.

Certain children under 9 require two doses of vaccine if they have not previously been vaccinated. All children at high risk for complications from influenza, including those aged 6 to 23 months, who present for vaccination, should be vaccinated with a first or second dose, depending on vaccination status. However, doses should not be held in reserve to ensure that two doses will be available. Instead, available vaccine should be used to vaccinate persons in priority groups on a first-come, first-serve basis.

Vaccination Of People In Nonpriority Groups

Persons who are not included in one of the priority groups described above should be informed about the urgent vaccine supply situation and asked to forego or defer vaccination.

People Who Should Not Receive Influenza Vaccine

People in the following groups should not receive influenza vaccine before talking with their doctor:

People with a severe allergy (i.e., anaphylactic allergic reaction) to hens' eggs, and
People who previously had onset of Guillain-Barré syndrome during the six weeks after receiving influenza vaccine.

Source: Centers for Disease Control and Prevention