Health Officials Urge Annual Influenza Vaccination for All

With influenza (flu) vaccine readily available and sufficient doses expected throughout the season, the National Foundation for Infectious Diseases
(NFID), along with public health and medical organizations, urged the public and healthcare professionals to follow the Centers for Disease Control and Prevention (CDC) recommendation that everyone age 6 months and older be vaccinated against influenza each year.

Vaccination coverage estimates from the 2016-2017 influenza season, presented today by U.S. Secretary of Health and Human Services Thomas E. Price, MD, show mostly stagnant vaccination rates among all age groups, with small increases in some of the most vulnerable populations (adults over the age of 50). Influenza vaccination coverage estimates for the public were published in CDC’s Morbidity and Mortality Weekly Report and on CDC’s FluVaxView website today.

Flu seasons are difficult to predict and can range from mild to severe. “While we don’t know what this season has in store, the science on flu vaccination is clear. Vaccination can help prevent you or someone you love from becoming sick and missing school or work, or worse, becoming severely ill or being hospitalized from or even dying from flu,” said Price. “Today, I am leading by example and getting vaccinated against flu. I urge everyone 6 months and older to do the same as soon as vaccine is available in their community.”

Influenza vaccination coverage across the entire U.S. population was 46.8 percent, an increase of 1.2 percentage points from the previous season. That level of coverage means that more than half of the U.S. population was unprotected against flu last season. After decreases during the 2015-2016 season among adults age 50 to 64 years and 65 years and older, vaccination coverage rates rebounded in the 2016-2017 season. Rates increased by 1.8 percentage points to 45.4 percent in the 50-64 age group and by 1.9 percentage points to 65.3 percent in the 65 and older age group. Yet, overall, among both of these age groups, vaccination rates remained steady over a five-year period.

The highest influenza vaccination coverage during the 2016-2017 season was among children age 6 months through 23 months. At 76.3 percent, this is the only group that exceeded the national U.S. public health goals of 70 percent vaccination coverage.

Additional highlights of the reports showed:
- African-American, Hispanic, Asian and American Indian/Alaskan Native children continued to have higher influenza vaccination coverage than non-Hispanic white children.
- Hispanic and African-American adults continued to have lower influenza vaccination coverage than non-Hispanic white adults.
- Wide variation in influenza coverage was seen across states among children age 6 months to 17 years ranging from 43 percent (Wyoming) to 74.2 percent (Rhode Island) and in adults age 18 years and older from 33.4 percent (Nevada) to 51.1 percent (South Dakota).
- For adults, flu vaccination coverage was higher among females than males for every age group except for adults age 65 years and older.

Last season’s high hospitalization rates occurred despite overall fewer deaths attributed to flu and pneumonia. During the 2016-2017 season, the hospitalization rate was nearly double that of the 2015-2016 season and higher across all age groups (cumulative rate for all ages of 62.6/100,000) than the previous eight seasons, with the exception of the 2014-2015 season. During most seasons, the highest hospitalization rate was among adults age 65 years and older, followed by children younger than 5 years old.

A panel of leading public health and medical experts joined Dr. Price, including William Schaffner, MD, medical director of NFID and professor of Preventive Medicine and Infectious Diseases at Vanderbilt University School of Medicine; Patricia A. Stinchfield, RN, MS, CPNP, CIC, senior director of Infection Prevention and Control and pediatric nurse practitioner in Infectious Disease/Immunology at Children’s Minnesota; and Kathleen M. Neuzil, MD, MPH, director of the Center for Vaccine Development at the University of Maryland School of Medicine.

“We are pleased to see that the decrease in vaccination coverage among adults age 50 years and older that we saw in the 2015-2016 season was not sustained during the 2016-2017 season,” said Neuzil. “It is critical to maintain the highest level of vaccination coverage for older adults because they are disproportionally affected by flu. Vaccination not only reduces the chance that older adults will get the flu, it can also help keep them out of the hospital by reducing the severity of the infection and related complications if they do get the flu.”

Influenza vaccination reduced the risk of flu-associated death by half (51 percent) among children with underlying high-risk medical conditions and by nearly two-thirds (65 percent) among healthy children according to a recent study in Pediatrics. The study examined data from four flu seasons between 2010 and 2014. Additionally, a study in Clinical Infectious Diseases showed that flu vaccination reduced deaths, intensive care unit (ICU) admissions, ICU length of stay and overall duration of hospitalization among adults hospitalized because of influenza.

“This data adds to the already strong body of evidence of the benefits of flu vaccination, especially for children,” said Patricia Stinchfield. “I urge parents to remember that even the healthiest children are at risk from the flu so it’s really important to get them vaccinated every year.”

The panel also stressed the importance of pneumococcal vaccination for adults age 65 years and older and younger adults with high-risk factors, such as diabetes, heart disease and lung disorders as well as people who smoke. Unlike the milder form of pneumonia, panelists warned that pneumococcal pneumonia is usually more severe and can lead to sepsis as well as other serious infections in addition to pneumonia. Pneumococcal disease is often a common and deadly complication of influenza.

Schaffner urged all adults in high-risk groups to talk to their healthcare provider and to get pneumococcal vaccines as recommended. “Pneumococcal vaccination can be administered at the same time as the influenza vaccine. Fall is a great time to make sure you are protected against both flu and pneumonia.”

For the 2017-2018 season, vaccine manufacturers have estimated that up to 166 million doses of injectable influenza vaccine will be available in the U.S. More than 73 million doses of flu vaccine have already been delivered. This season’s vaccines have been updated and will protect against the influenza viruses that research suggests will be most common during the 2017-2018 season.

For the 2017-2018 season, CDC recommends only the use of injectable influenza vaccines (flu shots), including inactivated influenza vaccines and recombinant influenza vaccines. Nasal spray flu vaccine (live attenuated influenza vaccine or LAIV) is not recommended for use this season.

There are several types of influenza vaccine and vaccine delivery options available this flu season:
- Adjuvanted vaccine and high dose vaccine for adults age 65 years and older, both of which are designed to help initiate a more robust immune response
- Recombinant vaccine that does not use an influenza virus
- Cell-based vaccine, which is produced without growing the virus in eggs; this season, a cellgrown vaccine virus is being used for one component (H3N2) of the cell-culture based flu vaccine
- Standard influenza vaccine, which will include either three influenza virus strains (trivalent- two influenza A and one influenza B) or four virus strains (quadrivalent-two influenza A and two influenza B)
- Intradermal and jet injection delivery of the vaccine

All vaccine options may not be available at all locations, so experts emphasized that people should not wait to get vaccinated if their first choice of vaccine is not available. To find a location where you can get a flu vaccine, visit https://vaccinefinder.org/.

Although not a substitute for getting an annual flu vaccine, health officials also stressed the importance of everyday preventive actions to decrease the spread of flu and the appropriate use of influenza antiviral drugs to treat influenza as part of the CDC “Take 3” approach to fight the flu. Three FDA-approved influenza antiviral drugs are recommended for use in the U.S. during the 2017-2018 influenza season: oseltamivir (generic version or Tamiflu®), zanamivir (Relenza®), and peramivir (Rapivab®).

Source: NFID