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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 urge the public and healthcare professionals to follow the Centers for Disease Control and Prevention (CDC) recommendation for everyone age six months and older to be vaccinated against influenza each year.
Vaccination coverage estimates from the 2015-2016 influenza season, presented today by CDC director Tom Frieden, MD, MPH, show steady vaccination rates among children, but a concerning drop in influenza vaccination among adults 50 years and older. Data also show that U.S. healthcare personnel are getting their flu vaccines at the highest rates ever. Influenza vaccination coverage estimates for the public, health care providers and pregnant women were published in CDC's Morbidity and Mortality Weekly Report and on CDC's FluVaxView website today.
While the flu typically makes most people sick for a few days and sometimes for a week or more, Frieden stressed that it can be more serious and even life-threatening for others. "Getting a flu vaccine is important for all of us, for our own protection and for the protection of those around us who may be more vulnerable to flu, such as young children, people with certain chronic health conditions and the elderly," says Frieden. "Flu can strike anyone and it can strike hard. I'm getting vaccinated today and I ask that you join me."
Influenza vaccination coverage across the entire U.S. population was 45.6 percent, down by 1.5 percentage points from the previous season. The largest coverage decreases were seen among older people with a drop of 3.4 percentage points to 43.6 percent among people 50 to 64 years old and a drop of 3.3 percentage points to 63.4 percent among people 65 years and older. The highest influenza vaccination coverage among the public during the 2015-2016 season was among children age 6 months through 23 months. At 75 percent, this is the only group of people that exceeds the national public health goals of 70 percent vaccination coverage. Coverage of 46 percent among the public means about 144 million people received a flu vaccine last season in the U.S.
Coverage among healthcare personnel (including medical and nonmedical staff) has continued to increase. Last season, coverage in that group was 79 percent as opposed to 77.3 percent during 2014-2015 and 75.2 percent during 2013-2014. Physician vaccination coverage last season reached an all-time high of 95.6 percent. Also notable was a significant increase in vaccination among staff at long-term care facilities, where coverage increased from 64 percent to 69 percent; the highest coverage ever reported for this group of people. Experts say this is an encouraging trend in a setting that cares for some of the nation's most vulnerable patients. "This is progress, but it still leaves too many unprotected from flu. The more people who get vaccinated, the fewer preventable illnesses, hospitalizations and deaths from flu we will see in the coming months," says Frieden.
Additional highlights of the reports show:
• About half of all pregnant women reported receiving an influenza vaccine, consistent with recent years. The highest coverage (63 percent) was seen among pregnant women whose obstetricians recommended vaccination and also offered it in their practices.
• Among adults, Hispanic and non-Hispanic African-American adults continued to have lower influenza vaccination coverage than non-Hispanic white adults.
• Wide variation in influenza coverage is seen across individual states.
Frieden was joined by a panel of leading public health and medical experts, including William Schaffner, MD, medical director of NFID and professor of Preventive Medicine at Vanderbilt University School of Medicine; Wilbur H. Chen, MD, associate professor, chief of the Adult Clinical Studies section at the Center for Vaccine Development, University of Maryland School of Medicine; and Patricia N. Whitley-Williams, MD, vice president of NFID and division chief and professor of Pediatrics at Rutgers-Robert Wood Johnson Medical School.
While all of the experts stressed that vaccination is recommended for everyone, Schaffner, explained why the drop in coverage for older adults is of particular concern. "Adults age 65 years and older are disproportionally affected by flu," says Schaffner. "During the severe 2014-2015 season, more than three-quarters of the nearly one million people hospitalized due to influenza were age 65 years and older. Vaccination not only reduces the chance that older adults will get the flu, it can help keep them out of the hospital by reducing the severity of the infection and related complications if they do get the flu."
Everyone 65 Years and Older as well as Certain Younger Adults Need Pneumococcal Vaccination
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 people who smoke. These people should talk to their healthcare professional about pneumococcal vaccination. 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. Additionally, pneumococcal disease is often a common and deadly complication of influenza.
Schaffner urged all adults in high-risk groups to talk to their healthcare professional and to get pneumococcal vaccines as recommended. "Pneumococcal vaccines can be given at the same time as the influenza vaccine, meaning now is a great time to make sure you are protected against flu and pneumonia."
Influenza Vaccine Supply and New Options
For the 2016-2017 season, vaccine manufacturers have estimated that up to 168 million doses of injectable influenza vaccine will be available in the U.S. this season. More than 93 million doses of flu vaccine have already been delivered. This season's vaccines have been updated and will protect against the three or four influenza viruses that research suggests will be most common during the 2016-2017 season.
For the 2016-2017 season, CDC and the American Academy of Pediatrics recommend 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.
"Parents who normally opt for the nasal spray vaccine should not view this as a reason to pass on vaccinating their children against flu this season," says Dr. Whitley-Williams. "Flu shots have been proven to work very well in children. Parents need to make sure their children are fully vaccinated."
Two new flu vaccine options are available this season. One is a four-component flu shot made with virus grown in cell culture, a different process than the more traditional egg-based method. That vaccine is licensed for use among people 4 years and older. Another new option this year is licensed for adults age 65 years and older and includes an adjuvant, which is an ingredient that helps create a stronger immune response. This flu vaccine is available this season for those age 65 years and older. The second of these vaccines was developed specifically to protect older adults, who may not respond as well to vaccination as younger people.
"As people age, their immune systems decline, which can reduce vaccine effectiveness as well as increase their risk of complications from flu, such as pneumonia, heart attack or stroke. The availability of vaccine options specifically for older adults, including the high-dose flu vaccine licensed in the U.S. in 2009 and the new adjuvanted vaccine, will hopefully play a role in helping to boost vaccination rates among older people," says Dr. Chen, who recently participated in an NFID roundtable which was the basis for a Call to Action: Reinvigorating Influenza Prevention in US Adults Age 65 Years and Older. The document is available at: www.nfid.org/flu-older-adults.
Not all vaccine options will be available at all locations; experts cautioned that people should not wait to get vaccinated if their first choice in vaccine is not available.
Although not a substitute for getting a 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 2016-2017 influenza season: oseltamivir (Tamiflu®), zanamivir (Relenza®), and peramivir (Rapivab®). Generic versions of oseltamivir also have been FDA approved and may be marketed during the 2016-2017 season.
"Even during a mild season, flu takes a serious toll, among the young and old as well as otherwise healthy adults. Flu prevention needs to be taken seriously each and every year," says Schaffner. "Your doctor and other healthcare providers are getting vaccinated and we all want the same protection for the public."
Source: National Foundation for Infectious Diseases