Influenza season 2011-12 was unprecedented for its mildness and set a record for the lowest and shortest peak for influenza-like illness. Such a season can make it harder this time around for providers to get patients to receive their annual influenza vaccine during the 2012-13 season. The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practice (ACIP) recommends that all individuals older than 6 months of age should receive the influenza vaccine, including healthcare providers.
The CDC has information about vaccination, infection control, prevention, treatment and diagnosis of seasonal influenza on its website. The site is updated frequently and keeps abreast of flu activities and surveillance.
PAs are well positioned to counsel their patients on the benefits of the influenza vaccine. Preliminary data from the National Immunization Survey (children) and National Flu Survey (adults) revealed 46 percent of people 6 months of age and older were vaccinated during the 2011-12 season, a slight increase when compared to the 2010-11 season. Among adults, coverage was highest among non-Hispanic whites compared to other racial and ethnic groups. Among children, Hispanics had higher vaccination coverage (61 percent) than non-Hispanic white (45 percent) and non-Hispanic black children (48 percent). The most common places for vaccination among both adults and children were at medical locations, but retail settings and work places were other important venues for adults.
In order to attain the Healthy People 2020 target goal of 90 percent influenza coverage, more work in the domain of provider communication is needed. In addition, PAs need to continue to build awareness of universal recommendation, discuss with patients their reason for vaccine hesitancy and address their vaccine safety concerns.
In May 2012, vaccine manufacturers released their projected supply for the 2012-13 season and it is anticipated that 146-149 million doses are to be distributed this year. Shipment has already begun and many providers are already vaccinating their patients. ACIP now recommends that immunization providers immunize their patients as soon as the vaccine is available in their communities and to continue vaccinating throughout the influenza season or until they have exhausted their supplies.
There are currently four types of vaccine on the market. The traditional flu shot, trivalent inactivated vaccine (TIV), is approved for everyone 6 months old or older. But age indications differ by brand and manufacturer – consult the product index for details. The intradermal TIV formulation is approved for adults ages 18 to 64 years. This product uses a shorter and thinner needle. For adults 65 years and older, a high-dose TIV is available. This vaccine contains a higher concentration of vaccine and will confer higher levels of productive antibody and a higher immune response to the vaccine. This may lead to greater protection from influenza infection. At this time, ACIP does not express a preference for the high-dose vaccine compared to other vaccines. The live attenuated influenza vaccine (LAIV) administered nasally is recommended for healthy, non-pregnant persons ages 2 to 49 years. The full ACIP recommendation for the 2012-13 season was published in the Aug. 17, 2012, issue of MMWR Weekly.
Several tools are available to help providers during the upcoming influenza season. A web-based tool, HealthMap Vaccine Finder, is available to help providers and patients locate where they can get their vaccines locally. This tool is being provided at no cost to the public or to vaccine providers and will play a significant role in helping patients access providers committed to improving the public health of their communities. PAs will have the opportunity to enter information on their vaccine services into the database.
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Marie-Michèle Léger, MPH, PA-C, is AAPA’s senior director of clinical and health affairs. Contact her at email@example.com or 571-319-4376.
This article originally appeared in PA Professional magazine, September 2012.