To: Prevention Partners
From: Prevention Team Members
Re: 2010-2011 Influenza Season
Date: October 2010
On September 22, 2010, Litjen (L.J.) Tan, MS, PhD, Chair of the National Influenza Vaccine Summit and Director of
Medicine and Public Health, American Medical Association gave a presentation to national Quality Improvement
Organizations and CMS staff titled Influenza: Epidemics, Pandemics, and More. We thought the information was
timely as well as pertinent and wanted to share it with you!
A transcribed copy of Dr. Tan’s presentation as well as the WebEx recording are available at:
1. Go to www.qualitynet.org.
2. Click on the MedQIC tab at the top of the page.
3. Click on Prevention in the top navigation bar.
4. Click on Influenza in the drop down box.
5. Click on Presentations in the box on the right.
6. Click on the presentation "Influenza: Epidemics, Pandemics and More" dated 9/22/2010.
The direct link to the WebEx recording and transcript is:
http://www.qualitynet.org/dcs/ContentServer?c=MQPresentations&pagename=Medqic/MQPr
esentations/PresentationTemplate&cid=1228760304030&parentName=Category
Seasonal Flu Impact
About 5-20% of the population gets influenza each year; this equates to 15-60 million illnesses
There are about 226,000 influenza related hospitalizations per year
Influenza is one of the top ten leading causes of death in adults
As many as 48,000 people die annually from influenza (1990-2007), depending on the severity of
the season
Influenza infection typically results in 3 days loss of work
The financial impact of influenza on the US economy annually is $10 billion
2010-2011 Universal Recommendation for Influenza Vaccination
The CDC’s Advisory Committee on Immunization Practices (ACIP) recommends universal
influenza vaccination to include ALL people 6 months and older to whom the vaccine is not
contraindicated
300 million people are recommended for vaccination
Possible Misconceptions Regarding Influenza Vaccinations
If the patient receives the vaccination too early they will need a second vaccine
FALSE: According to the CDC, one flu vaccine provides protection against influenza for the entire
season. The recommendation is to administer the vaccine as soon as it becomes available with
protection provided after about 2 weeks.
There is no need to vaccinate after September/October
FALSE: The timing and duration of the flu season varies year to year but can begin as early as
October and as late as May. Immunization peaks around Thanksgiving while most flu activity
peaks in February making it beneficial to immunize through January
The “big box” stores get preferential distribution of the flu vaccine
FALSE: Although this may seem true to providers, Dr. Tan explains that the
production/distribution of influenza vaccination is a complex system with shortages not related
to preferential distribution, rather to the complexities of a free market system. For instance, if
the vaccine is purchased directly from one of the six manufacturers, eliminating one or more
distributors, providers (big box stores or otherwise) will receive their supply sooner. Some
manufacturers state that they ship equal percentages to all providers as the vaccine comes off
FDA lot approval but again with other variables such as involvement of one or more distributors
and FDA lot approval there may be ebbs and flows in how the vaccine is distributed with the
smaller providers being more sensitive to this than large providers. Supply problems are NOT
anticipated this flu season even with the goal of vaccinating 300 million people and as
manufacturers produce more vaccine doses, they will arrive over time through December and
beyond as opposed to one short burst in September and October.
Items to consider
39-40% of patients receive the vaccine in a provider office tending to be chronically ill patients
with standing appointments
Immunize everyone that presents in the office and order enough vaccine to do so; an active
provider should NOT have leftover vaccines
The majority of patients that receive their vaccine at the big box stores tend to be healthy
patients that wouldn’t typically be coming in to a provider office, “vaccine of convenience”,
while there is a persistent failure to vaccinate those that really need protection, i.e., the
chronically ill
With the immunization season expanded, providers need to order more supply and immunize
throughout the entire season-this does not mean more time to vaccinate the same number of
people. Remember the goal is 300 million vaccinated!
Order vaccine from multiple manufacturers and/or distributors which may reduce the impact
should there be a production problem with one manufacturer
Encourage and/or mandate medical/office staff to get vaccinated-healthcare worker
immunization rates are below 50%. This is not just a healthcare worker protection issue but a
patient safety issue
Consider standing orders which have been shown to improve immunization rates with no
increase in adverse events
And lastly…..
National Influenza Vaccination Week, December 5-11, is a national observance established to
highlight the importance of continuing influenza vaccinations as well as fostering greater use of
the flu vaccine after the holiday season into January and beyond
Provider recommendation is the # 1 reason a patient gets vaccinated!
Flu vaccination reminder cards are available at no cost! Contact your Prevention team
member if you are interested!