2002 ACIP Influenza Vaccination Recommendations

1
2002 ACIP Influenza Vaccination Recommendations

• Keiji Fukuda
• Influenza Branch
• National Center for Infectious Diseases
• Centers for Disease Control and Prevention

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Advisory Committee on Immunization Practices
(ACIP)

• Advisory group to CDC
• Primary group setting U.S. vaccine policy
• Public meetings (Feb, June, Oct)
• Format
• Presentations and discussion
• Formal voting on recommendations
• Publication of recommendations in MMWR

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ACIP February 2002

• 14 voting members
• Academic and private physicians
• State local health officials
• 8 (non voting) ex officio members
• DoD, CMS, FDA, NIH, IHS, NVPO, VA, HRSA
• 20 (non voting) liaison members
• AAP, ACP, AAFP, AAHP, ACOG, AHA, AMA, ATPM, NACI
  (Canada), HICPAC, IDSA, London DOH, NCAI, NICCHP
  (Mexico), NMA, NVAC, PhRMA

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Changes in 2002 ACIP Recommendations Document

• Timing of vaccinations by risk group
• Vaccination of children 6-23 months encouraged
• and household contacts of children 0-23 months
• B strain change for 2002-03 vaccine
• Vaccine with reduced thimerosol available

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Vaccination Recommended for

• Persons at increased risk of complications
• Persons gt65 years
• Residents of chronic care facilities
• Persons with certain chronic medical conditions
• Children receiving chronic aspirin therapy
• Women in 2nd or 3rd trimester during flu season

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Vaccination Recommended for

• Persons who can transmit influenza to those at
  high-risk
• Health care workers (and staff of chronic care
  institutions)
• Household members
• All persons 50-64 years of age
• Anyone wishing to avoid influenza

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Vaccination Encouraged for

• Healthy children 6-23 months when feasible
• Household contacts and out-of-home caretakers of
  children 0-23 months, particularly for contacts
  taking care of children 0-5 months

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2002 Timing of Vaccination

• October and November are optimal months for
  vaccination
• However, staggered timing recommended for 2002-03
  season

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2002 Timing of Annual Influenza Vaccination
10
2002 Timing of Organized Vaccination Campaigns

• Should consider scheduling substantial
  organized campaigns after mid-October
• If held in Oct or earlier, should focus on
• Persons at high risk
• Health care workers
• Household contacts

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Vaccination after December

• Should continue to offer vaccine in December
  and later
• as long as vaccine supplies are available
• even after influenza activity documented in
  community

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Discrepancy in 2002 ACIP Recommendations Document

• Page 10, column 1
• Vaccination in Oct
• High-risk
• Health care workers
• Children lt9, 1st time

• Page 10, column 2
• Organized campaigns before November
• High-risk
• Health care workers
• Household contacts

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Correction

• October for individual providers AND campaigns
• High risk
• Health care workers
• Household contacts
• lt9 year old, 1st time
• Discussed with ACIP Influenza Work Group
• Will be presented to ACIP June 20
• Will be published in erratum in MMWR

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Conclusions

• 2000 and 2001 vaccine delays heavily influenced
  ACIP decision to recommend staggered timing of
  vaccination
• Full recommendation for young children expected
  in 1-3 years