Flu Shots For All Coming To US?

February 25, 2004

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Flu shots for all could become goalBy M.A.J. McKENNA Cox News Service ATLANTA -- Vaccination experts who advise the Centers for Disease Control and Prevention are debating a significant change in immunization policy: Suggesting or recommending that every American receive a flu shot every year.

If the change becomes policy, it could -- depending on the strength of its wording -- more than triple the number of flu shots now given annually in the United States.

Those shots could sharply reduce the 36,000 U.S. deaths and 114,000 hospitalizations caused each year by influenza and its complications, health officials say.

Producing them could either shore up the vaccine manufacturing industry or stress it severely, depending on demand. But the plan could impose significant costs on state health departments that make flu shots available through local clinics.

Scientists from CD's flu branch will open discussion of the possible change today before the Advisory Committee on Immunization Practices (ACIP), a CDC panel that holds public meetings in Atlanta three times each year.

The question of universal immunization arises as health authorities evaluate the current influenza season, which struck hard unusually early in the fall. A cluster of flu deaths among children in Western states concerned parents, triggering a higher-than-normal demand for flu vaccine, in turn causing shortages in many states.

Early data show that 134 children and teenagers under 18 died of flu, 82 of them under the age of 5.

Dr. Keiji Fukuda, CDC's chief of influenza epidemiology, confirmed that CDC representatives will "raise the question [of blanket vaccination] to the committee for them to begin considering."

Clinicians and influenza researchers expressed support for universal vaccination, but cautioned that debate over it is just beginning and could take months to solidify into a government recommendation.

"This is long overdue," said Dr. Paul Offit, chief of infectious diseases at Children's Hospital of Philadelphia, who served on ACIP until last summer. "Influenza is an infectious disease than can be prevented easily and safely, and it should be."

But it is necessary to move slowly, said Dr. Arnold Monto, a noted flu researcher at the University of Michigan who belongs to the vaccine advisory committee of the Food and Drug Administration, which voted last week on what strains to include in next winter's flu vaccine.

"I think we should view this as a goal, and move in that direction, but not commit ourselves at this point," he said. "It will take more vaccine than we have got right now."

The current influenza season attracted extraordinary scrutiny, due both to alarm over the avian influenza circulating in Southeast Asia and to the unusual series of flu-related events at home.

Complicating the problem of vaccine shortages, the available vaccine was not a perfect match for the circulating strain of flu virus. At this time last year, as the 2003 vaccine formula was being debated, influenza surveillance systems uncovered a change in the viruses being detected around the globe. One influenza A viral strain, nicknamed "Panama," was fading in influence; a second and related variant, nicknamed "Fujian" for the Chinese province where it was isolated, was gaining ground.

Adding Fujian to the 2003 vaccine would have delayed vaccine production by several months -- so the ACIP, CDC and FDA authorized use of the fading Panama strain, gambling that it would provide at least some protection against Fujian.

It is still not clear how well that gamble worked. One small study done for the CDC in Colorado suggested the vaccine offered little protection against Fujian. Larger investigations that should deliver more precise results are under way.

Meanwhile, though the flu season appeared harsh at its earlier-than-expected beginning, CDC data gathered throughout the winter appear to contradict that first impression.

"The aspect of the season that is relatively clear is that it was medium in terms of overall impact," Fukuda said. "The question that is still unclear is whether there was a more severe impact on children specifically."

Countering the universal vaccination proposal is the public's erratic interest in vaccination. The CDC currently recommends that a number of categories of Americans take the flu vaccine each year, including children younger than 2, adults over 55, health care workers, and people with some chronic conditions. That adds up to about 185 million Americans -- but in an average year, only 70 million doses of vaccine are used.

M.A.J. McKenna writes for The Atlanta Journal-Constitution.

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February 26, 2004

ONLY WAY I AM GETTING A FLU SHOT IS WHEN I AM DEAD!

Lucky

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Bea Bernhausen

beabernhausen

Wednesday, February 25, 2004 3:42 PM