CDC: save flu vaccine for high-risk groups till Oct 24
Sep 1, 2005 (CIDRAP News)  Because of continuing uncertainty about the supply of influenza vaccine this winter, federal health officials said today that inactivated flu vaccine should be reserved for high-risk groups until late October.
"Beginning October 24, all persons will be eligible for vaccination," the Centers for Disease Control and Prevention (CDC) said in this week's Morbidity and Mortality Weekly Report.
The groups recommended to get first use of inactivated vaccine include people aged 65 and older, those with chronic illness, nursing home residents, children aged 6 to 23 months, pregnant women, healthcare workers who provide direct patient care, and household contacts and caregivers of children younger than 6 months.
However, people need not wait until Oct 24 to receive MedImmune's live nasal-spray vaccine, FluMist, the CDC said. FluMist is licensed for healthy people between the ages of 5 and 49, except for pregnant women.
The recommendation comes a day after the flu vaccine supply picture improved with the Food and Drug Administration's (FDA's) approval of a GlaxoSmithKline vaccine and a positive report on Chiron's progress in addressing problems at its flu vaccine production plant in England. The CDC said the recommendation was necessary because the overall vaccine supply and the timing of distribution remain uncertain.
In today's article, the CDC gives estimates of flu vaccine supplies for the United States that add up to a range of 89 million to 97 million doses. That includes 60 million doses from Sanofi Aventis, 18 million to 26 million from Chiron, 8 million from GlaxoSmithKline, and 3 million from MedImmune. (Yesterday, as reported here, a CDC spokesman had listed Sanofi Aventis's expected production at 50 million doses instead of 60 million, yielding a total production estimate of 79 million to 87 million doses.)
Last fall and winter, the loss of 48 million doses of vaccine expected from Chiron prompted an effort to reserve vaccine for high-risk groups until late in the flu season. Ultimately, 57 million Americans were vaccinated and about 3 million doses went unused. In the 2003-04 season, which also saw some shortages, about 87 million doses were available in the US market. The US supply in 2002-03 totaled about 95 million doses, according to the CDC.
Yesterday the FDA said Chiron had made "significant progress" in addressing the contamination problems that had forced the company to cancel delivery of doses to the United States. But the agency said more work is needed to determine how many doses the company will be able to supply this year.
CDC. Update: influenza vaccine supply and recommendations for prioritization during the 2005-06 influenza season. MMWR 2005 Sep 2;54(34):850 [Full text]
See also:
CDC's Aug 6, 2005, recommendations on tiered use of flu vaccine in the event of a shortage
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5430a4.htm
Grippeschutzimpfung. Quelle: U.S. Navy

 Vertreter US-amerikanischer Gesundheitsbehörden haben erneut die Bemühungen um ausreichende Versorgung der USA mit Impfstoffen gegen Grippe dargestellt. Nach Schätzungen der Experten reichen die von den Impfstoffherstellern voraussichtlich angebotenen Mengen in diesem Winter aus. Dennoch wird den Ärzten empfohlen, bis zum 24. Oktober nur Personen zu impfen mit hohem Risiko, an Grippe oder an einem schweren Verlauf der Grippe zu erkranken, weil einige Hersteller die Produktion neu aufgenommen haben und noch keine ausreichenden Vorräte eingelagert sind. Außerdem hoffen die Behörden auf eine höhere Impfrate, die mit 40 Prozent bei medizinischem Personal als zu niedrig eingeschätzt wird. Auch werden Flüchtlinge aus den vom Hurrikan Katrina betroffenen Gebieten, die in Massenunterkünften untergebracht sind, der Hochrisikogruppe zugerechnet und sollen frühzeitig kostenlos geimpft werden.

Vor einem Jahr, im Herbst 2004, war es zu Versorgungsengpässen gekommen, kanadische Ärzte hatten zahlreiche US-Amerikaner geimpft, und Reiseunternehmen hatten Pauschalreisen mit Grippeimpfung nach Kanada angeboten. Zuvor hatte Chiron, einer der wichtigsten Hersteller des Grippeimpfstoffs, wegen Kontamination seine Produktionsanlage in Liverpool, England schließen müssen.