Indiana health officials are appealing to health care providers to limit use of this year’s diminished supply of flu vaccine

Indiana State health officials are appealing to health care providers to limit use of this year’s diminished supply of flu vaccine to immunizing people at high risk from complications of influenza.

The Centers for Disease Control and Prevention (CDC) has issued these guidelines for targeting these groups at highest risk from complications of influenza:

• Adults 65 years of age or older
• People 24 months to 64 years of age with chronic medical conditions
• Children 6 to 23 months of age
• Women who are pregnant during influenza season
• Residents of long term care and nursing home facilities
• Persons age 6 months to 18 years on long term aspirin therapy
• Health care workers with direct patient contact
• Household contacts and out-of-home caregivers of children 0-6 months of age

California-based Chiron Corporation announced yesterday that it will not be able to supply influenza vaccine this year, thus cutting the nation’s supply of flu vaccine available by about 50 percent for the 2004-2005 influenza season.

“There is a critical shortage of influenza vaccine this year and there have been significant changes in the recommendations for vaccine administration,” said State Health Commissioner Greg Wilson, M.D., who sent an appeal today to all physicians in the state to follow the CDC guidelines. “Only by limiting administration of the vaccine to high risk groups will we be able to protect most of our vulnerable populations.”

Wilson said that the public can call the Indiana Family Helpline, at 800-433-0746, for information about the flu vaccination guidelines. Information is also available on the State Department of Health Web site, at www.statehealth.in.gov

The State Department of Health had originally ordered 85,000 doses of influenza vaccine for use this season by local health departments and health care providers participating in the Vaccines for Children Program (VFC).

This program provides immunizations to children under 19 years of age who are uninsured or who are insured through Medicaid. Local health departments also receive vaccine through Federal Act 317 funding, for children not covered by VFC.

In a letter today to local health departments and other VFC providers, the State Department of Health discussed how these providers should allocate flu vaccine:

“As of October 5, 2004, the Immunization Program has received 18,330 doses of influenza vaccine (Fluzone), which will be distributed to local health departments and VFC health care providers. The amount of vaccine distributed to providers will be rationed based on the amount of influenza vaccine ordered by each site during the 2003-04 influenza season. Health care providers will receive approximately 30 percent of last year’s doses ordered, or a minimum of 10 doses.

“This vaccine must be prioritized for use in persons in groups listed above, particularly those at increased risk of complications from influenza because of chronic medical conditions, as listed below:

• children who have chronic heart or lung conditions, including asthma
• children who have required regular medical follow-up or hospitalization during the preceding year because of these conditions:
  • diabetes mellitus and other chronic metabolic conditions
  • chronic kidney disease
  • hemoglobinopathies such as sickle-cell disease
  • weakened immune system (caused by medications or by HIV)
  • children and adolescents (aged 6 months–18 years) who are receiving long-term aspirin therapy

“The VFC Program is not able to provide the live attenuated nasal spray vaccine, which is licensed for use in persons age 5-49 years of age who do not have medical high risk conditions. However, if available within your practice, the live attenuated influenza vaccine (FluMist) should be used to immunize:

• health care workers working in direct patient care (although not in contact with severely immunocompromised persons)
• healthy individuals 5-49 years of age in close contact with infants 0-6 months of age (household contacts or out-of-home caregivers).”

Other flu vaccine, including vaccine offered to adults, is ordered and dispensed by private providers.