Posted on the Pediatric SuperSite on July 30, 2009

ACIP issues vaccine recommendations for influenza A H1N1

About 160 million people are eligible for vaccination.

The Advisory Committee on Immunization Practices recommended five specific populations as the initial focus for novel influenza A H1N1 vaccination efforts at a meeting held in Atlanta.

Based on data from the outbreak so far, officials believe the following groups are at higher risk for disease and will bear a greater burden of complications:

• Pregnant women.

• Contacts of children aged younger than 6 months.

• Health care workers and emergency medical personnel.

• Children and young adults aged 6 months through 24 years

• Non-elderly adults with underlying risk conditions or medical conditions that increase their risk of complications from influenza.

“These recommendations will really help state and local officials go ahead with planning efforts,” Anne Shuchat, MD, Director of the National Center for Immunization and Respiratory Diseases at the CDC said during a press briefing. “We should really go out full force to identify opportunities to vaccinate these five target groups.

The committee also established priority groups encompassing a much smaller population in the event of a vaccine shortage.

These include: pregnant women; household contacts of children younger than 6 months; a subset of health care workers and emergency services personnel who have direct patient contact or contact with infectious substances; children aged 6 months through 4 years; children aged 5 to 18 years who have underlying risk factors that put them at risk for complications associated with flu.

“That prioritized small group really won’t be used in most circumstances, but we’ll have it in our pocket if we need it,” Schuchat said.

ACIP members recommended that health care providers continue to emphasize the importance of seasonal influenza vaccine and ensure that patients are vaccinated as soon as those vaccines become available, particularly among patients aged 65 and older, who will not be targeted in initial H1N1 vaccination campaigns. “The H1N1 outbreak so far has spared that population to a large extent. After younger age groups have been addressed, if supply is adequate vaccination could be offered at that time,” Shuchat said.

Although officials are projecting that anywhere between 120 million to 160 million doses will be available this fall and expect the vaccine schedule to include two doses, these target groups encompass about 160 million people.

Schuchat clarified that disparity between demand and supply is common with the seasonal influenza vaccines — current recommendations extend to 83% of the population, but coverage is typically only around 40%.

“It’s really important to differentiate the size of the target population from the number of doses we have and what we need,” Schuchat said. “We’re using the seasonal influenza demand and uptake for our expectations, but there are lots of uncertainties. We don’t know what supply and demand will be at any one time in any one community.” – by Nicole Blazek

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