Prevention and Control of Influenza and Pneumococcal Disease - 2005-2006 Season

The purpose of this document is to provide important information regarding the influenza vaccine supply and upcoming flu season to facilitate the planning of immunization campaigns.

Health and residential care providers are encouraged to evaluate the immunization status of all individuals to whom they provide care and assistance and to facilitate increased immunization.

Most elderly and other at-risk populations do not live in nursing homes or facilities for the developmentally disabled. Therefore it is especially important that all types of health and residential care providers address this issue.

The information and resources provided here convey facts that can be used to overcome barriers and correct misconceptions that often hinder people from becoming immunized.

Please copy and distribute this material.

• Wisconsin State Influenza Information (including Vaccine Availability, Prioritization Plans)

• Shipment of the Flu Vaccine

• DQA Memo 02-019, Influenza, Pneumococcal Immunization Standing Orders

• October 1, 2002 Press Release, US Department of Health and Human Services:  "HHS Makes It Easier for At-Risk Americans to Receive Flu and Pneumonia Vaccinations" (exit DHFS)

• Live, Attenuated Intranasally-administered Vaccine

• Target Groups for Vaccinations

• Providers' Role

• Resources (federal, diabetes, etc.)

Wisconsin State 2005-2006 Influenza Information

• Letter from Jeffrey P. Davis, MD, State Epidemiologist,
  "Updated Influenza Recommendation for Prioritization During 2005-06 Influenza Season" (PDF, 36 KB)
• Wisconsin Immunization Program website - select "News" for more information.
• Guidelines for Clinicians Prescribing Neuraminidase Inhibitors (PDF, 37 KB)
• 2005-2006 Wisconsin Influenza Vaccine Prioritization Plan (PDF, 36 KB)

Shipment of the Flu Vaccine

Providers who may encounter difficulties with the influenza vaccine may wish to contact their state influenza vaccine supply representative for assistance.

The contact for Wisconsin is Tom Haupt at (608) 266-5326, or e-mail: hauptte@dhfs.state.wi.us.

• October 17, 2005 FDA Update on Influenza Vaccine Supply (exit DHFS)
• 2005-06 Influenza Vaccine Supply and Vaccine Recommendations CDC’s Key Messages (PDF, 30 KB) - October 18, 2005

Live, Attenuated, Intranasally-administered Vaccine (LAIV)

On June 17, 2003 the Food and Drug Administration (FDA) approved an intranasal, trivalent, cold-adapted live attenuated influenza vaccine for use in healthy persons aged 5 – 49 years to prevent influenza A and B.

On September 26, 2003, the Advisory Committee for Immunization Practices (ACIP) released its recommendations for LAIV (trade name FluMist).

Their recommendations can be found in the September 26, 2003 Morbidity and Mortality Weekly Report (exit DHFS; PDF).

LAIV is a useful option for vaccination of specific population groups, but it does not replace the inactivated vaccine and is not approved for all groups who can use the inactivated vaccine.

Target Groups for Vaccinations

• Persons 65 years or older;
• Residents of nursing homes and other chronic-care facilities that house persons of any age who have chronic conditions;
• Adults and children who have chronic disorders of the pulmonary or vascular systems, including asthma;
• Adults and children who have required regular medical follow-up or hospitalization during the preceding year because of:
  • chronic metabolic diseases (including Diabetes Mellitus)
  • renal dysfunction
  • hemoglobinopathies
  • or immunosuppression (including those caused by medications or by HIV virus);
• Children and teenagers (aged 6 months to 18 years) who are receiving long-term aspirin therapy and, therefore, might be at risk for developing Reye syndrome after influenza infection; and,
• Women who will be in the second or third trimester of pregnancy during the influenza season.

B. Persons Aged 50-64 Years 
When vaccine supplies are adequate, vaccinate these individuals with Group A "Persons at High Risk for Complications"

This group has an increased prevalence of persons with high-risk conditions.

Vaccination of health-care workers is associated with decreased deaths among persons at high risk.

The following groups should be vaccinated:

• Physicians, nurses, and other personnel in both hospital and outpatient-care setting who have direct patient contact, including emergency response workers;
• Employees of nursing homes and chronic-care facilities who have direct contact with patients or residents;
• Employees of assisted living and other residences for persons in groups at high risk;
• Persons who provide home care to persons in groups at high risk; and,
• Household members (including children) of persons in groups at high risk.

D. Otherwise healthy persons aged 6 months and older who wish to reduce their likelihood of becoming ill with influenza.

E. Persons Who Should Not Be Vaccinated

The vaccination should NOT be administered to persons known to have anaphylactic hypersensitivity to eggs or other components of the influenza vaccine.

Providers' Role

Providers should actively encourage life-saving immunizations by consistently following the three important steps below:

• Educate clients, residents, patients and staff about the benefits of immunizations.
• Facilitate access to immunizations for clients, residents, patients, and staff. Public health departments are often interested in providers offering areas for them to set up immunization clinics.
• Set an Example. People in leadership positions should be immunized and they should also encourage employees to be immunized.
  • Some providers encourage their employees using the phrase, "You don’t get it for yourself, you get it for the residents."
  • For most people in the adult work force, influenza can mean a miserable illness and perhaps lost wages, but most healthy adults recover.
  • However, when employees have highly communicable illnesses, such as influenza, the chances are great that these illnesses will be passed on to clients, patients and residents, placing many vulnerable people at increased risk of a potentially deadly illness.

Resources for Further Information

Centers for Disease Control and Prevention
National Immunization Hotline toll-free numbers are:

1-800-232-2522 (English) or 1-800-232-0233 (Spanish) or 1-800-243-7889 (TTY)

The primary web site for the Centers for Disease Control and Prevention is: www.cdc.gov/ (exit DHFS).

Current information related to the influenza season and the availability of the influenza vaccine can be found at the following sites:

• Center for Disease Contol, Influenza Vaccine Bulletins (exit DHFS)
• National Immunization Program (exit DHFS)
• Pneumococcal Polysaccharide Vaccine information (exit DHFS; PDF, 49 KB)

Pat Zapp, Program Director
Wisconsin Diabetes Control Program
Bureau of Public Health
1 West Wilson, Room 218
Madison, WI 53702
Telephone (608) 261-6871; Fax (608) 266-8925

Contact your local public health department for information regarding vaccination clinics.

Bureau of Quality Assurance - Questions may be directed to the following contact persons in the Division of Quality Assurance
(Hours - 7:45 AM to 4:30 PM, Monday through Friday).

• Nursing Homes and Facilities Serving People with Developmental Disabilities should contact the appropriate Resident Care Review regional office.

• Community Based Residential Facilities, Adult Family Homes, Adult Day Care Providers and Residential Care Apartment Complexes should contact the appropriate Assisted Living regional office.

• All Other Providers Should Contact: Bureau of Health Services, Cremear Mims, Director, Phone: (608) 243-2028, Fax: (608) 243-2026

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Last Updated: June 30, 2008