MMS Flu Advisory: 2010-11 Seasonal Flu; Vaccine Distribution; Health Care Worker Vaccine Requirements

Flu Advisory BoxSeasonal Flu in U.S.

Influenza A (H3N2) virus infections have been recently detected in people in 12 states across the U.S., including two small localized outbreaks in Iowa, according to a CDC Health Alert. Sporadic cases of influenza and localized summer outbreaks from seasonal influenza viruses are detected each summer. Clinicians are reminded to consider influenza as a possible diagnosis when evaluating patients with acute respiratory illnesses, including pneumonia, even during the summer months. See CDC alert and recommendations.

Antigenic characterization of the influenza A (H3) viruses received at CDC are pending. However, based on hemagglutinin gene sequencing data from four viruses isolated from July specimens, these viruses are expected to be antigenically similar to A/Perth/16/2009-like H3N2 viruses. An A/Perth/16/2009-like H3N2 virus is included in the 2010-11 seasonal influenza vaccine. Perth-like H3N2 viruses were first identified in early 2009, but have not yet circulated widely in the United States. Past influenza vaccines did not contain this strain, so vaccination with last year’s seasonal vaccine would not be expected to provide substantial protection against this H3N2 Perth-like strain.

ACIP Seasonal Influenza Vaccination Recommendations

Highlights include:

  1. Annual vaccination be administered to all persons aged >=6 months for the 2010-11 influenza season
  2. Children aged 6 months-8 years whose vaccination status is unknown or who have never received seasonal influenza vaccine before (or who received seasonal vaccine for the first time in 2009-10 but received only 1 dose in their first year of vaccination) as well as children who did not receive at least 1 dose of an influenza A (H1N1) 2009 monovalent vaccine regardless of previous influenza vaccine history should receive 2 doses of a 2010-11 seasonal influenza vaccine (minimum interval: 4 weeks) during the 2010-11 season
  3. Vaccines containing the 2010-11 trivalent vaccine virus strains A/California/7/2009 (H1N1)-like (the same strain as was used for 2009 H1N1 monovalent vaccines), A/Perth/16/2009 (H3N2)-like, and B/Brisbane/60/2008-like antigens be used
  4. Information about Fluzone High-Dose, a newly approved vaccine for persons aged >=65 years; and
  5. Information about other standard-dose newly approved influenza vaccines and previously approved vaccines with expanded age indications.

Seasonal Flu Vaccine Distribution Underway

MedImmune has begun shipping intranasal influenza vaccine. GSK, Novartis, and Sanofi Pasteur have begun distribution of 2010-11 injectable seasonal influenza vaccine. Centers for Medicare and Medicaid Services (CMS) has confirmed that the new high dose formulation vaccine for patients 65 years and older, Fluzone HD, is covered by Medicare Part B and will be reimbursed for the upcoming 2010-2011 influenza season. CMS has updated its various pricing files to include Fluzone High-Dose vaccine in the “July 2010 AWP NDC – HCPCS Crosswalk File” for Medicare Part B Drugs.

Health Care Professional (HCP) Vaccine Requirements

The Massachusetts Department of Public Health (MDPH) has released its 2010-11 recommendations and guidelines for health care worker vaccination. (.pdf)

Sources: CDC; MMWR 2009;58:[No. RR-10]); MDPH

Seasonal Influenza (H3N2) Infections; ACIP 2010-11 Seasonal Flu Recommendations; Seasonal Flu Vaccine Distribution; MA 2010-11 Health Care Worker Vaccine Requirements

Seasonal Flu in U.S.

Influenza A (H3N2) virus infections have been recently detected in people in 12 states across the U.S., including two small localized outbreaks in Iowa, according to a CDC Health Alert. Sporadic cases of influenza and localized summer outbreaks from seasonal influenza viruses are detected each summer. Clinicians are reminded to consider influenza as a possible diagnosis when evaluating patients with acute respiratory illnesses, including pneumonia, even during the summer months. See CDC alert and recommendations. Antigenic characterization of the influenza A (H3) viruses received at CDC are pending. However, based on hemagglutinin gene sequencing data from four viruses isolated from July specimens, these viruses are expected to be antigenically similar to A/Perth/16/2009-like H3N2 viruses. An A/Perth/16/2009-like H3N2 virus is included in the 2010-11 seasonal influenza vaccine. Perth-like H3N2 viruses were first identified in early 2009, but have not yet circulated widely in the United States. Past influenza vaccines did not contain this strain, so vaccination with last year’s seasonal vaccine would not be expected to provide substantial protection against this H3N2 Perth-like strain.

ACIP has released its 2010 Seasonal Influenza Vaccination Recommendations.

Highlights include:

1. Annual vaccination be administered to all persons aged >=6 months for the 2010-11 influenza season;

2. Children aged 6 months-8 years whose vaccination status is unknown or who have never received seasonal influenza vaccine before (or who received seasonal vaccine for the first time in 2009-10 but received only 1 dose in their first year of vaccination) as well as children who did not receive at least 1 dose of an influenza A (H1N1) 2009 monovalent vaccine regardless of previous influenza vaccine history should receive 2 doses of a 2010-11 seasonal influenza vaccine (minimum interval: 4 weeks) during the 2010-11 season;

3. Vaccines containing the 2010-11 trivalent vaccine virus strains A/California/7/2009 (H1N1)-like (the same strain as was used for 2009 H1N1 monovalent vaccines), A/Perth/16/2009 (H3N2)-like, and B/Brisbane/60/2008-like antigens be used;

4. Information about Fluzone High-Dose, a newly approved vaccine for persons aged >=65 years; and

5. Information about other standard-dose newly approved influenza vaccines and previously approved vaccines with expanded age indications.

Seasonal Flu Vaccine Distribution Underway

MedImmune has begun shipping intranasal influenza vaccine. GSK, Novartis, and Sanofi Pasteur have begun distribution of 2010-11 injectable seasonal influenza vaccine. Centers for Medicare and Medicaid Services (CMS) has confirmed that the new high dose formulation vaccine for patients 65 years and older, Fluzone HD, is covered by Medicare Part B and will be reimbursed for the upcoming 2010-2011 influenza season. CMS has updated its various pricing files to include Fluzone High-Dose vaccine in the “July 2010 AWP NDC – HCPCS Crosswalk File” for Medicare Part B Drugs.

Health Care Professional (HCP) Vaccine Requirements

The Massachusetts Department of Public Health (MDPH) has released its 2010-11 recommendations and guidelines for health care worker vaccination.

Sources: CDC; MMWR 2009;58:[No. RR-10]); MDPH

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