In order to prepare for the upcoming influenza season, the following plan has been developed for influenza vaccination of The Nebraska Medical Center patients and UNMC, UMA and The Nebraska Medical Center staff.
The first priority is to administer flu vaccine to high-risk patients and healthcare workers who care for them, and persons who live with or care for patients at high risk. The next tier of persons to receive vaccine are otherwise healthy elderly patients and other healthcare workers. Finally, vaccine will be offered to all others who wish to avoid morbidity associated with influenza (staff without patient contact, younger/healthy patients, etc.)
A modest number of doses of live attenuated flu vaccine (LAIV, intranasal vaccine, FluMistTM) will be stocked this year. Note that LAIV is FDA approved for healthy persons aged 5 to 49. Because there is a small risk of person-to-person spread of live virus from LAIV, it is not recommended for immunosuppressed patients in protective environments or the healthcare workers caring for them. LAIV is significantly more costly and the increased cost will be passed on to recipients.
To meet these goals, the following timetable will be followed:
Tier I — Oct 1 to Oct 31 – vaccination of all high-risk patients* and healthcare workers directly involved in their care, and persons who live with or care for patients at high risk
Tier II — Nov 1 to Nov 15 – vaccination of patients greater than 50 years of age and healthcare workers directly involved in their care
Tier III — Nov 16 to Nov 30 – vaccination of all others, including those with no patient or high-risk contacts
Obviously, patients and staff should receive vaccine at a later date if they miss the target period. Timetable may change if flu season appears earlier than usual.
* High risk people are those greater than 65 years of age; children aged 6-23 months; pregnant women; persons of any age with certain chronic medical conditions, and caregivers of children aged < 6 months. (CDC, MMWR 54;RR08, 2005). Patients and staff can be vaccinated at the following locations:
Staff:
- Tier I — Vaccine will be distributed to high-risk areas for administration.
- Tier II and III– Schedules for vaccine stations will be announced later.
Patients: The Nebraska Medical Center will have influenza vaccine available at the following locations:
- The Nebraska Medical Center Outpatient Clinics,
- UMA Community Clinics,
- Durham Outpatient Center,
- The Lied Transplant Center.
Additional Information:
1. The trivalent influenza vaccine recommended for the 2005-06 season will include A/California/7/2004 (H3N2)-like, A/New Caledonia/20/99 (H1N1)-like, and B/Shanghai/361/2002-like antigens. The vaccine is produced from inactivated virus (noninfectious).
2. Because the vaccine viruses are initially grown in embryonic hen’s eggs, the vaccine may contain small amounts of egg protein. Therefore, persons with allergic reactions to eggs should not receive vaccine.
3. Persons with acute febrile illness should not receive vaccine until their symptoms have abated.
4. The vaccine is approximately 70 percent to 90 percent effective in preventing influenza illness and has been shown to be cost effective. (The Nebraska Medical Center cost for vaccine is approximately $10.55 / dose).
5. The CDC recommends that flu vaccine should be administered to any person who wishes to reduce the likelihood of becoming ill with influenza. The vaccine can be administered to children as young as age 6 months.
6. Information regarding influenza, influenza vaccine, and influenza treatment can be found at:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5408a1.htm
http://www.cdc.gov/nip/flu/default.htm
Updates will be submitted to UNMC Today as additional information becomes available. If you have any questions, contact The Nebraska Medical Center Department of Pharmacy (559-6041) or the Department of Healthcare Epidemiology (559-5276).