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Experts hope for better vaccination rates for 2016-2017 flu season
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William Schaffner
WASHINGTON — Influenza kills thousands of people each year, yet vaccination rates remain mostly stagnant despite wide agreement that the influenza vaccine is the best way to prevent infection. So each year health experts bang the drum to get more Americans vaccinated, even though they know there is no simple solution to the problem.
“Flu is serious. Flu is unpredictable. Flu often doesn’t get enough respect,” CDC Director Thomas R. Frieden, MD, MPH, said Thursday during the annual influenza news conference hosted by the National Foundation for Infectious Diseases (NFID).
Frieden rolled up his sleeve to receive one of the first 93 million doses of influenza vaccine to be delivered for the 2016-2017 season. At the same time, the CDC reported good and bad news about vaccination rates for 2015-2016, including what it called a concerning decline in vaccinations for older Americans, one of the most vulnerable groups.
The CDC recommends that all Americans aged 6 months and older get vaccinated.
“We’re at a critical milestone in the fight against influenza, and what we’ve learned over the past 2 decades is that there’s no magic bullet to get everyone vaccinated and to improve vaccination rates,” William Schaffner, MD, Infectious Disease News Editorial Board member, NFID medical director and professor of preventive medicine at Vanderbilt University School of Medicine, said during the event.
“That said, each of us can and must be part of the solution by working together to continue to increase awareness among the public and health care professionals alike and by getting vaccinated ourselves.”
CDC Director Thomas R. Frieden, MD, MPH, receives his annual influenza vaccine at an NFID news conference in Washington.
Source: NFID
Rates decline among older Americans
The CDC reported declining rates of influenza vaccination among older Americans, including a 3.3 percentage point dip among those aged 65 years and older to 63.4%. For those aged 50 to 64 years, the rate dropped 3.4 percentage points to 43.6% coverage.
“Despite all of the benefits, we’re not seeing the kinds of trends we would like,” Frieden said.
But there was good news, including a nearly 4 percentage point rise in the vaccination rate for health care workers between 2013-2014 and last season to 79%. The rate climbed from 64% to 69% among staff at long-term care facilities, an all-time high for that group, the CDC said. And the vaccination rate among physicians also reached an all-time high of nearly 96%.
Children aged 6 to 23 months were better vaccinated than any other age group at 75% — the only group of Americans who exceeded the national public health goal of 70% coverage, the CDC said. Around half of all pregnant women were vaccinated in 2015-2016, consistent with recent numbers.
Overall coverage for Americans was 45.6 percent — or around 144 million people — which was down 1.5 percentage points from the 2014-2015 season.
“If we could increase vaccination coverage in this country by just 5%, that would prevent about 800,000 illnesses and nearly 10,000 hospitalizations,” Frieden said. “Flu vaccine is one of the best buys in public health. For employers, it will reduce your absenteeism rate. For families, it will reduce the likelihood that you will have to miss school or work. And for all of us, increasing our rate will keep us healthier and reduce health care costs.”
Ineffective nasal spray not recommended
The CDC is not recommending the use of the live-attenuated influenza vaccine — offered as the nasal spray FluMist Quadrivalent (MedImmune) — for this influenza season after data showed that it was ineffective for the past 3 years. Frieden called the finding “surprising.”
“For a lot of kids, it’s certainly preferable to getting a shot, so we hope this option will be available in the future,” he said.
The CDC recommends receiving an influenza vaccine by the end of October.
“The problem is, a vaccination deferred is often a vaccination forgotten,” Frieden said. “We want to be sure that as many people as possible get the flu vaccine. There’s plenty to go around, although if I said there wasn’t enough, maybe that would increase vaccination rates.”
Up to 168 million doses of injectable influenza vaccine are expected to be available, including two new options: a four-component shot made with a virus grown in cell culture rather than eggs that is licensed for use in patients aged 4 years and older, and a vaccine licensed for adults aged older than 65 years that contains an adjuvant.
The CDC recommends that people aged 65 years and older also receive the pneumococcal vaccine.
“Each year we ought to make influenza vaccination part of what we do in the fall for ourselves and every member of our family,” Schaffner said. “Don’t think about it, just do it.” – by Gerard Gallagher.
Disclosures: Frieden is the director of the CDC. Schaffner reports being a member of the data safety monitoring boards for Merck and Pfizer, a consultant to Dynavax, Novavax and Sanofi Pasteur, and a lecturer for Genentech.