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Press Briefing Transcript

National Influenza Vaccination Week: Updates on U.S. Influenza Activity

Friday, December 3, 2010 – 12:30pm ET

Von Roebuck: Good afternoon, everyone. I'm Von Roebuck, with CDC's main press office. Thank you all for joining us. Today we are providing updates on influenza activity in the United States and current influenza vaccination rates for the season. We're also kicking off National Influenza Vaccination Week which begins this Sunday, December 5th. With me today is Dr. Howard Koh. He is an M.D. and assistant secretary for health, for the U.S. Department of Health and Human Services. We also have Dr. Anne Schuchat. She is also an M.D. and an admiral in the U.S. Public Health Service. She is director of CDC's National Center for Immunization and Respiratory Diseases. Both Dr. Koh and Dr. Schuchat will make brief remarks and then take your questions. Let's start, though, with Dr. Koh. Dr. Koh?

Howard Koh: Von, thank you so much for organizing this call, and thank you, everyone for joining us to discuss the importance of seasonal flu vaccination. It's always critical to update the public on this very important issue, and so we're grateful to you for joining us. We're reaching out to you today to send the message that flu activity is now increasing across the country, and indeed the flu season is now well under way. If you've been thinking of getting vaccinated for influenza, now is a very good time to do so. With the holidays coming up, we are encouraging all Americans to be vaccinated and to protect themselves and their families, friends, and community from the flu. And we also want to stress that we want to build on the lessons learn from the H1N1 epidemic from last year.

Last year at this time we were preparing for one of the largest mass vaccination campaigns in the nation's history. The response to that campaign was tremendous. I want to stress that we could not have had that level of response without the critical role of the media who helped to raise awareness about this important public health topic. So, this year with the flu season now well under way, despite the fact that we no longer have a pandemic, we need to stress always that the flu is unpredictable, and the flu is potentially deadly, and so that all Americans need to take this threat seriously and promote prevention as much as possible. Flu viruses are always changing. That's why vaccines are updated every year to meet the need. This year's flu vaccine will protect not only against H1N1 but against other seasonal flu viruses as well. And we must always remember that even healthy people, young adults and children can become severely ill from the flu. That's why the CDC and Health and Human Services this year has promoted what's called the universal vaccination recommendation. That is that all people with the exception of children under six months of age should be vaccinated against the flu. We need to send that message of the universal recommendation throughout every venue that we can. Not only with media, but health care providers, faith-based and community-based organizations, employers, pharmacies that have done a great added push this year, and other stake holders to promote this message of prevention.

We're also very pleased to promote this message now in the context of the Affordable Care Act. Which makes a truly historic investment in individual and community-level prevention. The act removes many barriers to preventive care and offers new opportunities. For example, as of September 23rd of this year, all new health plans must cover high-value preventive services that have strong scientific evidence of their health benefits with no cost sharing. So, specifically, with respect to immunization, that means that all vaccines recommended by the Advisory Committee on Immunization Practices at CDC will be covered in these new insurance plans without cost sharing, and that specifically relates to flu vaccinations. So we're hoping that's going to knock down an important barrier with respect to access of certain preventive services.

As Mr. Roebuck mentioned, this is the beginning of National Influenza Vaccination Week. It starts on Sunday. It's a week that we traditionally highlight the importance of continuing flu vaccination and fostering greater use of the flu vaccine as the holiday season approaches and into the new year. The week extends from December 5 to December 11. Each day will have a number of very exciting, creative activities to promote vaccination among key populations. If you want to know exactly what those series of events are, please visit flu.gov. And just to highlight two particular examples, our partnership center at the Department of Health and Human Services has two new resources. One very attractive and easy to understand guide for community and faith-based organizations and leaders. That's a very easy to use resource for such community leaders. And the second is called Faith and Communities Fight Flu and both of these can be found on hhs.gov/partnerships.

So we want to thank you for your role in raising awareness about flu, understanding that we have learned a lot of lessons from last year, and need to stress that the flu continues to be a serious and unpredictable threat. We have a new universal vaccination recommendation. The flu season is now under way, and now is a great time to be vaccinated. Health reform eliminates many of the cost barriers and with this National Influenza Vaccination Week, we have an opportunity to really improve our emphasis on this important prevention message for the holiday season, and moving into the new year. And so with that I'm happy to turn this back to Mr. Roebuck.

Von Roebuck: Thank you, Dr. Koh. We'll now go next to Dr. Schuchat.

Anne Schuchat: Good afternoon. It's a pleasure to talk with you this afternoon. What I want to do is describe where we are so far with the activity for flu this year and give you results from a few recent surveys that we've done about vaccine use this fall. My first message is "don't be fooled by the past few months". Flu is coming. In most years flu is most active in the winter months. If we look at where we are today, what a difference a year can make. Because of the 2009 H1N1 virus, by this time a year ago we had already seen a tremendous amount of flu in communities throughout the country. We were holding press briefings like this on a weekly basis. Last year's H1N1 situation was a sobering reminder about the severity and unpredictability of flu. We're estimating that over 12,000 people died from the H1N1 2009 virus. More than 340 deaths in children with laboratory confirmed flu were reported to us, although we estimate that more than a thousand deaths in children were caused by that virus. But this fall has begun like so many influenza seasons, with relatively few flu viruses circulating through the end of November.

We want to make sure that you to understand that last year was unusual in terms of the amount of disease we had early in the fall. We don't want people to be complaisant because disease activity has been low so far this year. Flu is coming. We do have early indications that flu activity is now increasing. The percentage of viruses testing positive for influenza nationally continue to increase this week, led by sharp increases that we're seeing in the southeast region of the country. This signal of the start of increased flu has been in the southeast led by Georgia. Georgia is reporting high levels of influenza-like activity. On the maps that we have on our website, you can see Georgia is showing up as a ten out of ten on their scale. It's been called regional disease spread by the state epidemiologists of Georgia, and it's probably leading the country in terms of what we may be seeing later in the – in the later months. The increase in Georgia is occurring in multiple sites around the state. It's been seen primarily so far in school-aged children. They've seen an increase in the number of influenza viruses that they're detecting, and it's an increase in influenza B. Preliminary data show the majority of the B viruses from Georgia are related to the B virus that's in our vaccine. So we expect the vaccine to be a good match against this B strain already causing quite a bit of disease here in Georgia. Their detailed analyses of the viruses from Georgia are in progress. But everything we know so far suggests to us that the vaccine should be a good match for the circulating strain.

Human influenza A and B viruses cause seasonal epidemics of disease almost every winter in the U.S., so the increase in the number of specimens testing positive for flu and the first state reporting regional activity are both signals that flu activity is picking up. So far we're seeing multiple strands of flu causing illness. But this season's vaccine is a good match for the three main strains that we're seeing. Influenza viruses identified so far this season includes the 2009 H1N1 A virus. Also the influenza A H3N2 viruses, and influenza B viruses. The viruses that we're seeing remain similar to the viruses that were selected for the current season flu vaccine. So, again, we believe the vaccine being offered is a very good match for the strains that we're seeing. Flu is unpredictable, but based on the viruses circulating so far this year, we do expect the vaccine to be a good match and a good way to protect yourself.

Next I want to provide results from a few surveys that have been done to help us know where we are so far with influenza vaccine use. I want to say that we're very encouraged by the number of people who have already received a flu vaccine, but many others could benefit from being vaccinated and do still need to be protected. We carried out a rapid survey by telephone of about 38,000 adults and 9,100 children around the country to give us an early snapshot of vaccine coverage results in the general population. These data go through the second week of November, and at that time about 33 percent or one out of three Americans reported having already been vaccinated. Among those who had not yet been vaccinated, 15 percent said that they will definitely get vaccinated and 25 percent reported that they'll probably get vaccinated. Details of the survey result are available on our website at CDC.gov for those who want details.

Like last year, people are taking advantage of a number of different places to get vaccinated. In our survey we did ask where you'd been vaccinated. People have been seeing a lot of ads for vaccinations at chain stores and pharmacies. But like most years, we find medical locations are the most common place for people to have received the vaccine this year. Almost two-thirds or 63 percent of people reported having been vaccinated in the doctor's office, a hospital or clinic. We found that 16 percent of people reported getting their seasonal flu vaccine in a supermarket, pharmacy or other store, and we found that 18 percent of people had been vaccinated at their workplace or at school. So a lot of different places to be vaccinated; the medical sites the most common, but many other options are convenient for people. The groups that had the highest proportion of vaccinations so far were people 65 years of age and over. Almost two-thirds or 64 percent of seniors had received their flu vaccine already. So those are the results of our general survey. More details about that large telephone survey are available on our website. I do want to say that when we compare where we are this year by this survey, with a similar approach we used last year, we're either about the same place or a little ahead of last year's seasonal flu vaccine. And we find that very encouraging because this year we haven't had back-to-back media talking about flu.

We also did two snapshots using the internet to survey people. We focused on two populations of great interest to all of us. We looked at health care worker influenza vaccine use and pregnant women influenza vaccine use so far this season, in the fall of 2010. I want to give a little bit of results from those two snapshots. As of mid-November, more than half of all health care workers or 56 percent reported having already been vaccinated against flu. About four out of five of those people reported that they got their vaccine at their site of work. An additional 7 percent of the health care workers in the internet survey reported that they planned to definitely be vaccinated this season, they just haven't gotten to it yet. Yesterday we reported some results from pregnant women from last year's flu vaccination based on ten states where we did surveys and there's lots of details of this on the website, for the MMWR. But for last season when, of course, we were having the pandemic, in these ten states, about half of pregnant women reported having received a seasonal flu vaccine and half reported receiving an H1N1 vaccine. That was last year, what about this year? This internet survey we carried out, which included about 1,400 pregnant women surveyed as of mid-November, we found that nearly half of pregnant women had already reported being vaccinated. It was 45 percent of the pregnant women said they'd been vaccinated already this season in 2010. Another 4 percent said they're definitely going to get vaccinated before their babies do.

The last result of our surveys that I want to give relates to who is getting vaccinated at higher rates compared with others. We found in the general population that whites were more often vaccinated than were minority populations. This is something we've seen over many years and unfortunately still is the case. More than a quarter of everyone in the general population surveyed has reported received the vaccine so far this season. But whites were more likely to have been vaccinated. Coverage was 10 percent higher among whites than among blacks or hispanics. We know that we have an opportunity to vaccinate more people and that it's not too late to make a difference in being able to protect everyone in the country. More people would benefit from being vaccinated. Now is a very good time to be vaccinated. As you heard, our data show many people haven't yet gotten vaccinated but are interested in doing so. As disease activity has begun to pick up, particularly in Georgia with cold weather setting in, with people making plans to get together with family and friends over the holidays, it's a really good time right now to get vaccinated if you haven't already done so.

I want people to know that we've already had one report of a pediatric death from flu this season. And I just strongly encourage people to get vaccinated to make sure you're protected and to make sure your children are protected, too. So the timing of flu activity in any community is difficult to predict. Large increases in flu illnesses often occur after the holidays. So this is the time to take action. Getting vaccinated is the first and best way to prevent flu, and this year, vaccine supply is plentiful. Manufacturers have already distributed more than 160 million doses of flu vaccine, more than they have ever distributed in a single season in the United States. It's best to get vaccinated before disease is widespread, and in most years flu is most intense between January and March. But it can occur earlier as we're seeing here in Georgia.

So, we encourage people who aren't yet vaccinated to get vaccinated as soon as possible because flu vaccines can safely protect people from the flu and can be life saving for people who have a risk of complications, people like pregnant women or people with asthma or diabetes, who really do have a worse time with flu. I also want to remind parents that many children need two doses of vaccine to be fully protected from flu. If your child is under nine years of age and has gotten their first dose of vaccine, you'll probably want to check with their health care provider to find out if they need a second dose. And again, there's information on our website about the details of those recommendations. Flu vaccines have protected hundreds of millions of people safely. And they've been used for decades. They can't give you the flu. Every influenza season varies in terms of its timing and severity and when people will get sick. But flu comes every year, and this season will be no exception. So I just want to close encouraging you to find more information about the summary of the data I shared as well as general flu recommendations at either CDC's website or flu.gov. We'll turn it back over for questions now.

Von Roebuck: Hi, Rose. Let's go ahead and take your questions.

Operator: Thank you. At this time if you would like to ask a question, please press star one on your touch tone phone. Again, press star followed by one and record your name. One moment for our first question. Our first question is from Stephanie Nano from the Associated Press. Your line is open.

Stephanie Nano: Hi, thanks for taking my call. I'm not sure which one could address this, but I wanted to see on the flu activity outside of Georgia, how would you describe that? Very low, mild, or what are we seeing nationwide?

Anne Schuchat: It's early. So we know the flu season has started here in Georgia. While we do have sporadic influenza viruses occurring throughout the country, we don't have the major increase that we've already seen in Georgia. So in regions around the country, there are increases, but they haven't yet hit the point that they've reached in Georgia. There's substantial increases, though, in the southeast region, which Georgia is leading, and then there's some increases in the western states as well. So I think the key point is that flu is coming. Now is the time to get vaccinated. Places that don't have as much disease as Georgia right now are probably going to have a lot of disease in the weeks and months ahead. Next question?

Operator: Thank you. The next is from Denise Mann from WebMD. Your line is open.

Denise Mann: I was wondering if you had any sort of predictions about what type of flu season you think we're going to see this year. Is it going to be mild in general? That sort of thing?

Anne Schuchat: I wish that I could tell you what kind of flu season we're going to have. What I can say is that we have more vaccine than we've ever had before to keep this as minimal of a season as possible. More than 160 million doses of flu vaccine is more than we've ever had available to us in this country. And we see that there is still time to use it. Last year, of course, we had so much disease before the H1N1 vaccine doses became readily available. And we can really have a different situation this year. So I encourage people not to wait to find out how bad the season is going to be, but to take advantage by protecting yourself. Next question?

Operator: The next is from Carrie Teagardin, Atlanta Journal-Constitution. Your line is open.

Carrie Teagardin: Yes, our readers will be interested in specifically what's happening in Georgia. You described it as high levels here, as ten on the scale. Could you speak more about what that means? I assume we're not at the kind of levels we had last year.

Anne Schuchat: Right. Thanks for that question. Georgia is seeing a much higher percentage of viruses positive for flu than we're seeing at the national level. Nationally about 10.7 percent of specimens that are being tested for flu are positive. But in Georgia it's about double that. Over 20 percent of specimens tested for flu have flu virus in them. That's at the level that we call the flu season is here. Once it goes over 12 percent we say flu season has arrived. So Georgia is categorizing the intensity as regional, which is one step below widespread. That's because it's within multiple areas within the state, but it's not yet everywhere. So the season is not over in Georgia. It's essentially arrived and in good shape. For all of my neighbors here in Georgia, I hope you'll take advantage of getting vaccinated. Next question?

Operator: If you would like to ask questions, please press star 1. The next question is from Don Sapatain, from Philadelphia Inquirer. Your line is open.

Don Sapatain: Thanks for taking my question. Can you explain in a little more detail how the health reform law works with vaccine coverage? For example, somebody has private insurance, should they be able to simply go to their doctor without any co-pay and get it? Should they be able to go to a pharmacy without any co-pay and get a vaccine?

Howard Koh: We want to stress that this provision is for new plans that started or new policies that started after September 23rd. So this provision doesn't apply to everybody just yet. But in upcoming years it will apply to tens of millions of people. So, at this point patients should ask their providers about the status of coverage, and it will apply to those who have new plans that start after September 23rd, or new policy years after that date.

Anne Schuchat: And I just want to supplement a little bit to remind people that children who don't have insurance are eligible for the Vaccines for Children Program and can access free vaccines against flu and other routine immunizations. We really don't want cost to be a barrier. It's really important for parents to know children can get free vaccines if you're not insured through the vaccine program, either at their doctor's office or at the health department or other setting. Next question?

Operator: Stephanie Nano, Associated Press, your line is open.

Stephanie Nano: I forgot to ask last time. How much of H1N1 are we seeing?

Anne Schuchat: There is some H1N1 being seen this season. Right now we're seeing a mixture of H3N2, H1N1, and B strains and A strains that haven't yet been characterized. So if we look at the cumulative data this season, there were 85 H1N1 strains that were characterized and more than 350 H3N2 strains and more than 770 B strains. So it's still there. It's not the majority, as you can see. And last year practically all the influenza viruses that were circulating were H1N1. So I think the key message is we can see different strains in different communities at different times, and the great thing about the vaccine this year is it has all three strains in it. You don't need to get a separate vaccine. It also reminds people that if they think, well I got the H1N1 disease last year so I don't have to worry about flu anymore, you're not protected against all the other kinds of flu out there. So very important to know flu viruses change, and that's why we update the vaccines every year, and there are multiple different flu viruses circulating already this year in different places.

Operator: Again, if you would like to ask a question, press star one. No other questions at this point. We're showing no questions at this time.

Von Roebuck: Okay, thank you, rose. Then this concludes our briefing today. I want to thank you all again for joining us. Please note the transcript for this briefing will be noted on CDC's website later, the media location on the website. And also as mentioned the seasonal flu information can be found at www.CDC.gov and at www.flu.gov. Have a good weekend, everyone.

Operator: This concludes today's conference call. Thank you for joining. You may disconnect at this time.

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