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Interim Influenza Vaccination Recommendations, 2004--05 Influenza Season
On October 5, this report was posted as an MMWR Dispatch on the MMWR website (http://www.cdc.gov/mmwr).
On October 5, 2004, CDC was notified by Chiron Corporation that none of its influenza vaccine (Fluvirin®) would be available for distribution in the United States for the 2004--05 influenza season. The company indicated that the
Medicines and Healthcare Products Regulatory Agency (MHRA) in the United Kingdom, where Chiron's Fluvirin vaccine is
produced, has suspended the company's license to manufacture Fluvirin vaccine in its Liverpool facility for 3 months, preventing any release of the vaccine for this influenza season. This action will reduce by approximately one half the expected supply
of trivalent inactivated vaccine (flu shot) available in the United States for the 2004--05 influenza season.
The remaining supply of influenza vaccine expected to be available in the United States this season is approximately
54 million doses of Fluzone® (inactivated flu shot) manufactured by Aventis Pasteur, Inc. Of these doses, approximately 30 million doses already have been distributed by the manufacturer. In addition, approximately 1.1 million doses of
live attenuated influenza vaccine
(LAIV/FluMist®) manufactured by MedImmune will be available this season.
Because of this urgent situation, CDC, in coordination with its Advisory Committee for Immunization Practices (ACIP),
is issuing interim recommendations for influenza vaccination during the 2004--05 season. These interim recommendations were formally recommended by ACIP on October 5 and take precedence over earlier recommendations.
Priority Groups for Influenza Vaccination
The following priority groups for vaccination with inactivated influenza vaccine this season are considered to be of equal importance and are:
all children aged 6--23 months;
adults aged >65 years;
persons aged 2--64 years with underlying chronic
medical conditions;
all women who will be pregnant during the influenza
season;
residents of nursing homes and long-term care facilities;
children aged 6 months--18 years on chronic aspirin therapy;
health-care workers involved in direct patient care; and
out-of-home caregivers and household contacts of
children aged <6 months.
Other Vaccination Recommendations
Persons in priority groups identified above should be
encouraged to search locally for vaccine if their regular health-care provider does not have vaccine available.
Intranasally administered, live, attenuated influenza vaccine, if available, should be encouraged for healthy persons
who are aged 5--49 years and are not pregnant, including health-care workers (except those who care for
severely immunocompromised patients in special care units) and persons caring for children aged <6 months.
Certain children aged <9 years require 2 doses of vaccine if they have not previously been vaccinated. All children at high
risk for complications from influenza, including those aged 6--23 months, who are brought for vaccination, should be
vaccinated with a first or second dose, depending on vaccination status. However, doses should not be held in reserve to ensure that
2 doses will be available. Instead, available vaccine should be used to vaccinate persons in priority groups on a first-come, first-serve basis.
Vaccination of Persons in Nonpriority Groups
Persons who are not included in one of the priority groups described above should be informed about the urgent
vaccine supply situation and asked to forego or defer vaccination.
Persons Who Should Not Receive Influenza Vaccine
Persons in the following groups should not receive influenza vaccine before talking with their doctor:
persons with a severe allergy (i.e., anaphylactic allergic reaction) to hens' eggs and
persons who previously had onset of Guillain-Barré syndrome during the 6 weeks after receiving influenza vaccine.
Additional information is available at http://www.cdc.gov/flu or through the CDC public response hotline, telephone 888-246-2675 (English), 888-246-2857 (Español), or 866-874-2646 (TTY).
Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of
Health and Human Services.References to non-CDC sites on the Internet are
provided as a service to MMWR readers and do not constitute or imply
endorsement of these organizations or their programs by CDC or the U.S.
Department of Health and Human Services. CDC is not responsible for the content
of pages found at these sites. URL addresses listed in MMWR were current as of
the date of publication.
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