Synopsis for December 17, 2004

The MMWR is embargoed until Thursday, 1 PM EDT.

1. Estimated Influenza Vaccination Coverage Among Adults and Children ― United States, September 1-November 27, 2004
2. Experiences with Obtaining Influenza Vaccination Among Persons in Priority Groups During a Vaccine Shortage ― United States, October-November, 2004
3. Experiences with Influenza-Like Illness and Attitudes Regarding Influenza Prevention ― United States, 2003-04 Influenza Season
4. Respiratory Syncytial Virus Activity ― United States, 2003-2004

Estimated Influenza Vaccination Coverage Among Adults and Children ― United States, September 1-November 27, 2004

Adults and children in ACIP-defined priority groups who have not received an influenza vaccination during the 2004-05 season should continue to seek vaccination as more vaccine is made available.

Influenza vaccination coverage estimates for September 1–December 11 from the Behavioral Risk Factor Surveillance System (BRFSS) suggest that adults and children in influenza vaccine priority groups are receiving vaccine at higher rates than persons in non-priority groups during the 2004–05 season. However, these early estimates of vaccine coverage are well below the vaccination rates for the full 2003–04 season for these priority groups. Because influenza activity usually peaks in February or later, adults and children in priority groups should continue to seek vaccination as more vaccine becomes available. In addition, until such time as the demand for vaccine has been met for all persons in ACIP priority groups in all states, vaccine held in the public sector should continue to be directed to persons in priority groups or shared with those states whose vaccine supply is not sufficient to meet vaccine demand for its priority groups.

Experiences with Obtaining Influenza Vaccination Among Persons in Priority Groups During a Vaccine Shortage ― United States, October-November, 2004

More than half of adults at high risk did not try to get the influenza vaccine and for many, this was due to perceived shortages, underscoring the need to continue to inform these groups that there will be an adequate vaccine supply to meet their needs. The campaign to vaccinate these groups should include efforts to educate them about the severity of influenza and the effectiveness of the vaccine.

It should also address the public’s unwarranted fears of getting influenza from the vaccine. A new national survey by Harvard School of Public Health researchers of experiences with obtaining influenza vaccination among persons in high priority groups during the vaccine shortage finds that 63 percent of adults 65 and older and 46 percent of chronically ill adults who tried to get the influenza vaccine this season were able to get it. However, 37 percent of adults 65 and older and 54 percent of chronically ill adults were unable to get the vaccine when they tried. Among adults 65 and older or those with a chronic health condition, 60 percent reported that they did not try to get the vaccine during the preceding 3 months; for many of these adults, awareness of influenza vaccine shortages was an important reason for not trying to get the vaccine.

Experiences with Influenza-Like Illness and Attitudes Regarding Influenza Prevention ― United States, 2003-04 Influenza Season

CDC recommends that during periods of increased respiratory infection activity in the community, masks should be offered as part of a respiratory hygiene/cough etiquette strategy to patients who are coughing or have other symptoms of a respiratory infection when they present for health-care services.

There is high support and awareness among the public for influenza prevention and respiratory protection measures. A randomized household survey conducted in 11 states to determine Americans’ experiences, beliefs and practices regarding influenza prevention found that more than 80 percent of Americans are willing to take measures that might prevent influenza transmission including wearing a mask while waiting to see a healthcare provider. During the flu season many people head to their doctor for respiratory-related illnesses; therefore, there is a significant risk for transmitting infections because of close contact in waiting rooms. Whenever possible, healthcare providers and the public should practice and support respiratory hygiene measures to prevent the spread of infection including wearing a mask to reduce the spread of germs.

Respiratory Syncytial Virus Activity ―
United States, 2003-2004

The 2004-2005 outbreak of RSV infections has begun.

Healthcare providers should consider RSV infection in the differential diagnosis for persons of all ages presenting with lower respiratory tract infection, implement appropriate isolation precautions to prevent nosocomial spread of virus, and provide appropriate immune prophylaxis to eligible children. Respiratory syncytial virus (RSV) causes annual winter outbreaks of lower respiratory tract infections among young children, the elderly, and persons with compromised respiratory, cardiac, or immune systems. Data reported to the National Respiratory and Enteric Virus Surveillance System suggest the 2004-2005 outbreak of RSV infections has begun in the South and Northeast regions, and will likely begin in other regions soon. Healthcare providers should consider RSV infection in the differential diagnosis for persons of all ages presenting with lower respiratory tract infection, implement appropriate isolation precautions to prevent nosocomial spread of virus, and provide monthly doses of humanized murine anti--RSV monoclonal antibody to eligible children, including some premature infants or infants and children with chronic lung and heart disease.
 

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