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Preliminary Report: Epidemiology of the Avian Influenza A (H7N9) Outbreak in China
Preliminary Report: Epidemiology of the Avian Influenza A (H7N9) Outbreak in China
Source: New England Journal of Medicine
The first identified cases of human infection with a novel influenza A (H7N9) virus occurred in eastern China during February and March 2013 and were characterized by rapidly progressive pneumonia, respiratory failure, acute respiratory distress syndrome (ARDS), and fatal outcomes.1 We analyzed available data from field investigations to characterize the descriptive epidemiology of laboratory-confirmed cases of avian influenza A (H7N9) virus infection in humans reported to the Chinese Center for Disease Control and Prevention (China CDC) as of April 17, 2013. In this report, we summarize the preliminary findings of case investigations and follow-up monitoring of close contacts of persons with confirmed cases of H7N9 virus infection who have been identified to date. This is an ongoing investigation.
New From the GAO
New GAO Reports
Source: Government Accountability Office
INFLUENZA
Progress Made in Responding to Seasonal and Pandemic Outbreaks
GAO-13-374T, Feb 13, 2013
U.S. POSTAL SERVICE
Urgent Action Needed to Achieve Financial Sustainability
GAO-13-347T, Feb 13, 2013
VA HEALTH CARE
Reported Outpatient Medical Appointment Wait Times Are Unreliable
GAO-13-363T, Feb 13, 2013
CDC — Situation Update: Summary of Weekly FluView
Situation Update: Summary of Weekly FluView
Source: Centers for Disease Control and Prevention
The United States is having an early flu season with most of the country now experiencing high levels of influenza-like-illness (ILI). In this week’s FluView report, some key flu activity indicators continued to rise, while others fell. It’s too soon to say exactly what this means; but some regions may have peaked, while other parts of the country are still on the upswing. This FluView update contains data for the week between December 30, 2012 and January 5, 2013.
Below is a summary of the key indicators:
- The proportion of people seeing their health care provider for influenza-like illness (ILI) decreased from 6.0% to 4.3% for the week ending in January 5, but remains above the national baseline for the fifth consecutive week.
- Twenty-four states and New York City are now reporting high ILI activity. Last week 29 states reported high ILI activity. Additionally, 16 are reporting moderate levels of ILI activity; an increase from 9 states in the prior week. States reporting high ILI activity for the week ending January 5, 2013 include Alabama, Colorado, Delaware, Georgia, Illinois, Iowa, Kansas, Louisiana, Michigan, Minnesota, Mississippi, Missouri, New Jersey, New Mexico, North Carolina, North Dakota, Oklahoma, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Virginia, and West Virginia.
- Forty-seven states reported widespread geographic influenza activity for the week between December 30, 2012 and January 5, 2013. This is an increase from 41 states in the previous week. Geographic Spread data are based on assessments made by each state health department and show how many areas within a state or territory are seeing flu activity. The assessments made by each state health department are based on the detection of outbreaks of flu, increases in the percent of people visiting the doctor with flu-like symptoms, and patients with laboratory-confirmed influenza.
- Since October 1, 2012, 3,710 laboratory-confirmed influenza-associated hospitalizations have been reported; an increase of 1,443 hospitalizations from the previous week. This translates to a rate of 13.3 influenza-associated hospitalizations per 100,000 people in the United States.
The Compelling Need for Game-Changing Influenza Vaccines: An Analysis of the Influenza Vaccine Enterprise and Recommendations for the Future
Source: Center for Infectious Disease Research and Policy, University of Minnesota
Influenza vaccine was first recommended for use in US military personnel in 1945. The Advisory Committee on Immunization Practices (ACIP) thereafter made a number of incremental changes to the annual influenza vaccine recommendations, leading to recommended coverage for an ever-increasing proportion of the US population. In 2010 the ACIP recommended the first national universal seasonal influenza vaccination for all persons 6 months old and older. With the vast majority of Americans now recommended for vaccination, the public health benefits of the current influenza vaccination strategy have largely been maximized.
Current hemagglutinin (HA)-head antigen influenza vaccines, regardless of the platform in which they are manufactured, are inadequate to provide robust clinical protection across multiple strains or long-term protection. Evidence for consistent high-level protection is elusive for the present generation of vaccines, especially in individuals at risk of medical complications or those 65 years old or older. The ongoing public health burden caused by seasonal influenza and the potential global effect of a severe pandemic create an urgent need for a new generation of highly effective and cross-protective vaccines that can be manufactured rapidly. A universal vaccine should be the goal, with a novel-antigen game-changing vaccine the minimum requirement.
Influenza Vaccination Coverage Among Health-Care Personnel — 2011–12 Influenza Season, United States
Influenza Vaccination Coverage Among Health-Care Personnel — 2011–12 Influenza Season, United States
Source: Morbidity and Mortality Weekly Report (CDC)
Influenza vaccination of health-care personnel (HCP) is recommended by the Advisory Committee on Immunization Practices (ACIP) (1). Vaccination of HCP can reduce morbidity and mortality from influenza and its potentially serious consequences among HCP, their family members, and their patients (1–3). To provide timely estimates of influenza vaccination coverage and related data among HCP for the 2011–12 influenza season, CDC conducted an Internet panel survey with 2,348 HCP during April 2–20, 2012. This report summarizes the results of that survey, which found that, overall, 66.9% of HCP reported having had an influenza vaccination for the 2011–12 season. By occupation, vaccination coverage was 85.6% among physicians, 77.9% among nurses, and 62.8% among all other HCP participating in the survey. Vaccination coverage was 76.9% among HCP working in hospitals, 67.7% among those in physician offices, and 52.4% among those in long-term care facilities (LTCFs). Among HCP working in hospitals that required influenza vaccination, coverage was 95.2%; among HCP in hospitals not requiring vaccination, coverage was 68.2%. Widespread implementation of comprehensive HCP influenza vaccination strategies is needed, particularly among those who are not physicians or nurses and who work in LTCFs, to increase HCP vaccination coverage and minimize the risk for medical-care–acquired influenza illnesses.
See also: Influenza Vaccination Coverage Among Pregnant Women — 2011–12 Influenza Season, United States
Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Pra ctices (ACIP) — United States, 2012–13 Influenza Season
Source: Morbidity and Mortality Weekly Report (CDC)
In 2010, the Advisory Committee on Immunization Practices (ACIP) first recommended annual influenza vaccination for all persons aged ≥6 months in the United States (1). Annual influenza vaccination of all persons aged ≥6 months continues to be recommended. This document 1) describes influenza vaccine virus strains included in the U.S. seasonal influenza vaccine for 2012–13; 2) provides guidance for the use of influenza vaccines during the 2012–13 season, including an updated vaccination schedule for children aged 6 months through 8 years and a description of available vaccine products and indications; 3) discusses febrile seizures associated with administration of influenza and 13-valent pneumococcal conjugate (PCV-13) vaccines; 4) provides vaccination recommendations for persons with a history of egg allergy; and 5) discusses the development of quadrivalent influenza vaccines for use in future influenza seasons. Information regarding issues related to influenza vaccination that are not addressed in this update is available in CDC’s Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010 and associated updates (1,2).
New From the GAO
New GAO Reports and Testimony
Source: Government Accountability Office
+ Reports
1. Influenza Pandemic: Agencies Report Progress in Plans to Protect Federal Workers but Oversight Could Be Improved. GAO-12-748, July 25.
http://www.gao.gov/products/GAO-12-748
Highlights – http://www.gao.gov/assets/600/592990.pdf
2. Medicare: CMS Needs an Approach and a Reliable Cost Estimate for Removing Social Security Numbers from Medicare Cards. GAO-12-831, August 1.
http://www.gao.gov/products/GAO-12-831
Highlights – http://www.gao.gov/assets/600/593216.pdf
3. Medicaid Expansion: States’ Implementation of the Patient Protection and Affordable Care Act. GAO-12-821, August 1.
http://www.gao.gov/products/GAO-12-821
4. Counter-Improvised Explosive Devices: Multiple DOD Organizations are Developing Numerous Initiatives. GAO-12-861R, August 1.
http://www.gao.gov/products/GAO-12-861R
5. Service-Disabled Veteran-Owned Small Business Program: Vulnerability to Fraud and Abuse Remains. GAO-12-697, August 1.
http://www.gao.gov/products/GAO-12-697
Highlights – http://www.gao.gov/assets/600/593237.pdf
6. Contingency Contracting: Agency Actions to Address Recommendations by the Commission on Wartime Contracting in Iraq and Afghanistan. GAO-12-854R, August 1.
http://www.gao.gov/products/GAO-12-854R
7. Ensuring Drug Quality in Global Health Programs. GAO-12-897R, August 1.
http://www.gao.gov/products/GAO-12-897R
+ Related Product
Survey on States’ Implementation of the Patient Protection and Affordable Care Act (GAO-12-944SP, August 2012), an E-supplement to GAO-12-821. GAO-12-944SP, August 1.
http://www.gao.gov/products/GAO-12-944SP
+ Testimony
1. Medicare: Action Needed to Remove Social Security Numbers from Medicare Cards, by Kathleen M. King, director, health care, and Daniel Bertoni, director, education, workforce, and income security issues, before the Subcommittees on Social Security and Health, House Committee on Ways and Means GAO-12-949T, August 1.
http://www.gao.gov/products/GAO-12-949T
Annual economic impacts of seasonal influenza on US counties: Spatial heterogeneity and patterns
Annual economic impacts of seasonal influenza on US counties: Spatial heterogeneity and patterns
Source: International Journal of Health Geographics
This research computed annual economic costs of seasonal influenza for 3,143 US counties based on Census 2010, identified inherent spatial patterns, and investigated cost-benefits of vaccination strategies. The computing model modified existing methods for national level estimation, and further emphasized spatial variations between counties, in terms of population size, age structure, influenza activity, and income level. Upon such a model, four vaccination strategies that prioritize different types of counties were simulated and their net returns were examined. The results indicate that the annual economic costs of influenza varied from $13.9 thousand to $957.5 million among US counties, with a median of $2.47 million. Prioritizing vaccines to counties with high influenza attack rates produces the lowest influenza cases and highest net returns. This research fills the current knowledge gap by downscaling the estimation to the county level, and adds spatial variability into studies of influenza economics and interventions. Compared to the national estimates, the presented statistics and maps will offer detailed guidance for state and local health agencies to fight against influenza.
+ Full Paper (PDF)
The Flu, the Common Cold, and Complementary Health Practices
The Flu, the Common Cold, and Complementary Health Practices
Source: National Center for Complementary and Alternative Medicine
Each year, approximately 5 to 20 percent of Americans come down with the flu. Although most recover without incident, flu-related complications result in more than 200,000 hospitalizations and between 3,000 and 49,000 deaths each year. Colds generally do not cause serious complications, but they are among the leading reasons for visiting a doctor and for missing school or work.
To prevent or treat these illnesses, some people turn to complementary health practices such as herbs or vitamins and minerals. This issue provides information on “what the science says” about some of these practices for the flu and for the common cold, including zinc, vitamin C, echinacea, and probiotics.
Adaptations of Avian Flu Virus Are a Cause for Concern
Adaptations of Avian Flu Virus Are a Cause for ConcernSource: U.S. National Science Advisory Board for Biosecurity (via Science)
Risk assessment of public harm is challenging because it necessitates consideration of the intent and capability of those who wish to do harm, as well as the vulnerability of the public and the status of public health preparedness for both deliberate and accidental events. We found the potential risk of public harm to be of unusually high magnitude. In formulating our recommendations to the government, scientific journals, and the broader scientific community, we tried to balance the great risks against the benefits that could come from making the details of this research known. Because the NSABB found that there was significant potential for harm in fully publishing these results and that the harm exceeded the benefits of publication, we therefore recommended that the work not be fully communicated in an open forum. The NSABB was unanimous that communication of the results in the two manuscripts it reviewed should be greatly limited in terms of the experimental details and results. This is an unprecedented recommendation for work in the mammal-adapted influenza A/H5N1 viruses for harmful purposes. We believe that as scientists and as members of the general public, we have a primary responsibility “to do no harm” as well as to act prudently and with some humility as we consider the immense power of the life sciences to create microbes with novel and unusually consequential properties. At the same time, we acknowledge that there are clear benefits to be realized for the public good in alerting humanity of this potential threat and in pursuing those aspects of this work that will allow greater preparedness and the potential development of novel strategies leading to future disease control. By recommending that the basic result be communicated without methods or details, we believe that the benefits to society are maximized and the risks minimized.
Although scientists pride themselves on the creation of scientific literature that defines careful methodology that would allow other scientists to replicate experiments, we do not believe that widespread dissemination of the methodology in this case is a responsible action. life sciences, and our analysis was conducted with careful consideration both of the potential benefits of publication and of the potential harm that could occur from such a precedent. Our concern is that publishing these experiments in detail would provide information to some person, organization, or government that would help them to develop similar mammal-adapted influenza A/H5N1 viruses for harmful purposes. We believe that as scientists and as members of the general public, we have a primary responsibility “to do no harm” as well as to act prudently and with some humility as we consider the immense power of the life sciences to create microbes with novel and unusually consequential properties. At the same time, we acknowledge that there are clear benefits to be realized for the public good in alerting humanity of this potential threat and in pursuing those aspects of this work that will allow greater preparedness and the potential development of novel strategies leading to future disease control. By recommending that the basic result be communicated without methods or details, we believe that the benefits to society are maximized and the risks minimized. Although scientists pride themselves on the creation of scientific literature that defines careful methodology that would allow other scientists to replicate experiments, we do not believe that widespread dissemination of the methodology in this case is a responsible action.
The El Niño–Southern Oscillation (ENSO)–pandemic Influenza connection: Coincident or causal?
The El Niño–Southern Oscillation (ENSO)–pandemic Influenza connection: Coincident or causal? (PDF)
Source: Proceedings of the National Academy of Sciences
From press release (Columbia University Mailman School of Public Health):
Worldwide pandemics of influenza caused widespread death and illness in 1918, 1957, 1968, and 2009. A new study examining weather patterns around the time of these pandemics finds that each of them was preceded by La Niña conditions in the equatorial Pacific. The study’s authors–Jeffrey Shaman of Columbia University’s Mailman School of Public Health and Marc Lipsitch of the Harvard School of Public Health—note that the La Niña pattern is known to alter the migratory patterns of birds, which are thought to be a primary reservoir of human influenza. The scientists theorize that altered migration patterns promote the development of dangerous new strains of influenza.
Influenza-Associated Pediatric Deaths — United States, September 2010–August 2011
Influenza-Associated Pediatric Deaths — United States, September 2010–August 2011
Source: Morbidity and Mortality Weekly Report (CDC)
Influenza-associated pediatric mortality has been a nationally notifiable condition since October 2004. This report summarizes the 115 cases of influenza-associated pediatric mortality reported to CDC that occurred from September 1, 2010, through August 31, 2011. Deaths occurred in 33 states. Nearly half of the deaths (46%) occurred in children aged <5 years. Of the children who died, 49% had no known Advisory Committee on Immunization Practices (ACIP)–defined* high-risk medical conditions, and 35% died at home or in the emergency department. Of the 74 children aged ≥6 months for whom vaccination data were available, 17 (23%) had been fully vaccinated. ACIP recommends that all children aged ≥6 months receive vaccination against influenza annually (1,2). These findings underscore the importance of vaccinating children to prevent influenza virus infection and its potentially severe complications. Health-care providers should develop a comprehensive strategy to increase vaccination coverage among children.
Influenza Vaccination Coverage Among Health-Care Personnel — United States, 2010–11 Influenza Season
Influenza Vaccination Coverage Among Health-Care Personnel — United States, 2010–11 Influenza Season
Source: Morbidity and Mortality Weekly Report (CDC)
The Advisory Committee on Immunization Practices (ACIP) and the Healthcare Infection Control Practices Advisory Committee recommend that all U.S. health-care personnel (HCP) be vaccinated annually against influenza (1). Nonetheless, influenza vaccination coverage among HCP in the United States has increased slowly over the past decade (2,3); during the 2009–10 influenza season, 61.9% of HCP received seasonal influenza vaccination (4). To update data with estimates from the 2010–11 influenza season, CDC conducted an Internet-based survey of 1,931 HCP who participated in three online survey panels. This report summarizes the results of that survey, which indicated that overall influenza vaccination coverage among HCP was 63.5% during the 2010–11 influenza season, similar to coverage for the 2009–10 season. Among HCP who reported working at a facility where vaccination was required by their employer, 98.1% were vaccinated. Among HCP without such an employer requirement but who were offered vaccination onsite, greater coverage was associated with a personal reminder from the employer to get vaccinated (69.9%), vaccination availability at no cost (67.9%), and vaccination availability for >1 day (68.8%). Influenza vaccination of HCP is needed to protect patients from HCP-transmitted disease. Maximizing influenza vaccination for all HCP is an important part of any comprehensive infection-control program.
See also: Influenza Vaccination Coverage Among Pregnant Women — United States, 2010–11 Influenza Season
Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2011
Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2011
Source: Morbidity and Mortality Weekly Report (CDC)
This document provides updated guidance for the use of influenza vaccines in the United States for the 2011–12 influenza season. In 2010, the Advisory Committee on Immunization Practices (ACIP) first recommended annual influenza vaccination for all persons aged ≥6 months in the United States (1,2). Vaccination of all persons aged ≥6 months continues to be recommended. Information is presented in this report regarding vaccine strains for the 2011–12 influenza season, the vaccination schedule for children aged 6 months through 8 years, and considerations regarding vaccination of persons with egg allergy. Availability of a new Food and Drug Administration (FDA)–approved intradermally administered influenza vaccine formulation for adults aged 18 through 64 years is reported. For issues related to influenza vaccination that are not addressed in this update, refer to the 2010 ACIP statement on prevention and control of influenza with vaccines and associated updates (1,2).
Methodology for the formulation of the ACIP annual influenza statement has been described previously (1). The ACIP Influenza Work Group meets every 2–4 weeks throughout the year. Work Group membership includes several voting members of the ACIP, as well as representatives from ACIP Liaison Organizations. Meetings are held by teleconference and include discussion of influenza-related issues, such as vaccine effectiveness and safety, coverage in groups recommended for vaccination, feasibility, cost-effectiveness, and anticipated vaccine supply. Presentations are requested from invited experts, and published and unpublished data are discussed. CDC’s Influenza Division provides influenza surveillance and antiviral resistance data, and the Immunization Safety Office and Immunization Services Division provide information on vaccine safety and distribution and coverage, respectively.
Using implementation intentions prompts to enhance influenza vaccination rates
Using implementation intentions prompts to enhance influenza vaccination rates (PDF)
Source: Proceedings of the National Academy of Sciences
We evaluate the results of a field experiment designed to measure the effect of prompts to form implementation intentions on realized behavioral outcomes. The outcome of interest is influenza vaccination receipt at free on-site clinics offered by a large firm to its employees. All employees eligible for study participation received reminder mailings that listed the times and locations of the relevant vaccination clinics. Mailings to employees randomly assigned to the treatment conditions additionally included a prompt to write down either (i) the date the employee planned to be vaccinated or (ii) the date and time the employee planned to be vaccinated. Vaccination rates increased when these implementation intentions prompts were included in the mailing. The vaccination rate among control condition employees was 33.1%. Employees who received the prompt to write down just a date had a vaccination rate 1.5 percentage points higher than the control group, a difference that is not statistically significant. Employees who received the more specific prompt to write down both a date and a time had a 4.2 percentage point higher vaccination rate, a difference that is both statistically significant and of meaningful magnitude.
Guidance on the release of information concerning deaths, epidemics or emerging diseases
Guidance on the release of information concerning deaths, epidemics or emerging diseases
Source: Association of Health Care Journalists
A set of recommendations emerged from a meeting of public health officials, health care journalists and public health information officers, co-sponsored by the Association of State and Territorial Health Officials, the National Association of County and City Health Officials and the Association of Health Care Journalists in October 2010. A draft was circulated to ASTHO members, NACCHO and the AHCJ board, and their comments were incorporated.
The meeting was prompted by the wide variation in information released by state and local public health officials about people in their localities who died in the H1N1 pandemic of 2009. The disparate approaches – with some jurisdictions releasing specific information about the age, gender and residence of victims and others releasing little or no personal information – became the subject of news reports, distracting from health messages and inadvertently undermining public trust.
Below are voluntary guidelines for journalists and public health officials to consult when decisions must be made about what information should be released about deaths, epidemics, emerging diseases or illnesses. These guidelines are deliberately flexible so they can be adapted to each case, local circumstances and local regulations. At the same time, the groups agreed that a common set of information should, with rare exceptions, be released in these situations.A unique aspect of this process was that journalists were involved in developing the guidelines and agreed to promulgate ethical standards, calling on their peers to respect privacy and attend to context.
FDA approves vaccines for the 2011-2012 influenza season
FDA approves vaccines for the 2011-2012 influenza season
Source: U.S. Food and Drug Administration
The U.S. Food and Drug Administration announced today that it has approved the 2011-2012 influenza vaccine formulation for all six manufacturers licensed to produce and distribute influenza vaccine for the United States.
Vaccination remains the cornerstone of preventing influenza, a contagious respiratory disease caused by influenza viruses. The vaccine formulation protects against the three virus strains that surveillance indicates will be most common during the upcoming season and includes the same virus strains used for the 2010-2011 influenza season.
On average, between 5 percent and 20 percent of the U.S. population develops influenza each year, leading to more than 200,000 hospitalizations from related complications, according to the U.S. Centers for Disease Control and Prevention (CDC). Influenza-related deaths vary yearly, ranging from a low of about 3,000 to a high of 49,000 people.
Risk Factors for Severe Outcomes following 2009 Influenza A (H1N1) Infection: A Global Pooled Analysis
Risk Factors for Severe Outcomes following 2009 Influenza A (H1N1) Infection: A Global Pooled Analysis
Source: PLoS Medicine
What Did the Researchers Do and Find?
As part of routine surveillance, countries were asked to provide risk factor data on laboratory-confirmed H1N1 in patients who were admitted to hospital, admitted to the intensive care unit (ICU), or had died because of their infection, using a standardized format. The researchers grouped potential risk conditions into four categories: age, chronic medical illnesses, pregnancy (by trimester), and other conditions that were not previously considered as risk conditions for severe influenza outcomes, such as obesity. For each risk factor (except pregnancy), the researchers calculated the percentage of each group of patients using the total number of cases reported in each severity category (hospitalization, admission to ICU, and death). To evaluate the risk associated with pregnancy, the researchers used the ratio of pregnant women to all women of childbearing age (age 15–49 years) at each level of severity to describe the differences between levels.The researchers were able to collect data on approximately 70,000 patients requiring hospitalization, 9,700 patients admitted to the ICU, and 2,500 patients who died from H1N1 infection. The proportion of patients with H1N1 with one or more reported chronic conditions increased with severity—the median was 31.1% of hospitalized patients, 52.3% of patients admitted to the ICU, and 61.8% of patients who died. For all levels of severity, pregnant women in their third trimester consistently accounted for the majority of the total of pregnant women. The proportion of patients with obesity increased with increasing disease severity—median of 6% of hospitalized patients, 11.3% of patients admitted to the ICU, and 12.0% of all deaths from H1N1.
What Do These Findings Mean?
These findings show that risk factors for severe H1N1 infection are similar to those for seasonal influenza, with some notable differences: a substantial proportion of people with severe and fatal cases of H1N1 had pre-existing chronic illness, which indicates that the presence of chronic illness increases the likelihood of death. Cardiac disease, chronic respiratory disease, and diabetes are important risk factors for severe disease that will be especially relevant for countries with high rates of these illnesses. Approximately 2/3 of hospitalized people and 40% of people who died from H1N1 infection did not have any identified pre-existing chronic illness, but this study was not able to comprehensively assess how many of these cases had other risk factors, such as pregnancy, obesity, smoking, and alcohol misuse. Because of large differences between countries, the role of risk factors such as obesity and pregnancy need further study—although there is sufficient evidence to support vaccination and early intervention for pregnant women. Overall, the findings of this study reinforce the need to identify and target high-risk groups for interventions such as immunization, early medical advice, and use of antiviral medications.
See also: Predicting the Epidemic Sizes of Influenza A/H1N1, A/H3N2, and B: A Statistical Method
New From the GAO
New GAO Reports and Correspondence (PDFs)
Source: Government Accountability Office
+ Reports
1. Influenza Pandemic: Lessons from the H1N1 Pandemic Should Be Incorporated into Future Planning. GAO-11-632, June 27.
http://www.gao.gov/products/GAO-11-632
Highlights - http://www.gao.gov/highlights/d11632high.pdf
2. Influenza Vaccine: Federal Investments in Alternative Technologies and Challenges to Development and Licensure. GAO-11-435, June 27.
http://www.gao.gov/products/GAO-11-435
Highlights - http://www.gao.gov/highlights/d11435high.pdf
+ Correspondence
1. Military Buildup on Guam: Costs and Challenges in Meeting Construction Timelines. GAO-11-459R, June 27.
http://www.gao.gov/products/GAO-11-459R
Place of Influenza Vaccination Among Adults — United States, 2010–11 Influenza Season
Place of Influenza Vaccination Among Adults — United States, 2010–11 Influenza Season
Source: Morbidity and Mortality Weekly Report (CDC)
The 2010–11 influenza season was the first season after the 2009 influenza A (H1N1) pandemic and the first season that the Advisory Committee on Immunization Practices (ACIP) recommended influenza vaccination for all persons aged ≥6 months (1). During the pandemic, many new partnerships between public health agencies and medical and nonmedical vaccination providers were formed, increasing the number of vaccination providers (2). To provide a baseline for places where adults received influenza vaccination since the new ACIP recommendation and to help vaccination providers plan for the 2011–12 influenza season, CDC analyzed information from 46 states and the District of Columbia (DC) on influenza vaccination of adults aged ≥18 years for the 2010–11 season, collected during January–March 2011 by the Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of that analysis, which found that, for adults overall, a doctor’s office was the most common place (39.8%) for receipt of the 2010–11 influenza vaccine, with stores (e.g., supermarkets or drug stores) (18.4%) and workplaces (17.4%) the next most common. For those aged 18–49 years and 50–64 years, a workplace was the second most common place of vaccination (25.7% and 21.1%, respectively). Persons aged ≥65 years who were not vaccinated at a doctor’s office were most likely (24.3%) to have been vaccinated at a store. The results indicate that both medical and nonmedical settings are common places for adults to receive influenza vaccinations, that a doctor’s office is the most important medical setting, and that workplaces and stores are important nonmedical settings.
