Public, Physicians Paying More Attention to Flu Shots

Neil Osterweil

February 17, 2011

February 17, 2011 (Washington, DC) — The American public may be starting to take to heart messages about the importance of universal influenza vaccination, and the government is getting savvy about flogging the benefits of immunization, say US health officials convened here for a meeting of the National Vaccine Advisory Committee.

Hot on the heels of the 2009 H1N1 influenza pandemic and the adoption of a new standard calling for vaccination of all healthy people aged 6 months and older, vaccination rates among children appear to be on the rise compared with last year, according to Cindy Weinbaum, MD, associate director of immunization services at the Centers for Disease Control and Prevention in Atlanta, Georgia.

In addition, the increase in immunization rates over previous years among healthcare workers, pregnant women, and adults in general seen in the 2009/2010 season seem to be holding steady this season, Dr. Weinbaum said.

"Flu became a super-hot topic last year during the pandemic, but in any given year of course there's flu. It varies substantially from year to year and it's always difficult to predict its severity or its timing," she said.

Aggressive Marketing

This season, at least, the crystal ball gazers at the CDC and other health agencies appear to have gotten it right. A record 163 million doses were shipped to vaccinators this year, and manufacturers were able to keep pace with demand, with few — if any — glitches in manufacturing or shipping.

Part of the success of this year's efforts may be the result of more broadly targeted public health messages, including on social media sites, and of aggressive marketing on the part of national pharmacy chains such as Walgreens, Rite-Aid, and CVS, said Litjen Tan, PhD, director of medicine and public health for the American Medical Association.

Although some health officials had expressed concern that drugstore clinics could keep patients out of physicians' offices, current trends show that immunization seems to be on the rise both in the retail sector and in physicians' offices.

Surveys suggest that about 20% of adults get their influenza vaccinations at the workplace, and another 20% at grocery stories, big box stores, and pharmacies, Dr. Weinbaum said.

The new universal vaccination recommendation appears to have played a role in the increase in adult immunizations, Dr. Tan said, citing data from an American Medical Association survey in which nearly one third of physicians responding said they vaccinated more patients because of the recommendations.

Slightly more than two thirds of the respondents said their patients were at least somewhat familiar with the recommendations.

Room for Improvement

Worries about the efficacy and safety of influenza vaccines continue to be significant barriers to more widespread acceptance of seasonal immunization, Dr. Tan noted.

An obstetrician-gynecologist on the panel said that trend of vaccination among pregnant women was encouraging.

"The pregnancy numbers look incredibly good, but it could be better — it should be better," said Laura Riley, MD, medical director for labor and delivery at the Massachusetts General Hospital in Boston.

"It didn't take too many maternal deaths [in 2009 - 2010] to have women flying into the office looking into a vaccine, and I was a little concerned that that message was louder and more of a driver to vaccination than apparently it was. I think it's great that we were able to keep the vaccine numbers up as high this season, with obviously less morbidity," she said.

The Vaccine Safety Risk Assessment Working group, established in October 2009 to oversee safety data on the H1N1 vaccine, saw weak safety signals for 3 conditions possibly associated with the vaccine: thrombocytopenia/idiopathic thrombocytopenic purpura, Bell's palsy, and Gullian-Barré syndrome, reported committee chair Marie McCormick, MD, ScD, professor and chair of maternal and child health at the Harvard School of Public Health in Boston.

Further investigation showed no significant link with the vaccine and either thrombocytopenia/idiopathic thrombocytopenic purpura or Bell's palsy, and the group is currently reviewing charts to see whether the association with Guillain-Barré is real or a statistical phantom. If the risk were real, it would be on the order of 1/1,000,000 cases, Dr. McCormick said.

National Vaccine Advisory Committee Meeting. Presented February 16, 2011.

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