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Federal Officials To Expand List Of Who Should Get Flu Vaccine

By Rob Stein
Washington Post Staff Writer
Saturday, December 18, 2004; Page A02

Federal health officials, concerned that scarce flu vaccine may go unused, yesterday announced plans to relax the guidelines on who should receive shots after one last push to encourage Americans who are at highest risk from the flu to get vaccinated.

Beginning Jan. 3, people ages 50 to 64 and those in close contact with people at high risk should also be allowed to get the vaccine where enough vaccine is available, the federal Centers for Disease Control and Prevention said.

Gloria Last, 83, left, fills out forms for a flu shot in Plantation, Fla., as officials expressed concern that vaccine may go unused. (J. Albert Diaz -- Miami Herald Via AP)


Q. What is the flu?
A viral respiratory infection. Symptoms include headaches, dry cough, muscle aches and fatigue, and possible congestion, sore throat and fever.
spacer spacer Q. How do you treat the flu?
Rest, drink plenty of fluids and avoid alcohol and tobacco. Since the flu is a virus, antibiotics can't cure it.
spacer spacer Q. Who should get a flu vaccine?
People older than 65, children 6 to 23 months old, pregnant women and adults or children with chronic health conditions are at greater risk for severe illness.
From The Post: Flu Q & A
_____On the Web_____
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Centers for Disease Control and Prevention
Global Influenza Surveillance

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_____Avian Flu News_____
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More on Avian Flu
_____Avian Flu Facts_____

Q. What is avian flu?
Avian influenza is an infectious disease of birds caused by type A strains of the influenza virus. The disease, which was first identified in Italy more than 100 years ago, occurs worldwide.

Q. Is avian flu contagious?
Yes. All birds are thought to be susceptible to infection with avian influenza, though some species are more resistant to infection than others. The first documented infection of humans with an avian influenza virus occurred in Hong Kong in 1997, when the H5N1 strain caused severe respiratory disease in 18 humans, of whom 6 died.

Q. What are the symptoms of avian flu?
Published information on human infection is limited to studies of the 1997 Hong Kong outbreak. Symptoms included fever, sore throat, cough and, in several of the fatal cases, severe respiratory distress secondary to viral pneumonia.

Q. How do you treat avian flu?
The quarantining of infected farms and destruction of infected or potentially exposed flocks are standard control measures aimed at preventing spread to other farms and eventual establishment of the virus in a country’s poultry population.

Q. How can you protect yourself against avian flu?
Workers involved in the culling of poultry flocks must be protected, by proper clothing and equipment, against infection. These workers should also receive antiviral drugs as a prophylactic measure.

Q. How effective is the vaccine?
Vaccination of persons at high risk of exposure to infected poultry, using existing vaccines effective against currently circulating human influenza strains, can reduce the likelihood of co-infection of humans with avian and influenza strains.

WHO Fact Sheet
CDC: Avian Flu Information
Source: World Health Organization

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The move followed new recommendations from the Advisory Committee on Immunization Practices, which advises the agency. The panel also said that as of that date, state and local health officials who think they have enough vaccine to meet remaining demand from high-risk individuals should be free to offer it to any others they deem appropriate.

The CDC recommended in October that only those 65 and older, the chronically ill, health care workers, children younger than 2 and pregnant women get the shot because a manufacturing problem at a British vaccine factory had cut in half the expected supply of vaccine for American consumers.

To date, however, only about 34 percent of people in the high-risk groups have gotten vaccinated, raising concern that some vaccine may go unused despite the overall shortfall. That prompted the committee to consider revising the recommendations. Because flu vaccine has to be reformulated each year according to which strains of the virus become dominant, it cannot be saved from one year to the next.

"On the one hand, we don't want any to go to waste. On the other hand, we don't want to start using it all and have the high-risk [people] finally show up and not be able to get vaccine," said Myron J. Levin of the University of Colorado School of Medicine, who chaired the panel.

After two hours of discussion, the committee recommended that federal, state and local officials work between now and Jan. 3 to encourage all high-risk individuals to get vaccinated. A Harvard School of Public Health survey released this week found many had either decided to forgo the vaccine so there would be enough for others who need it more, or had tried and been unable to get the vaccine. That, coupled with the fact that the flu season has been mild so far, raised concern that there could be a rush for vaccine among high-risk people if the season intensifies. The flu season usually peaks in February.

"The season has been slow to develop, and so they might not have seen a demand yet. We're still afraid we'll run out of vaccine," Levin said. "The prime emphasis is to make sure the high-risk individuals get vaccinated. We're going to make another push on that, and following that, we want to broaden it to make sure the excess vaccine that exists in certain areas is well-utilized."

Vaccine availability varies around the nation, with some states reporting excess vaccine while others have shortages. The CDC has been working to direct vaccine to places with shortages and has been buying excess vaccine from other countries.

Several states with excess vaccine have already relaxed their guidelines for who should get vaccinated. But most of the jurisdictions, including Virginia, Maryland and the District, have been waiting to see whether the CDC would change its recommendations.

"In most communities, we're still targeting vaccine to the people in the highest priority groups," CDC Director Julie L. Gerberding said.

© 2004 The Washington Post Company


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