National Influenza Immunization Week 2014
It's National Influenza Immunization Week, an observance sponsored every year by the CDC to highlight national immunization influenza vaccination recommendations. For the past several years, most people in the United States over 6 months of age have been recommended by the Advisory Committee on Immunization Practices to get the influenza vaccine.
This influenza season has already been eventful, not only in terms of morbidity and mortality, with five pediatric deaths reported, but also in terms of questions about influenza vaccination effectiveness. First, earlier this fall CDC announced a puzzling finding: in certain groups of children during the 2013-14 flu season, the live attenuated influenza vaccine was less effective against the circulating H1N1 virus than the inactivated vaccine. This finding was unexpected because the live vaccine has in other seasons provided superior protection than the inactivated vaccine. The manufacturer and CDC are considering a variety of hypotheses as to what might have led to inferiority, including a potential vulnerability with the H1N1 strain used in the vaccine that might be affected by storage temperatures. This CIDRAP report provides a useful overview of the situation.
Second, at a press conference on December 4, CDC director Tom Frieden announced that in about half of samples analyzed, the most common type of influenza vaccine circulating this season has acquired a mutation that will likely mean the vaccine will be less effective than expected. He still urged people to continue to get the vaccine and noted that the vaccine may provide some level of protection against severe disease from the mutated virus and will continue to be effective against the other strains included in the vaccine.
Before the news about the drifted influenza viruses broke, I interviewed Leonard Friedland, MD, of GSK about influenza immunization.* Dr. Friedland is Vice President/Director, Scientific Affairs & Public Health, North America Vaccines, GSK. He was formerly a practicing pediatrician at Children's Hospital Philadelphia.
Dr. Friedland described some of the opportunities we have to meet Healthy People 2020's ambitious influenza immunization goals, particularly among adolescents. This is a challenging group to immunize yearly because they don't see a doctor as often as younger children do. Venues for immunization are expanding outside the pediatrician's office, though, and so parents may find it easier to get the vaccine for their children, whether it's at school, at an urgent care clinic, or in some other setting. He also described some particularly important groups of children to target, such as those prone to more severe disease from influenza, such as very young children and those with underlying medical conditions. Children whose mothers are pregnant are another important group to reach because of the risk of serious disease during pregnancy.
A topic I'm especially interested in is the relative equality in influenza vaccination among children of different ethnic and racial groups compared with the wide disparity we see in influenza vaccine update in adults. In short, African American and Hispanic adults lag behind white adults in influenza vaccination. Dr. Friedland attributed this difference in large part to the influence of the federally funded Vaccines for Children program, which ensures that children from low-income families have access to the vaccine.
Below is the full interview with Dr. Friedland.
Later this week I'll publish an interview with the US Department of Health and Human Services Region 3 Administrator Dalton Paxman, PhD, about HHS influenza vaccination activities.
*GSK makes influenza vaccines and has provided History of Vaccines with independent educational grants.