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December 1, 2004

Prioritizing Influenza Vaccination

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292(21):2577-2583. doi:10.1001/jama.292.21.2582-b

To the Editor: The sudden loss of half of the anticipated United States influenza vaccine supply raises the possibility of increased morbidity and mortality among persons in high-risk groups for the 2004-2005 season. Based on the 2002 National Health Interview Survey, the US Centers for Disease Control and Prevention (CDC) estimates that there are 98.2 million high-risk individuals in the United States, including 36 million people older than 65 years.1 To date, 30 million doses of vaccine have been distributed and another 28 million doses are anticipated, enough to vaccinate only 60% of all high-risk patients.2 Publicity surrounding the shortage has created demand even among lower-risk adults, further threatening the supply for those who need it most. Despite the CDC’s recommendation that all priority groups “are considered to be of equal importance,”2 the risk to individual patients within priority groups varies considerably depending on age and comorbid conditions. This study compared allocation of limited vaccine supply using a vaccine lottery strategy vs a targeted vaccination strategy in terms of the potential impact on hospitalizations and deaths resulting from an influenza epidemic.

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