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From the Centers for Disease Control and Prevention
November 10, 2004

Interim Influenza Vaccination Recommendations, 2004-05 Influenza Season

JAMA. 2004;292(18):2206. doi:10.1001/jama.292.18.2206-a

MMWR. 2004;53:923-924

On October 5, this report was posted as an MMWR Dispatch on the MMWR website (http://www.cdc.gov/mmwr).

On October 5, 2004, CDC was notified by Chiron Corporation that none of its influenza vaccine (Fluvirin®) would be available for distribution in the United States for the 2004-05 influenza season. The company indicated that the Medicines and Healthcare Products Regulatory Agency (MHRA) in the United Kingdom, where Chiron’s Fluvirin vaccine is produced, has suspended the company’s license to manufacture Fluvirin vaccine in its Liverpool facility for 3 months, preventing any release of the vaccine for this influenza season. This action will reduce by approximately one half the expected supply of trivalent inactivated vaccine (flu shot) available in the United States for the 2004-05 influenza season.

The remaining supply of influenza vaccine expected to be available in the United States this season is approximately 54 million doses of Fluzone® (inactivated flu shot) manufactured by Aventis Pasteur, Inc. Of these doses, approximately 30 million doses already have been distributed by the manufacturer. In addition, approximately 1.1 million doses of live attenuated influenza vaccine (LAIV/FluMist®) manufactured by MedImmune will be available this season.

Because of this urgent situation, CDC, in coordination with its Advisory Committee for Immunization Practices (ACIP), is issuing interim recommendations for influenza vaccination during the 2004-05 season. These interim recommendations were formally recommended by ACIP on October 5 and take precedence over earlier recommendations.

Priority Groups for Influenza Vaccination

The following priority groups for vaccination with inactivated influenza vaccine this season are considered to be of equal importance and are:

  • all children aged 6-23 months;

  • adults aged ≥65 years;

  • persons aged 2-64 years with underlying chronic medical conditions;

  • all women who will be pregnant during the influenza season;

  • residents of nursing homes and long-term care facilities;

  • children aged 6 months—18 years on chronic aspirin therapy;

  • health-care workers involved in direct patient care; and

  • out-of-home caregivers and household contacts of children aged <6 months.

Other Vaccination Recommendations

  • Persons in priority groups identified above should be encouraged to search locally for vaccine if their regular health-care provider does not have vaccine available.

  • Intranasally administered, live, attenuated influenza vaccine, if available, should be encouraged for healthy persons who are aged 5-49 years and are not pregnant, including health-care workers (except those who care for severely immunocompromised patients in special care units) and persons caring for children aged <6 months.

  • Certain children aged <9 years require 2 doses of vaccine if they have not previously been vaccinated. All children at high risk for complications from influenza, including those aged 6-23 months, who are brought for vaccination, should be vaccinated with a first or second dose, depending on vaccination status. However, doses should not be held in reserve to ensure that 2 doses will be available. Instead, available vaccine should be used to vaccinate persons in priority groups on a first-come, first-serve basis.

Vaccination of Persons in Nonpriority Groups

Persons who are not included in one of the priority groups described above should be informed about the urgent vaccine supply situation and asked to forego or defer vaccination.

Persons Who Should Not Receive Influenza Vaccine

Persons in the following groups should not receive influenza vaccine before talking with their doctor:

  • persons with a severe allergy (i.e., anaphylactic allergic reaction) to hens’ eggs and

  • persons who previously had onset of Guillain-Barré syndrome during the 6 weeks after receiving influenza vaccine.

Additional information is available at http://www.cdc.gov/flu or through the CDC public response hotline, telephone 888-246-2675 (English), 888-246-2857 (Español), or 866-874-2646 (TTY).

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