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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
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
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
all women who will be pregnant during the influenza
residents of nursing homes and long-term care facilities;
children aged 6 months—18 years on chronic
health-care workers involved in direct patient
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
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).
Interim Influenza Vaccination Recommendations, 2004-05 Influenza Season. JAMA. 2004;292(18):2206. doi:10.1001/jama.292.18.2206-a
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