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Health Experts Press Urgency in Flu Vaccinations
Senior citizens, others at high risk are priority for
vaccinations through October 24
Sept. 14, 2005 Government agencies and national
health associations came together today for a press conference at the
National Press Club to warn about the severity of influenza and
pneumonia and call for renewed efforts to increase vaccination rates
among senior citizens and others considered at high risk from these
vaccine-preventable diseases.
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Medicare/Medicaid Action |
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CMS Administrator Mark McClellan, MD, PhD,
stressed the importance of annual influenza vaccination for
Americans 65 years of age and older. Medicare Part B and
Medicaid cover both influenza and pneumococcal vaccines.
Dr. McClellan announced Medicare has
increased the amount of the payments for influenza and
pneumococcal vaccines as well as the administration fee.
Medicare will pay $24.57 per dose for the pneumococcal vaccine
this year, up from $23.28 in 2004. Payment for the influenza
vaccine also increases to $12.06, compared to $10.10 last
season. The administration fee for both vaccinations has risen
more than 100 percent this year from $8.21 in 2004 to $18.57 in
2005.
In another development, Dr. McClellan
provided an update on a new rule requiring nursing homes in the
U.S. to vaccinate all their patients against influenza and
pneumococcal disease to be eligible for Medicare and Medicaid
programming benefits.
"Many at-risk people are not getting the
vaccines they need," said Dr. McClellan. "If approved, this
proposed rule will go a long way toward ensuring the vaccination
of approximately 2 million nursing home residents in 18,000
nursing homes each year." |
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What was described as an urgent immunization
message was issued by experts from the American Academy of Pediatrics (AAP),
American Medical Association (AMA), Centers for Medicare & Medicaid
Services (CMS) and Centers for Disease Control and Prevention (CDC).
Officials from these groups joined a press conference held by the
National Foundation for Infectious Diseases (NFID) in partnership with
the National Influenza Vaccine Summit (NIVS) at the press club in
Washington, D.C.
"Everyone would benefit from an annual influenza
vaccination, but for many people, influenza vaccination is critical,"
said Julie L. Gerberding, MD, director, CDC.
"This year, to help ensure that people at highest
risk for serious complications are vaccinated, we're making them a
priority for the next six weeks. From now until October 24, we're
asking those who provide influenza vaccine to give the first available
doses to people in our priority groups and to health care providers who
have contact with patients or people in the priority groups. Getting
an influenza vaccine is the best way to protect yourself and your
patients against this disease," said Gerberding.
People who are at high priority for influenza
vaccination are: anyone age 65 years and older; people with chronic
health conditions, such as heart disease, diabetes, asthma, chronic
bronchitis or HIV; and children age 6 to 23 months old.
In addition, health care professionals and
household contacts or out-of-home caregivers of children less than 6
months of age should be vaccinated to prevent giving influenza to
vulnerable patients and children who are at high risk of complications.
Dr. Gerberding also said that while there is
heightened concern surrounding avian influenza outbreaks in Europe and
Asia, regular influenza seasons pose an immediate danger that result, on
average, in about 36,000 deaths and more than 200,000 hospitalizations
in this country each year.
Overall immunization rates among high-risk groups
have not increased in recent years, prompting health experts to call for
concerted efforts to ensure those at greatest risk for hospitalization
and death receive influenza vaccine this season.
For the past several years, immunization rates
among those age 65 years and older have been below 68 percent -- far
short of the Healthy People 2010 goal of 90 percent. Only one-third of
children with underlying medical conditions (e.g., asthma, diabetes) are
immunized against influenza annually -- the lowest vaccination rate for
any recommended childhood vaccine in the U.S. Moreover, the 34.2 percent
immunization rate among adults (18-64 years of age) with medical
conditions is substantially lower than the 2010 Healthy People Goal of
60 percent for this group. Coverage rates among health care workers were
no higher than 40 percent, further underscoring a call to action for
vaccination this season.
Health officials also urged vaccination against
pneumococcal disease for Americans 65 years of age and older and those
of any age with certain underlying medical condition. Pneumococcal
vaccination with the polysaccharide vaccine is appropriate at any time
of the year, and can be administered at the same time as the influenza
vaccine. Of the nearly 40,000 cases and more than 4,000 deaths from
invasive pneumococcal disease each year in the U.S., over half occur
among adults who are recommended to receive vaccination.
Immunization Rates Among Children With Asthma
Lowest of Any Childhood Vaccine
Despite long-standing recommendations to vaccinate
all children with underlying medical conditions, such as asthma and
diabetes, vaccination rates among these children have consistently
remained low. Nearly 70 percent of children with asthma do not receive
an influenza vaccine in a given year making this the lowest immunization
rate for any recommended childhood vaccine. According to the CDC, an
estimated nine million U.S. children younger than 18 years have been
diagnosed with asthma at some point in their lives.
"Immunization rates are alarmingly low among
children with asthma and other chronic medical conditions, putting them
at greater risk for serious influenza infection and its complications,"
said Henry H. Bernstein, DO, member of the Committee on Infectious
Diseases of the AAP. "Parents and providers need to make every effort in
getting high-risk older children and all children 6 through 23 months of
age vaccinated every year."
Last season, new vaccination recommendations for
all children 6 through 23 months resulted in a higher than expected 48
percent coverage rate for a new recommendation, yet it was far below the
Healthy People 2010 goal of 90 percent for routinely recommended
childhood vaccines. Studies show that children less than 2 years of age
who get influenza are hospitalized at rates similar to those seen in
adults age 65 years and older. In 2003, more than 150 influenza-related
deaths among children younger than 18 years of age were reported to the
CDC.
Dr. Bernstein further underscored the need for
vaccination of every household member and out-of-home caregiver who
comes into direct contact with children who have chronic medical
conditions and children younger than 24 months, to prevent the spread of
the influenza virus. In particular, vaccination is urged for parents,
older brothers and sisters, grandparents, babysitters and others in
contact with children 6 to 23 months and older children with medical
conditions, such as asthma or diabetes.
Improving Immunization Among Health
Professionals Important
Physicians, nurses and other health care
professionals play an important role in preventing influenza from
spreading by getting vaccinated. "The AMA encourages physicians to lead
by example and get vaccinated against influenza," said AMA Trustee Ardis
D. Hoven, M.D.
"Only about 40 percent of health care professionals
receive the flu vaccine, we need to raise that number to protect our
patients -- particularly those at risk of serious complications from
influenza," said Dr. Hoven. "Hospitals and nursing homes are high-risk
areas for acquiring influenza. We encourage health care facilities to
develop flu vaccination programs that measure and maximize vaccination
rates for health care professionals."
Studies show that vaccination of health care
professionals leads to fewer deaths among nursing home patients, and
also helps to increase vaccination rates among patients who seek a
health care professional's advice.
"For many patients, the advice of their physician
remains the tipping point toward healthy behaviors," said Dr. Hoven.
"Let's follow the advice we give our patients and prevent influenza
outbreaks by getting vaccinated."
Low Pneumococcal Vaccination Rates Signal Need
For Renewed Vaccination Efforts
"Low pneumococcal coverage rates leave too many
Americans vulnerable to invasive disease," said Cynthia G. Whitney, MD,
MPH, acting chief, Respiratory Diseases Branch, CDC. "Americans may not
realize the risk pneumococcal disease poses to patients 65 years and
older."
Dr. Whitney warned that with just 57 percent of
those 65 and older being vaccinated, the death rate could increase. The
Healthy People 2010 goal for pneumococcal vaccination coverage of those
age 65 and older is 90 percent.
Although anyone can contract pneumococcal disease,
some groups are at particularly high risk for the disease or its
complications, including persons age 65 years and older, those with
chronic illness or weakened immune systems and residents of chronic or
long-term care facilities.
Prioritization of Influenza Vaccine for the
2005-06 Season
The CDC has instituted prioritization of
inactivated (injectable) influenza vaccine as a temporary measure to
ensure that those persons who are at highest risk of complications from
influenza have access to vaccine. Until October 24, 2005, CDC recommends
the following priority groups receive the inactivated influenza vaccine:
all adults aged 65 years and older; residents of long-term care
facilities; adults and children with underlying medical conditions, such
as asthma and diabetes; children ages 6 through 23 months; pregnant
women; health care workers who provide direct patient care; and
household contacts and out-of-home caregivers of children less than 6
months of age.
Beginning October 24, 2005, all persons will be
eligible for vaccination with the inactivated influenza vaccine, which
can be administered to healthy and high-risk persons aged six months and
older.
These prioritized recommendations do not pertain to
the nasally administered vaccine, live attenuated influenza vaccine (LAIV),
which can be administered at any time for vaccination of non-pregnant
healthy persons aged 5-49 years, including most health care personnel
and persons in close contact with high-risk groups. In addition,
antiviral medications are useful for early treatment of influenza, as a
supplement to influenza vaccination for disease prevention and control.
Antiviral medication can also be used for prevention of influenza among
patients one year old and younger, specifically those at highest risk of
influenza who cannot get vaccinated.(1)
About the National Foundation for
Infectious Diseases and National Influenza Vaccine Summit
Founded in 1973, NFID is a
non-profit organization dedicated to public and professional educational
programs about the causes, treatment and prevention of infectious
diseases. The NIVS is co-sponsored by the AMA and the CDC, and is
comprised of organizations representing physicians, public health,
nurses, pharmacists, managed care and community providers.
This press conference was presented
in partnership with the National Influenza Vaccine Summit and supported,
in part, by unrestricted educational grants to the National Foundation
for Infectious Diseases by the Centers for Medicare & Medicaid Services,
Chiron Vaccines, GlaxoSmithKline, Henry Schein, Inc., ID Biomedical,
MedImmune Vaccines, Merck and Co., Inc., Roche and sanofi pasteur.
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