Review and special articleStrengthening the Nation’s Influenza Vaccination System: A National Vaccine Advisory Committee Assessment
Introduction
Each year more Americans are vaccinated for influenza than for any other disease. Although vaccine shortages and delays have garnered much attention during the past several years, it is important to highlight the success of the program: Millions of people are vaccinated in a short time period each year; good collaboration exists between the public and private sectors, which have documented an ability to respond appropriately to vaccine supply problems and other events; and healthcare providers and the public have acted responsibly in targeting vaccines to those who need it most at times of shortage. Nevertheless, one cannot underestimate the importance and impacts of vaccine supply shortage, particularly that occurring for the 2004–2005 season. A sufficient and predictable vaccine supply is critical for a successful prevention effort.
Several interventions have been implemented to reduce the risk of disruptions to the future supply of vaccine, to strengthen influenza vaccine security, and to foster preparedness for an influenza pandemic. In 2004, the Acting Assistant Secretary for Health, Department of Health and Human Services (DHHS) requested that the National Vaccine Advisory Committee (NVAC) evaluate strategies and capabilities to improve influenza prevention efforts in the United States. An NVAC Influenza Vaccine Working Group evaluated both published and unpublished data and held discussions with stakeholders—including industry, public health officials, providers, purchasers, and consumers—to develop a set of recommendations. Based on the findings, the Working Group developed several recommendations that can be used to improve influenza prevention efforts in the United States. This report summarizes those recommendations.
Section snippets
Background
The Centers for Disease Control and Prevention (CDC) and its Advisory Committee on Immunization Practices (ACIP) recommend annual influenza vaccinations for people at increased risk of severe influenza infection, their close contacts, and all healthcare workers.1 Influenza vaccination uptake increased dramatically through the 1990s. However, since the late 1990s, of the 185 million people for whom the vaccination is recommended, only about 80 million are vaccinated in a typical influenza season.
Process
At the request of Cristina Beato, MD, the Acting Assistant Secretary for Health, NVAC established a working group to evaluate strategies to reduce the impact of influenza disease in the United States and to make recommendations on how to substantially improve the prevention of influenza and reduce disease burden. The working group was encouraged to ask challenging questions and consider new strategies, paradigms, infrastructures, and technologies as well as incremental changes that could be
Vaccine Financing and Demand
1. Improve vaccination coverage among recommended groups by facilitating the delivery of influenza vaccines in a range of settings, especially in “medical homes,” other medical sites, workplaces, and community sites where people have not previously had access to vaccination.
Rationale: Several barriers exist to achieving high rates of influenza vaccine coverage among recommended groups through vaccination at primary care provider offices.22, 23 While children commonly make routine age-based
Concluding Remarks
A wide range of influenza disease- and prevention-related research is being supported and conducted by multiple agencies in the public and private sectors. An influenza research program review that describes ongoing activities, defines key objectives, and also identifies gaps in the research portfolio is an important first step in strengthening the program and providing the techniques and tools that will improve the ability to prevent the most common and most deadly of all vaccine-preventable
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The Cost of Interventions to Increase Influenza Vaccination: A Systematic Review
2018, American Journal of Preventive MedicineCitation Excerpt :In this systematic review, the cost of implementing 23 diverse QI interventions designed to increase seasonal influenza vaccination rates among the general population and six among healthcare workers was examined. The interventions were generally aligned with recommendations by major health authorities12–16 and effective relative to the status quo. The median program cost per additional individual vaccinated was $50.78 for general populations and $125.24 among healthcare workers.
A qualitative study of physicians' experiences ordering and receiving influenza vaccine during the 2005-2006 influenza season
2008, Preventive MedicineCitation Excerpt :Our findings provide the first picture of the complex effects of vaccine supply and distribution problems on medical practices as reported by the physicians who staff them. In this study, physicians found communication to be inadequate, supporting reports of similar issues in previous years (Helms et al., 2005; Tan, 2006). Some physicians explained how poor communication made it difficult to plan influenza clinics, an important strategy for successful vaccination in primary care offices.
The annual impact of seasonal influenza in the US: Measuring disease burden and costs
2007, VaccineCitation Excerpt :Even among those that are vaccinated, some may not be adequately protected by the vaccine [49–51]. Consequently, new strategies such as vaccination of school-aged children or universal vaccination are being discussed as a means to decrease the burden in all ages and complications among the elderly [52–54]. Further research is necessary to identify the most efficient and effective methods of minimizing influenza disease in the elderly and its contribution to the annual economic burden of influenza epidemics in the United States.
Optimal regulatory control of early contract termination
2014, IMA Journal of Management MathematicsCost-effectiveness assessment of influenza control strategies
2014, IIE Annual Conference and Expo 2014
Address reprint requests to: Bruce G. Gellin, MD, MPH, Director, National Vaccine Program Office, Department of Health and Human Services, 200 Independence Avenue, SW, Room 725H, Washington DC 20201-0004