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August 31, 2010 ? Physicians should no longer delay vaccinating elderly patients against seasonal influenza until October or November, but instead encourage all patients aged 6 months and older to get immunized as soon as vaccine is available in their community, an official with the US Centers for Disease Control and Prevention (CDC) said yesterday.
Medical epidemiologist Carolyn Bridges, MD, associate director for science in the agency's influenza division, said during a nationwide telephone conference call with clinicians that contrary to past CDC guidance, seasonal influenza vaccine offers effective protection throughout the entire influenza season, even for the elderly.
The rationale for waiting until later in the influenza season to immunize elderly patients was that earlier vaccination might give them less protection in January and February, when most infections have occurred during recent seasons. Maximizing protection is important, as aging decreases the body's immune response to the influenza vaccine.
The protection offered by the vaccine begins to wane after 1 year, but until then, it works just fine, said Dr. Bridges.
"We used to recommend holding off on vaccination, particularly for the elderly and nursing home residents, but really, there's no evidence that waiting until October or November is beneficial at all in terms of effectiveness," said Dr. Bridges. "So in the last few years, we've changed the recommendation. There is no need to hold off on vaccinating high-risk patients."
Distribution of the 2010 to 2011 seasonal influenza vaccine, which contains a strain of last year's pandemic H1N1 virus, is now underway, with supplies showing up in commercial pharmacies. Dr. Bridges said vaccine manufacturers will turn out 160 million doses this season, which is "plenty of vaccine for everyone who wants to be vaccinated."
This quantity is larger than what is normally available, but more is needed in light of the CDC's recommendation this year of universal vaccination for everyone aged 6 months and older, said Howard Koh, MD, assistant secretary of the US Department of Health and Human Services, during the conference call.
Elderly Patients Can Receive High-Dose Vaccine
Although the CDC touts the ability of influenza vaccine to protect all patients during the influenza season, no matter when they receive it, the agency has also addressed the specific vaccination needs of the elderly.
One vaccine available for the 2010 to 2011 season is Fluzone High Dose, an injectable vaccine indicated for people aged 65 years and older that contains 4 times the amount of antigen found in a regular shot. The extra antigen is meant to trigger a stronger immune response in elderly patients. The vaccine is manufactured by Sanofi Pasteur, the vaccine division of Sanofi-Aventis Group.
Physicians are free to immunize elderly patients with either a regular dose of vaccine or the high-dose product. The CDC and its Advisory Committee on Immunization Practices, however, are not expressing a preference for 1 vaccine over the other, according to the agency's Web site.
The CDC reports that in a clinical trial comparing Fluzone High Dose to Fluzone, which contains a normal dose of antigen, elderly patients experienced a stronger immune response with the high-dose version.
"Whether or not the improved immune response leads to greater protection against influenza infection is not yet known," the agency states. An ongoing study to answer that question should be completed in 2012.
Medical epidemiologist Carolyn Bridges, MD, associate director for science in the agency's influenza division, said during a nationwide telephone conference call with clinicians that contrary to past CDC guidance, seasonal influenza vaccine offers effective protection throughout the entire influenza season, even for the elderly.
The rationale for waiting until later in the influenza season to immunize elderly patients was that earlier vaccination might give them less protection in January and February, when most infections have occurred during recent seasons. Maximizing protection is important, as aging decreases the body's immune response to the influenza vaccine.
The protection offered by the vaccine begins to wane after 1 year, but until then, it works just fine, said Dr. Bridges.
"We used to recommend holding off on vaccination, particularly for the elderly and nursing home residents, but really, there's no evidence that waiting until October or November is beneficial at all in terms of effectiveness," said Dr. Bridges. "So in the last few years, we've changed the recommendation. There is no need to hold off on vaccinating high-risk patients."
Distribution of the 2010 to 2011 seasonal influenza vaccine, which contains a strain of last year's pandemic H1N1 virus, is now underway, with supplies showing up in commercial pharmacies. Dr. Bridges said vaccine manufacturers will turn out 160 million doses this season, which is "plenty of vaccine for everyone who wants to be vaccinated."
This quantity is larger than what is normally available, but more is needed in light of the CDC's recommendation this year of universal vaccination for everyone aged 6 months and older, said Howard Koh, MD, assistant secretary of the US Department of Health and Human Services, during the conference call.
Elderly Patients Can Receive High-Dose Vaccine
Although the CDC touts the ability of influenza vaccine to protect all patients during the influenza season, no matter when they receive it, the agency has also addressed the specific vaccination needs of the elderly.
One vaccine available for the 2010 to 2011 season is Fluzone High Dose, an injectable vaccine indicated for people aged 65 years and older that contains 4 times the amount of antigen found in a regular shot. The extra antigen is meant to trigger a stronger immune response in elderly patients. The vaccine is manufactured by Sanofi Pasteur, the vaccine division of Sanofi-Aventis Group.
Physicians are free to immunize elderly patients with either a regular dose of vaccine or the high-dose product. The CDC and its Advisory Committee on Immunization Practices, however, are not expressing a preference for 1 vaccine over the other, according to the agency's Web site.
The CDC reports that in a clinical trial comparing Fluzone High Dose to Fluzone, which contains a normal dose of antigen, elderly patients experienced a stronger immune response with the high-dose version.
"Whether or not the improved immune response leads to greater protection against influenza infection is not yet known," the agency states. An ongoing study to answer that question should be completed in 2012.
