BOSTON — In the fall of 2005, the Tennessee Department of Health launched a campaign to vaccinate students in one county school system with a live attenuated intranasal influenza virus vaccine.
About 46% of the county's 24,281 students were vaccinated, and the campaign had widespread support from physicians in the area. However, some physicians may have been overly cautious in their advice to patients, according to results of a survey of more than 300 physicians in the county.
Rand Carpenter, D.V.M., of the Tennessee Department of Health, presented an analysis of the vaccination campaign at the annual meeting of the American Public Health Association.
As part of the campaign, donated live attenuated intranasal influenza virus vaccine was offered free to kindergarten through 12th -grade students and staff in the Knox County school system, which includes Knoxville, Tenn. The program lasted from October through December 2005. The live influenza virus vaccine was licensed in 2003 for use among healthy individuals aged 5–49 years.
All 598 pediatric and adult physicians in the county received surveys and about 56% responded (337 physicians). About 80% of those who responded were aware of the campaign (268 physicians). Of those who were aware of the campaign, 73% (196 physicians) gave advice to patients regarding the live influenza virus vaccine. Of those giving advice, about 94% (185 physicians) recommended participation for eligible patients.
However, state health officials noticed that some patients were confused by their physician's advice and that some of the information given by providers potentially limited the campaign's success, he said.
Physicians gave several reasons for advising patients against participating in the vaccination program. The most frequent reasons included having asthma, being immunocompromised or living with an immunocompromised household contact, having a chronic disease, egg allergy, or Guillain-Barré syndrome, or being pregnant or lactating or having a household contact who is pregnant or nursing.
Having an immunocompromised close contact is only a consideration among caregivers for people with bone marrow transplant in the hospital settings, Dr. Carpenter said. In addition, the live virus vaccine is not contraindicated in nursing patients and pregnant or nursing household contacts.