Despite recent improvements in influenza vaccination rates among U.S. health care personnel, their rates for the 2010-2011 flu season still fell short of national health objectives, a new survey has shown.
Similarly, although the record-high influenza vaccination levels among pregnant women during the 2009-2010 influenza season were sustained during the 2010-2011 season, vaccination levels in that group also remained well below the "Healthy People 2020" target of 80% coverage for pregnant women, Dr. Carolyn Bridges said during a telebriefing on the survey results.
Influenza vaccination coverage among all health care personnel for the 2010-2011 season was 63.5%, representing an increase over the 61.9% reported for the previous year. But that rate still fell short of the Healthy People 2020 coverage goal of 90%, said Dr. Bridges of the National Center for Immunization and Respiratory Diseases.
The most recent season’s results come from an Internet-based survey of 1,931 health care personnel, which the Centers for Disease Control and Prevention and the Rand Corp. conducted in April 2011.
"The vaccination rates were highest among physicians, health care personnel working in hospital settings, and those aged 60 years and older," Dr. Bridges reported.
Among the 13% of survey respondents whose workplace required influenza vaccination, the coverage rate was 98%, compared with 58% among the remaining respondents whose employers had no such requirement, she said.
In the absence of mandatory workplace immunization, offering the vaccine onsite at work, free of charge, and on more than 1 day were associated with an increased likelihood of influenza vaccination, Dr. Bridges stated.
Onsite vaccination in particular was a "key strategy," she said, noting that the coverage rate among respondents who had the onsite option was 66%, compared with 38.5% among those who did not.
With respect to influenza vaccine during pregnancy, the CDC and Rand estimated coverage for the 2010-11 season using data from an Internet panel survey, also conducted in April 2011, among 1,457 women who were pregnant any time between October 2010 and January 2011.
In all, 49% of respondents reported receiving the vaccine, including 32% who received it during pregnancy and 17% who received it [before or after] pregnancy," said Dr. Bridges. The rate is comparable to the 50% coverage rate reported for the previous influenza season, in response to the 2009 H1N1 influenza pandemic. And it was significantly higher than the consistently low rates of approximately 15% reported in prior seasons, she said.
Pregnant women whose providers offered them the influenza vaccination were approximately five times more likely to get vaccinated than were those whose providers did not, "which is consistent with other studies," Dr. Bridges said.
Despite the fact that the influenza vaccine given during pregnancy has been shown to decrease illness in mothers and decrease the risk of influenza and hospitalization in newborns younger than 6 months old who themselves are too young to get the vaccine, "4 out of 10 women reported not receiving an offer for vaccination from their providers," she reported.
An assessment of pregnant women’s attitudes and beliefs about vaccination during pregnancy determined that their top two concerns were safety risks to the baby and the possibility of getting influenza from the vaccine, Dr. Bridges stated. "Women who were offered the vaccine by their providers were more likely to have a positive attitude about the vaccine and its safety, she said.
The findings of both studies are reported in this week’s Morbidity and Mortality Weekly Report (2011;60:1073-7; 1078-82).
Although the 2011-2012 influenza vaccine will include the same influenza strains as last year, that’s not an excuse to skip this year’s shot, according to the CDC’s Advisory Committee on Immunization Practices.
"The levels of protective antibodies decline over the course of a year, so the ACIP continues to recommend annual immunization to ensure optimal protection, especially among the elderly, people with compromised immune systems, and those susceptible to complications of the flu," said Dr. Carolyn Bridges of the of the National Center for Immunization and Respiratory Disease.
The ACIP issued its updated influenza immunization recommendations for the 2011-2012 in the shortened format, because there were relatively few changes from last year, Dr. Bridges said.
In addition to the continued recommendation that all individuals ages 6 months and older get vaccinated, the updated guidelines include information on the selected influenza strains (an A/California/7/2009 [H1N1]–like virus; an A/Perth/16/2009 [H3N2]–like virus; and a B/Brisbane/60/2008–like virus), recommended schedules for children 6 months up to 8 years, and information about vaccination for individuals with egg allergies, she said.
Specifically, ACIP recommends that children aged 6 months to 8 years of age who were not vaccinated for influenza last year receive two doses of the vaccine this year, given at least 4 weeks apart, based on the data showing that two doses provide significantly greater protection than one.