Influenza Background and Importance of Vaccination

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InfluenzaBackground and Importance of Vaccination

• Marc Traeger, MD
• October 23, 2008

IHS Open Door Forum Influenza Vaccination
of Health Care Personnel
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Objectives

• Refresher on influenza disease and
  recommendations
• Understand the importance of influenza vaccine
• Understand the importance of vaccination in
  health care personnel (HCP)
• Understand national achievements and goals for
  influenza vaccination

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InfluenzaWhy do we vaccinate?

• PEOPLE DIE
• FROM INFLUENZA
• THE FLU

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InfluenzaBackground

• Accounts for 36,000 deaths annually (U.S.)
• Only S. Pneumoniae accounts for more
• vaccine-preventable deaths in the U.S.
• Deaths from pneumonia influenza are 40 higher
  in American Indians/Alaska Natives (AIs)
• AIs aged 65 years 20 higher mortality

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U.S. Infectious Disease MortalityThe Impact of
Influenza and AIDS
1918-1920
1957 Hong Kong flu pandemic
1928 Penicillin discovery
1945 Influenza vaccine
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InfluenzaBackground

• Every year
• 5 20 of the population get the flu
• More than 200,000 people are hospitalized from
  flu complications, including 20,000 children
• Increased work absenteeism/decreased productivity
  due to influenza

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InfluenzaClinical

• Illness
• Abrupt onset
• Fever
• Myalgia
• Headache
• Malaise
• Non-productive cough (may persist gt2 weeks)
• Sore throat
• Rhinitis
• May resolve after 3-7 days
• May progress to pneumonia and other
  complications
• Children otitis media, nausea, vomiting common

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InfluenzaClinical

• Spread from person-to-person
• Large particle respiratory droplet (cough or
  sneeze)
• Incubation period 1- 4 days (average 2 days)
• Infectious period
• 1 day before symptom onset to 5 days after
  illness onset
• Young children may shed virus several days
  before illness to 10 days after illness onset

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InfluenzaBackground

• Infection rates highest among children
• Serious illness death rates highest among
• Persons 65 years
• Children 2 years
• Persons of any age with medical conditions
  placing them at higher risk (diabetes, asthma,
  renal, hepatic, hematologic, neuromuscular,
  immune-suppressed)

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Influenza Vaccination Background

• Additional conditions placing persons at
  increased risk for complications of influenza
• Children 59 months of age (lt6 months ineligible
  for vaccine)
• Persons aged 50 and older
• Pregnant women
• Residents of nursing homes or group homes

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Influenza Vaccination Background

• Others recommended to receive the flu shot
• Health Care Personnel (HCP)
• Children 6 years 18 years
• Persons who have a baby or take care of a baby
  under 6 months age
• Persons who live with or take care of anyone in
  the high risk groups
• Anyone without contraindications that requests
  the flu shot

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Reference
Found at http//www.cdc.gov Or http//www.cdc.g
ov/mmwr/
http//www.cdc.gov/mmwr/PDF/rr/rr5707.pdf
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Healthy People Goals

• Influenza vaccination
• Age 18-64 60
• Age 65 90
• Health Care Personnel 60
• Overarching Healthy People 2010 goal
• Eliminate Health Disparities

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Receipt of influenza vaccination during the
previous 12 months by race/ethnicity among
persons gt65, 1989-2005, National Health
Interview Survey
Healthy People 2010 Goal
Survey Year
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Percentage of persons aged 18 64 years who
reported receiving influenza vaccination during
the preceding 12 months, by race/ethnicity and
survey year National Health Interview Survey,
United States, 1989 2004
Healthy People 2010
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Influenza Vaccination 2005-2006, 2006-2007
National health interview survey, National
Immunization Survey Whiteriver Service Unit,
IHS, Fiscal year 2006
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Who are Health Care Personnel?

• All employees who work in a health care facility,
  regardless of their job category
• Including but not limited to
• Physicians Nurses
• Nursing assistants Pharmacists
• Clerical Housekeeping
• Dietary Maintenance
• Security Billing
• CHRs Ambulance crews
• Contractors and volunteers

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Health Care Personnel(HCP)Why do they need
vaccination?

• HCP care for patients that are at risk for death
  from influenza
• Patients entrust their health and lives to health
  care personnel
• HCP are exposed to patients with influenza
• An infected person is infectious 1 day before
  symptom onset

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Influenza Vaccination Whiteriver Service
UnitHealth Staff Information

• Message boards
• Verbal communications
• E-mail
• Provider infection control officer
  encouragement
• Influenza updates
• CDC influenza website link

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WRSU Employee Influenza Vaccination Program

• Vaccination begun upon vaccine arrival
• Provided without charge
• Vaccine brought to employee work stations, all
  shifts
• Electronic health record prompts
• Standing orders
• Refusals require signature

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Thank you
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InfluenzaWhy do we vaccinate?

• The single best way to protect against the flu is
  to get vaccinated each year