Taking Your Best Shot at the Flu

1. The CDC’s influenza home page: http://www.cdc.gov/flu/
2. The WHO’s influenza site: http://www.who.int/csr/disease/influenza/en/
3. The state Department of Public Health

10. Plan for next season. At the end of flu season, reconvene the influenza committee and debrief. It is important to keep a log of the successes and failures of the season’s flu vaccine initiative to permit growth in subsequent seasons.

The CDC’s program, Healthy People 2010, has set a goal for influenza and pneumococcal vaccination of appropriate non-institutionalized individuals of 90% (10). This goal is achievable if all available resources for reaching out to such patients are utilized. The Massachusetts Hospital Association reports:

“Inpatient hospital stays are among the many missed opportunities for flu and pneumonia vaccination across health care settings. Up to 46% of subsequent influenza-related hospitalizations and 2/3 of influenza-related deaths occur among the elderly who have been previously hospitalized during the flu season. Up to 2/3 of patients hospitalized with serious pneumococcal infections have been hospitalized at least once within the previous 3-5 years (8).”

Hospitalists must take advantage of the opportunity that hospitalization affords our patients to receive the vaccines they need to stay healthy. Appropriate vaccine delivery is no longer solely the purview of the primary care physician – hospitalists must share this goal as well.

References

1. The Commonwealth of Massachusetts Executive Office of Health and Human Services Department of Public Health. Revised order to establish rules and priorities for the distribution and use of influenza vaccine. Available at: http://www.mass.gov/dph/cdc/epii/flu/flu_order.htm. Accessed November 3, 2004.
2. Thompson WW, Shay DK, Weintraub E, et al. Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA.2003;289:179-86.
3. Thompson WW, Shay DK, Weintraub E, et al. Influenza-associated hospitalizations in the United States. JAMA. 2004;292:1333-40.
4. CDC. Interim Influenza Vaccination Recommendations – 2004-2005 Season. Available at: http://www.cdc.gov/flu/protect/whoshouldget.htm. Accessed November 3, 2004.
5. JCAHO. 2005 Disease-specific care national patient safety goals. Available at: http://www.jcaho.org/accredited+organizations/patient+safety/05+npsg/05_npsg_dsc.htm. Accessed November 3, 2004.
6. Martinello RA, Jones L, Topal JE. Correlation between healthcare workers’ knowledge of influenza vaccine and vaccine receipt. Infect Control Hosp Epidemiol. 2003.Nov;24(11):799-800.
7. CDC. Prevention and Control of Influenza Recommendations of the Advisory Committee on Immunization Practices (ACIP). Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/ rr5306a1.htm. Accessed November 8, 2004.
8. Massachusetts Hospital Association. Opt-Out Standing Orders for Pneumonia and Influenza Vaccination for Hospital Inpatients: Best Practice Adoption Proposal to Improve Massachusetts Hospital Performance and Public Health. Available at: http://www.masspro.org/publications/pubs/misc/PNEUMHA2.pdf.
9. CDC. Influenza: the disease. Available at: http://www.cdc.gov/flu/about/disease.htm. Accessed November 8, 2004.
10. CDC. Healthy People 2010. Immunization and Infectious Diseases. Section 14-29a. Available at: http://www.healthypeople.gov/document/html/volume1/14immunization.htm. Accessed November 8, 2004.