CDC strongly urges physicians to get flu shots.

WASHINGTON -- Getting more physicians and other health care professionals vaccinated against the flu is a key element in efforts by the Centers for Disease Control and Prevention to prevent transmission of the disease to vulnerable patients.

"Health care workers may not be at risk for a severe complication, but they can pass the flu virus on to somebody else under their care and cause a serious health risk to that individual," Dr. Julie Gerberding, who is director of the CDC, said at a press conference sponsored by the National Foundation for Infectious Diseases.

Available data suggest that only 38% of health care professionals get vaccinated against influenza each year. "That's an alarmingly low number, especially when you consider the CDC recommendation that all health care professionals receive the influenza vaccine," said Dr. Donald Palmisano, president of the American Medical Association.

Because of the nature of their jobs, health care workers are at a higher risk of exposure to influenza. During a flu epidemic, this could mean a short supply of health care staff. "Just picture the implications of a flu epidemic among the staff of a hospital, clinic, or private practice," Dr. Palmisano said.

An even more important consideration is that without vaccination, physicians and other health care professionals can transmit the flu to patients in their care, who are likely to be susceptible to the flu and vulnerable to its complications.

According to one study involving 264 hospital-based health care professionals, the efficacy of the flu vaccine was 88% for influenza A and 89% for influenza B (JAMA 281[10]:908-13, 1999).

The CDC estimates that on average 36,000 people die annually from complications of influenza, and 114,000 people are hospitalized because of the disease. Influenza is the leading cause of death among vaccine-preventable diseases, with 90% of those deaths occurring among the elderly.

The CDC has a goal of vaccinating 90% of people who should be vaccinated--those 65 years and older, anyone 50 years and older with a chronic health problem, children aged 6-23 months, and pregnant women in the second and third trimesters. In 2002, 69% of white Americans 65 years and older were immunized for the flu, while only 48% and 50% of African American and Hispanic people in the same age group were immunized.

Influenza vaccination reduces the risk of hospitalization for cardiac disease and stroke for people aged 65 years and older, a recent study showed (N. Engl. J. Med. 348[14]:1322-32, 2003). About 50% of patients received the vaccine. In the first year of the study--involving 140,055 patients--immunization reduced the risk of being hospitalized for heart disease and stroke by 19% and 16%, respectively. In the second year--involving 146,328 patients--those reductions were 19% and 23%, respectively. Pneumonia hospitalizations and all-cause deaths also were reduced by roughly 30% and 50%, respectively, each year.

Severe influenza seasons are strongly linked to the circulation of one group of influenza viruses--AH3N2, said Nancy Cox, Ph.D., chief of the CDC's influenza branch. This was the predominant flu virus group during the moderate to severe influenza season that recently ended in Australia and New Zealand. "We are very closely monitoring early influenza isolates in the United States for a possible indication that these troublesome viruses may predominate in the coming season."

There's more than one vaccine option this year for healthy people between the ages of 5 and 49 years. Earlier this year, FluMist became the first nasally administered vaccine available in the United States and the first live attenuated virus vaccine approved. The spray prevents both influenza A and B. Use of the live but weakened virus in FluMist is approved for use only in people without risk factors.

BY KERRI WACHTER

Senior Writer