Health Advisory
INFLUENZA VACCINATION CLINICS TO BE HELD STATEWIDE NOVEMBER 19

Delaware's Division of Public Health (DPH) will hold influenza vaccination clinics statewide Friday, November 19 for eligible individuals who schedule appointments on a first come, first served basis. DPH will operate a call center that will schedule appointments as follows:

• Kent and Sussex County residents, Monday, November 15 from 9 a.m. - 8 p.m.
• New Castle County residents, Tuesday, November 16 from 9 a.m. - 8 p.m.

All residents will be scheduled at clinics in their county of residence.

VACCINE AVAILABILITY

The number of appointments per county will be based on the percentage of county residents age 65 or older. DPH has 12,000 vaccine doses in stock, and is making 7,634 doses available for this round of flu vaccine clinics. An additional 4,000 doses are being held in reserve as a contingency in case expected additional vaccine is not made available to Delaware. Another 358 doses will be used to vaccinate long-term care residents in DPH institutions and eight doses will be administered to DPH laboratory staff that test clinical specimens for influenza virus.

ELIGIBILITY

To schedule an appointment, callers must live or go to school in Delaware. Callers must also meet one of these criteria:

• Age 65 years and older
• Age 9 - 64 years with underlying chronic health conditions
• Women who will be pregnant during the influenza season, which is October 2004 - February 2005
• Age 9-18 years who are on chronic aspirin therapy

Children less than 9 years will not be vaccinated in this round of clinics. It is difficult to vaccinate children less than 9 years of age safely in a mass vaccination environment because these children require a different dose of vaccine, which could lead to dosage error. Children are harder to vaccinate than adults and take longer, which would slow patient flow through the clinics. Also, DPH has made 6,200 doses of vaccine available through the Vaccine for Children Program (VFC) and expects an additional 1,800 doses of preservative free vaccine for distribution. VFC program vaccine is distributed through private physicians and clinics for indigent children and those in the Medicaid program.

Nursing home residents will not be vaccinated in this round of clinics because most nursing home residents cannot be safely vaccinated in a mass vaccination. However, DPH anticipates that the federal government will soon send vaccine to nursing homes for all residents and direct care staff. This also is another reason for the 4,000 dose contingency reserve.

TO SCHEDULE APPOINTMENTS

Individuals can schedule appointments by calling 1-800-282-8672. Callers should have pen and paper at hand to write down their appointment time and clinic location. Callers will be asked if they live or go to school in Delaware, which risk criteria they meet, name, and contact information. Depending on volume, callers may experience a busy signal. Callers who experience a busy signal are encouraged to call back.

When attending the clinic, individuals must bring identification, proof that they live or attend school in Delaware, and their Medicare card, if applicable. Clinics will be conducted statewide.

BACKGROUND INFORMATION REGARDING HIGH RISK GROUPS

HIGH RISK GROUPS INCLUDED

• Age 65 years and older
• Age 9 - 64 years with underlying chronic health conditions
• Women who will be pregnant during the influenza season, which is October 2004 - February 2005
• Age 9-18 years who are on chronic aspirin therapy

HIGH RISK GROUPS NOT INCLUDED

• All children aged 6-23 months
• People aged 2-8 years with underlying chronic medical conditions
• Children aged 6 months to 8 years on chronic aspirin therapy:
  Rationale: It is difficult to vaccinate children less than 9 years of age safely in a mass vaccination environment. Most of our vaccination clinics will not be in a medical setting. This is because these children require a different dose of vaccine that could lead to administration error, and because children are harder to vaccinate than adults. In addition, vaccination of children takes longer than adults, which will slow patient flow through the clinics. Instead, DPH has distributed 6200 doses out of an order of 8,000 doses for the VFC program with an additional 1800 doses promised by the CDC. Delaware VFC (Vaccines for Children) is a program for indigent children, including those on Medicaid.
• Residents of nursing homes and long-term care facilities:
  Rationale: DPH is very concerned that residents of nursing homes be protected against flu this year. Because of this concern DPH is holding vaccine in reserve for this population. Most nursing home residents cannot be safely vaccinated in a mass vaccination environment and vaccination clinics will not be in a medical setting.
• Healthcare workers involved in direct patient care:
  Rationale: The primary reason for vaccinating health care workers is to prevent them from infecting high-risk patients. While their vaccination is optimal, in this shortage situation, DPH’s strategy is to protect high-risk individuals directly. In addition, most hospitals in Delaware are vaccinating their employees, and long-term care agencies are anticipated to get their full request for vaccine for their patient caregivers. Finally, healthy direct patient caregivers under the age of 50 years may be eligible for FluMist, a live vaccine distributed nasally. Supplies of FluMist are also sporadic, but DPH has just received 900 doses and is developing a distribution plan.
• Out-of-home caregivers and household contacts of children aged less than 6 months:
  Rationale: Babies under 6 months cannot be vaccinated against flu. Optimally, vaccinating their caregivers helps to prevent the transmission of influenza from the caregivers to these young babies. Because this is such a large group of people, DPH does not, at this time, have enough vaccine to meet their needs. DPH anticipates additional vaccine and may be able to hold clinics for this group in the future. In the mean time, DPH urges caregivers of young children to practice other preventive measures such as keeping babies away from people who are sick and practicing diligent hand washing. DPH is preparing a media campaign to emphasize the importance of these other preventive measures.