Employee Guidance on Seasonal Influenza and H1N1 Vaccines

According to the CDC, between 5 percent and 20 percent of the U.S. population develops seasonal influenza each year. More than 200,000 are hospitalized from its complications and about 36,000 people die. Older people, young children, and people with certain chronic medical conditions are at higher risk for influenza-related complications. Annual vaccination of these groups is critical. Vaccination is one of the most effective ways to minimize suffering and death from influenza.  The seasonal flu vaccine will not provide protection from the 2009 H1N1 virus.  It is expected both seasonal influenza and 2009 H1N1 influenza will cause illness during the 2009-2010 influenza season.

The 2009 H1N1 influenza virus has infected people and spread worldwide among people. Influenza is unpredictable, but scientists believe that this flu season, the new virus may cause a lot more people to get sick than during a regular flu season. It is also expected to continue to cause hospital stays and deaths.  A 2009 H1N1 flu vaccine is expected to be available by mid-October.

What is the difference between seasonal influenza vaccines, and 2009 H1N1 influenza vaccines?

Seasonal influenza vaccines are vaccines that are updated yearly and that protect against three strains of circulating influenza viruses.  The viruses in the vaccine change annually based on international surveillance and scientists' estimations about which types and strains of viruses will circulate in the U.S. in a given year.  The seasonal influenza vaccine will not protect against the 2009 H1N1 influenza virus that resulted in the declaration of a pandemic by the World Health Organization (WHO) on June 11, 2009, and is expected to cause illness during the 2009-2010 flu season. 

Seasonal Flu Vaccine:

• Recommended for everyone who wants to avoid getting the flu, with extra emphasis on people at high risk of having serious flu complications or people who live with or care for those at high risk for serious complications, including young children and older people.
• One single dose annually (or 2 doses one-month apart for first-time vaccinations for children younger than 9 years old, or children younger than 9 years old who were vaccinated for the first time the previous influenza season, but only received one dose)
• Contains 3 different seasonal influenza virus strains of the seasonal influenza virus
• Does not give you protection against 2009 H1N1 novel flu
• Currently available from your health care provider and some pharmacies

Should I get the seasonal flu vaccination?
Although this year’s seasonal vaccine is directed against other strains of influenza expected to be circulating and will not provide protection against the 2009 H1N1 influenza virus, it is still important, for those Americans for whom it is recommended, to receive the seasonal influenza vaccine. No vaccine is 100 percent effective against preventing disease, but vaccination is the best protection against influenza and can prevent many illnesses and deaths.  The usual seasonal influenza viruses are still expected to cause illness this fall and winter. Individuals are encouraged to get their seasonal flu vaccine as soon as it is available.
Seasonal flu vaccination usually starts in September or as soon as vaccine is available, which is early this year, and continues throughout the influenza season. This is because the timing and duration of influenza seasons vary. While influenza activity can occur as early as October, most of the time seasonal influenza activity peaks in January or later.  People who are at highest risk and should get vaccinated annually are:

• Children aged 6 months up to their 19th birthday
• Pregnant women
• People 50 years of age and older
• People of any age with certain chronic medical conditions
• People who live in nursing homes and other long-term care facilities
• People who live with or care for those at high risk for complications from flu, including:
  • Health care workers
  • Household contacts of persons at high risk for complications from the flu
  • Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated)

Individuals are encouraged to get their seasonal flu vaccine from their health care provider.

2009 H1N1 Novel Flu Vaccine:

• Recommended for CDC designated priority populations who want to avoid getting the H1N1 flu
• As clinical trial data become available, CDC will make more specific recommendations on the number of doses needed  
• Contains 1 strain of novel 2009 H1N1 flu
• Does not give protection against seasonal flu
• Vaccine is still being tested and manufactured, and first doses are expected to be available by mid-October 

The Advisory Committee on Immunization Practices (ACIP) is the immunization advisory committee to CDC.  This advisory body recommends that 2009 H1N1 flu vaccine be made available first to the following five groups who are at high risk of infection or severe complications from the 2009 H1N1 virus:

ACIP Initial Target Groups:

• Pregnant women
• Persons who live with or provide care for infants aged <6 months (parents, siblings, and day care providers)
• Healthcare and emergency medical services personnel
• Persons aged 6 mos – 24 yrs
• Persons aged 25 yrs – 64 yrs who have certain medical conditions that put them at higher risk for influenza related complications

Subset of Target Groups (if supply can't meet demand this is the first wave for vaccination priority)

• Pregnant women
• Persons who live with or provide care for infants aged <6 months (parents, siblings, and day care providers)
• Healthcare and emergency medical services personnel who have direct contact with patients or infectious material
• Children aged 6 months – 4 years
• Children and adolescents aged 5 – 18 years who have medical conditions that put them at higher risk for influenza- – related complications

As vaccine supplies become readily available, the initial target groups and general population can be offered the H1N1 vaccine.  More information will be released as available.

It is expected that clinical trial results will be necessary to confirm that 2009 H1N1 and seasonal flu vaccines will be safe and effective if given at the same time. We expect the seasonal vaccine to be available earlier than the H1N1 vaccine. The usual seasonal influenza viruses are still expected to cause illness this fall and winter. Individuals are encouraged to get their seasonal flu vaccine.

ACIP makes the following additional recommendations about use of 2009 H1N1 monovalent vaccine:

• The number of doses of vaccine required for immunization against 2009 H1N1 influenza has not been established. Because vaccine availability is expected to increase over time, vaccine should not be held in reserve for patients who already have received 1 dose but might require a second dose.
• Simultaneous administration of inactivated vaccines against seasonal and 2009 H1N1 influenza viruses is permissible if different anatomic sites are used. However, simultaneous administration of live, attenuated vaccines against seasonal and 2009 H1N1 virus is not recommended.
• All persons currently recommended for seasonal influenza vaccine, including those aged 65 years or older, should receive the seasonal vaccine as soon as it is available to you. Recommendations for use of the 2009-10 seasonal influenza vaccines have been published previously.

• Clinical trial results are currently being conducted to confirm that 2009 H1N1 and seasonal flu vaccines will be safe and effective if given at the same time.

As a general reminder, keeping hands clean is one of the most important steps we can take to avoid getting sick and spreading germs to others. It is best to wash your hands with soap and clean running water for 20 seconds. When soap and running water are not available, use an alcohol based hand rub.   Always cough and sneeze into a tissue and throw the tissue away.

For further information on either seasonal influenza or Novel 2009 H1N1 influenza, please visit: http://www.flu.gov.

This document provides general guidance only for employees covered by Title 5, United States Code, and does not, and is not intended to create or violate any legal rights.