TJC2026A Note for "Influenza Immunization"

• Topic Version for Release TJC2026A: 16
• Topic has changed since last release: Compare versions

Rationale

The updates to IMM MIF include an updated rationale with more recent data, will provide abstractor clarification, alignment with updated CDC influenza vaccination guidance, and more up to date references.

Description

Rationale

Change from:

Up to 1 in 5 people in the United States get influenza every season (CDC, Key Facts 2015). Each year an average of approximately 226,000 people in the US are hospitalized with complications from influenza and between 3,000 and 49,000 die from the disease and its complications (Thompson 2003). Combined with pneumonia, influenza is the nation’s 8th leading cause of death (Heron 2012). Up to two-thirds of all deaths attributable to pneumonia and influenza occur in the population of patients that have been hospitalized during flu season regardless of age (Fedson 2000). The Advisory Committee on Immunization Practices (ACIP) recommends seasonal influenza vaccination for all persons 6 months of age and older to highlight the importance of preventing influenza. Vaccination is associated with reductions in influenza among all age groups (Kostova 2013).

The influenza vaccination is the most effective method for preventing influenza virus infection and its potentially severe complications. Screening and vaccination of inpatients is recommended, but hospitalization is an underutilized opportunity to provide vaccination to persons 6 months of age or older.

To:

An estimated 9.3 to 41 million people in the United States get influenza every season. Each year approximately 120,000 to 710,000 people in the US are hospitalized with complications from influenza and between 6,300 and 52,000 die from the disease and its complications (Center for Disease Control and Prevention [CDC], 2024a). Combined with pneumonia, influenza is in the nation’s top 10 leading causes of death for ages 1 through 44 (CDC, 2023). About 14.1% of people of all ages hospitalized with influenza were admitted to the intensive care unit during the 2021-22 flu season, down from 22.3% during the 2013-14 flu season (Naquin et al., 2024). The Advisory Committee on Immunization Practices (ACIP) recommends seasonal influenza vaccination for all persons 6 months of age and older to highlight the importance of preventing influenza. Flu vaccines substantially reduced the risk of flu related medical visits and hospitalizations for all age groups during the 2023-24 flu season (CDC, 2024b).

The influenza vaccination is the most effective method for preventing influenza virus infection and its potentially severe complications. Screening and vaccination of inpatients is recommended, but hospitalization is an underutilized opportunity to provide vaccination to persons 6 months of age or older.

Included Populations (Numerator)

Change from:

• Patients who have an allergy/sensitivity to the influenza vaccine, anaphylactic latex allergy or anaphylactic allergy to eggs, or for whom the vaccine is not likely to be effective because of bone marrow transplant within the past 6 months, or history of Guillian-Barre syndrome within 6 weeks after a previous influenza vaccination, or symptomatic suspected or confirmed COVID-19.

To:

• Patients who have documentation of a severe allergic reaction (e.g. anaphylaxis) after previous dose of influenza vaccine or to vaccine component, OR history of Guillian-Barré syndrome within 6 weeks after a previous influenza vaccination OR moderate or severe acute illness with or without fever.

Selected References

Change from:

• Centers for Disease Control and Prevention. (2013). Estimated Applications/LocalApps.Influenza Illnesses and Hospitalizations Averted by Influenza Vaccination — United States,2012–13 Influenza Season. MMWR. 2013;62(49):997-1000.

To:

• Centers for Disease Control and Prevention. (2013). Estimated Influenza Illnesses and Hospitalizations Averted by Influenza Vaccination — United States,2012–13 Influenza Season. MMWR. 2013;62(49):997-1000.

Remove:

• Centers for Disease Control and Prevention. (2015). Key facts about influenza and the influenza vaccine, October 2015. Available at:http://www.cdc.gov/flu/keyfacts.htm. Accessed October 14, 2015
• Centers for Disease Control and Prevention. (2013). Estimated Influenza Illnesses and Hospitalizations Averted by Influenza Vaccination — United States,2012–13 Influenza Season. MMWR. 2013;62(49):997-1000.
• Centers for Disease Control and Prevention. (2013). Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2013-2014. MMWR, September 20,2013; 62(RR07); 1-43. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6207a1.htm
• Centers for Disease Control and Prevention. (2015). Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2015–16 Influenza Season. MMWR,August 7, 2015; 64(30);818-825. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6430a3.htm
• Fedson DS, Houck PM, Bratzler DW. Hospital-based influenza and pneumococcal vaccination: Sutton’s Law applied to prevention. Infect Applications/LocalApps.ControlHosp Epi. 2000;21:692-699.
• Heron M (2015). Deaths: Leading Causes for 2012. National Vital Applications/LocalApps.StatisticsReports; vol 64 no 10. Hyattsville, MD: National Center for Health Statistics.2015.
• Kostova D, Reed C, Finelli L, Cheng P, Gargiullo PM, Shay DK, Singleton JA,Meltzer MI, Lu P, Joseph S. (2013). Influenza Illness and Applications/LocalApps.HospitalizationsAverted by Influenza Vaccination in the United States, 2005–2011. Applications/LocalApps.PLoS One.2013; 8(6): e66312.
• Reed C, Chaves SS, Daily Kirley P, Emerson R, Aragon D, Hancock EB, et al.(2015). Estimating Influenza Disease Burden from Population-Based Surveillance Data in the United States. Applications/LocalApps.PLoS ONE 10(3): e0118369
• Thompson WW, Shay DK, Weintraub E, Brammer L, Cox N, Anderson LJ,Fukuda. Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA. 2003 January 8; 289 (2): 179-186.

Add:

• Centers for Disease Control and Prevention. (2023). Leading causes of death. WISQARS. https://wisqars.cdc.gov/lcd/?o=LCD&y1=2023&y2=2023&ct=10&cc=ALL&g=00&s=0&r=0&ry=2&e=0&ar=lcd1age&at=groups&ag=lcd1age&a1=0&a2=199
• Centers for Disease Control and Prevention. (2024a). Frequently asked questions about estimating influenza burden. https://www.cdc.gov/flu-burden/php/about/faq.html
• Centers for Disease Control and Prevention. (2024b). 2023-2024 flu vaccines reduce medical visits. https://www.cdc.gov/flu/whats-new/2023-2024-vaccines-reduce-medical-visits.html
• Centers for Disease Control and Prevention. (2024, July 25). General best practices for immunization. Vaccines & immunizations. https://www.cdc.gov/vaccines/hcp/imz-best-practices/?CDC_AAref_Val=https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html
• Centers for Disease Control and Prevention. (2024, July 25). Contraindications and precautions. Vaccines & immunizations. https://www.cdc.gov/vaccines/hcp/imz-best-practices/contraindications-precautions.html
• Naquin, A., O’Halloran, A., Ujamaa, D., et al. (2024). Laboratory-confirmed influenza-associated hospitalizations among children and adults — Influenza Hospitalization Surveillance Network, United States, 2010–2023. MMWR Surveillance Summaries, 73(SS-6), 1–18. http://dx.doi.org/10.15585/mmwr.ss7706a1
• Rubin L, Levin M, Ljungman P, et al. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis. 2014;58(3):e44-100. DOI: 10.1093/cid/cit684