title: Survey of state practices during the 2004-2005 influenza vaccine shortage.
abstract: To describe state-level actions and policies during the 2004-2005 influenza vaccine shortage and determine whether these or other factors were related to vaccination coverage, we surveyed all state health departments (including the District of Columbia). We included 2004-2005 Behavioral Risk Factor Surveillance System data to examine whether state-level actions, policies, or other factors like vaccine supply were related to changes in vaccination coverage in adults aged > or = 65 years from the previous non-shortage year. We found that 96% (n = 49) of states reported adopting or recommending adherence to the initial national interim influenza vaccination recommendations. Of these, at some point during the season, 22% (n = 11) reported local public health agencies issued prioritization recommendations that differed from the state health department's guidance. Eighty percent (n = 41) initiated at least one emergency response activity and 43% (n = 22) referred to or implemented components of their pandemic influenza plans. In 35% (n = 18), emergency or executive orders were issued or legislative action occurred. In a multivariable linear regression model, the availability and use of practitioner contact lists and having a relatively high vaccine supply in early October 2004 were associated with smaller decreases in coverage for adults aged > or = 65 years from the previous non-shortage season (p = 0.003, r2 = 0.26). States over-whelmingly followed national vaccination prioritization guidelines and used a range of activities to manage the 2004-2005 vaccine shortage. The availability and use of practitioner contact lists and having a relatively high vaccine supply early in the season were associated with smaller decreases in coverage from the previous non-shortage season.
authors.affiliation: Epidemic Intelligence Service, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. TShimabukuro@cdc.gov
authors.forename: Tom T
authors.initials: TT
authors.lastname: Shimabukuro
authors.forename: Pascale M
authors.initials: PM
authors.lastname: Wortley
authors.forename: Barbara
authors.initials: B
authors.lastname: Bardenheier
authors.forename: Eddy A
authors.initials: EA
authors.lastname: Bresnitz
authors.forename: Anna M
authors.initials: AM
authors.lastname: DeBlois
authors.forename: Christine G
authors.initials: CG
authors.lastname: Hahn
authors.forename: Ellen J
authors.initials: EJ
authors.lastname: Mangione
mesh_terms: D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D002487:Centers for Disease Control and Prevention, U.S.; D006077:Government Agencies / Q000458:organization & administration*; D017408:Guidelines as Topic; D006291:Health Policy; D006801:Humans; D007252:Influenza Vaccines / Q000600:supply & distribution*; D011635:Public Health Administration; D013219:State Government; D014481:United States
chemical_list: D007252:Influenza Vaccines