title: The impact of the 2004-2005 influenza vaccine shortage in the Veterans Health Administration.
abstract: BACKGROUND
  The Veterans Health Administration (VHA) serves a population at high risk of influenza-related morbidity and mortality. The national public health response to the vaccine shortage of the 2004-2005 season resulted in prioritization of recipients and redistribution of available supply.
  
  
  OBJECTIVE
  To characterize the impact of the 2004-2005 influenza vaccine shortage on vaccination among users of VHA facilities.
  
  
  METHODS
  Analysis using data from the cross-sectional VHA Survey of Healthcare Experiences of Patients.
  
  
  METHODS
  Outpatients seen in VHA clinics during the months September 2004-March 2005.
  
  
  METHODS
  Sociodemographics, vaccination prevalence, setting of vaccination, and reasons cited for not getting vaccinated.
  
  
  RESULTS
  Influenza vaccination prevalence among VHA outpatients aged 50-64 was 56% and for those aged > or = 65 was 86%. Compared to the 2 previous seasons, this estimate was lower for patients age 50-64 but similar for patients > or = 65. After adjustment for patient characteristics, unvaccinated patients aged 50-64 were 8.3 (95% CI 6.0, 11.4) times as likely to cite that they were told they were not eligible for vaccination because of the national shortage compared to patients > or = 65. Regional VHA variation in vaccination receipt and shortage-related reasons for nonvaccination was small.
  
  
  CONCLUSIONS
  The national influenza vaccine shortage of 2004-2005 primarily affected VHA users aged 50-64, consistent with the tiered prioritization guidance issued by the Centers for Disease Control and Prevention and Advisory Committee on Immunization Practices. Despite the shortage, vaccination prevalence among VHA users > or = 65 remained high.
authors.affiliation: National Center for Health Promotion and Disease Prevention, Office of Patient Care Services, Veterans Health Administration, Department of Veterans Affairs, 3022 Croasdaile Dr. Suite 200, Durham, North Carolina 27705, USA. leila.kahwati@va.gov
authors.forename: Leila C
authors.initials: LC
authors.lastname: Kahwati
authors.forename: John R
authors.initials: JR
authors.lastname: Elter
authors.forename: Kristy A
authors.initials: KA
authors.lastname: Straits-Tröster
authors.forename: Linda S
authors.initials: LS
authors.lastname: Kinsinger
authors.forename: Victoria J
authors.initials: VJ
authors.lastname: Davey
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000600:supply & distribution*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D014481:United States; D014493:United States Department of Veterans Affairs; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D007252:Influenza Vaccines