The Advisory Committee on Immunization Practices (ACIP) and the Centers for Disease Control and Prevention (CDC) recommend annual vaccination from September through May.

Recommendations for Adult Influenza Vaccination:

• Vaccinate any adult at high risk for influenza complication, or in close contact with persons at higher risk.
• Vaccinate health care workers and caregivers.
• Healthy individuals are encouraged to receive influenza vaccination.
• Trivalent inactivated influenza (TIV) and live, attenuated influenza vaccine (LAIV) are available, each with different routes of administration, indications, populations, and side effects.
• Should influenza occur symptomatic care is the standard; early diagnosis of influenza prevents inappropriate use of antibiotics unless there is a secondary bacterial infection.

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Zanamivir and oseltamivir are the only recommended agents in the United States for chemoprophylaxis and treatment of influenza A and B. Given within 48 hours of onset of symptoms, treatment can reduce the duration of uncomplicated influenza A and B illness by approximately one day compared to placebo. Chemoprophylaxis with either antiviral may be considered for unvaccinated persons, or individuals at high risk who are vaccinated after the start of local influenza activity.

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• Discuss with patients non-pharmacological interventions to prevent, appropriately manage, and treat viral respiratory infections.
• Review over-the-the counter medications and home remedies that may offer future symptomatic relief and may prevent unnecessary office visits for antimicrobial therapies.

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To facilitate patient understanding of appropriate antibiotic use, the following communication strategies can be incorporated into the office visit:

• Verbalize any illnesses that are ruled out upon assessment of the ears, nose, throat, and lungs.
• Develop a contingency plan with patients. If symptoms do not begin to subside in 72 hours, schedule a re-visit for further evaluation.
• Assist patients to identify safe home remedies and appropriate over-the-counter (OTC) medications that may offer symptom relief. (OTC cold and cough medication are NOT recommended for use in children younger than 4 years of age.)
• Review illness prevention, including good hand and respiratory hygiene. Encourage that caregivers and family members get the influenza vaccine.

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Clinicians make the difference! Don’t hesitate to urge all of staff to get vaccinated. As medical leaders, it is our responsibility to model the importance of tackling the spread of influenza. Clinicians and medical office staff should protect themselves against influenza to reduce the risk of transmission and decrease the number of work days missed due to illness. Patients look to their physicians to determine if influenza vaccination is necessary. The power to prevent this infection is in our hands.

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Infectious Diseases In Children Influenza Vaccination:
Applying The Latest Data To Your Practice
VINDICO Medical Education March 2008
http://www.vindicomeded.com/cmelc/idc_monograph0308.asp

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