AoA November Newsletter

Table of Contents

Top Story

November Is National Family Caregivers Month

AoA News

AoA’s National Family Caregiver Support Program Celebrates 10 Years

November is National Alzheimer’s Disease Awareness Month

Message from Assistant Secretary Kathy Greenlee on Veterans Day 2010

AoA Recognizes Native American Heritage Month

Population Data on Older American Indian Adults Featured in AoA’s November
Widget

Eldercare Locator Takes on a New Look for a Rapidly Aging Population

2010-2011 Influenza Campaign

Other HHS News

Medicare Open Enrollment

AHRQ Launches New Website for Men

Hospitalizations for Medication and Illicit Drug-related Conditions on the Rise
among Americans Ages 45 and Older

More News

Scholarship Opportunity for Graduate Students

NCOA to Sponsor Webinar on Vision and Aging

Additional National Observances in November

CDC - Seasonal Influenza (Flu) - Final Season Vaccination Estimates: United States, 2009-10 Influenza Season

Image via WikipediaBecause the novel influenza A (H1N1) virus [2009 influenza A (H1N1)] was identified in April 2009, two separate influenza vaccines were distributed in the United States in 2009–2010: a seasonal vaccine and an influenza A (H1N1) 2009 monovalent vaccine (2009 H1N1 vaccine) [1, 2].

The final estimates in this report include vaccinations reported through May 2010 based on interviews through June 2010.

Key Finding:

Nationally, seasonal influenza vaccination coverage was highest among adults aged ≥65 years [69.6% (95% CI 69.0–70.2%)]. Among adults aged 50–64 years, national seasonal influenza vaccination coverage was 45.0% (95% CI 44.4–45.6%).

Seasonal Influenza Vaccination Coverage

• National 2009–10 seasonal influenza vaccination coverage among all persons aged ≥6 months in the United States was 41.2% (95% confidence interval [CI] 40.8–41.6%).(Table 1)
• Among children aged 6 months –17 years, national seasonal influenza vaccination coverage [43.7% (95% CI 42.8–44.6)] was higher than coverage for adults ≥18 years [40.4% (95% CI 40.0–40.8%)].
• For adults aged 18–49 years, national seasonal influenza vaccination coverage was higher for persons with high–risk conditions [38.2% (95% CI 36.9–39.5%)] compared to those without high–risk conditions [28.4% (95% CI 27.8–29.0%)].
• Nationally, seasonal influenza vaccination coverage was highest among adults aged ≥65 years [69.6% (95% CI 69.0–70.2%)]. Among adults aged 50–64 years, national seasonal influenza vaccination coverage was 45.0% (95% CI 44.4–45.6%).
• For children aged 6 months –17 years, healthy adults aged 18–49 years, adults aged 18–49 years with high–risk conditions and adults aged ≥65 years, 2009–10 final estimates were higher than estimates for the same groups in the 2008–09 season [2008–09 estimates: 30.2% (95% CI 28.4–32.0%), 19.5% (95% CI 18.2–20.8%), 33.0% (95% CI 29.8–36.5%) and 65.6% (95% CI 63.3–67.8%) respectively; CDC, unpublished data, 2009 National Health Interview Survey (NHIS)].
• One or more seasonal influenza vaccine doses were administered to 31.6 million (95% CI 30.9–32.3 million) children and 91.6 million (95% CI 90.7–92.5 million) adults, for an estimated 123.3 million (95% CI 122.1–124.5 million) seasonal influenza vaccinees during August 2009 through May 2010.

Full Article

Estimates of Deaths Associated with Seasonal Influenza --- United States, 1976--2007

Influenza infections are associated with thousands of deaths every year in the United States, with the majority of deaths from seasonal influenza occurring among adults aged ≥65 years (1--4). For several decades, CDC has made annual estimates of influenza-associated deaths, which have been used in influenza research and to develop influenza control and prevention policy. To update previously published estimates of the numbers and rates of influenza-associated deaths during 1976--2003 by adding four influenza seasons through 2006--07, CDC used statistical models with data from death certificate reports. National mortality data for two categories of underlying cause of death codes, pneumonia and influenza causes and respiratory and circulatory causes, were used in regression models to estimate lower and upper bounds for the number of influenza-associated deaths. Estimates by seasonal influenza virus type and subtype were examined to determine any association between virus type and subtype and the number of deaths in a season. This report summarizes the results of these analyses, which found that, during 1976--2007, estimates of annual influenza-associated deaths from respiratory and circulatory causes (including pneumonia and influenza causes) ranged from 3,349 in 1986--87 to 48,614 in 2003--04. The annual rate of influenza-associated death in the United States overall during this period ranged from 1.4 to 16.7 deaths per 100,000 persons. The findings also indicated the wide variation in the estimated number of deaths from season to season was closely related to the particular influenza virus types and subtypes in circulation.

The current study extends estimates of influenza-associated deaths from two previous CDC studies (2,3) by adding data from four more influenza seasons for a total of 31 influenza seasons (1976--2007). Estimates are provided for three age groups (<19>1) and can be considered a lower bound for deaths associated with influenza (2,4). However, a diagnosis of influenza virus infection often is not confirmed with sensitive and specific laboratory diagnostics, particularly among older persons, and even when identified is rarely recorded on death certificates (5). Many deaths associated with influenza infections occur from secondary infections such as bacterial pneumonia or complications of chronic conditions such as congestive heart failure and chronic obstructive pulmonary disease (6). Therefore, estimates using underlying respiratory and circulatory mortality data (which include pneumonia and influenza causes) can provide an upper bound for influenza-associated deaths (2,7).
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Scant Support for Flu Vaccines in Older Patients - in Geriatrics, Vaccines from MedPage Today

By Charles Bankhead, Staff Writer, MedPage Today

The practice of targeting influenza vaccine to older people has only poor-quality supporting evidence that fails to show a clear benefit or harm, authors of a systematic review concluded.

The only randomized, controlled trial of acceptable quality "seemed" to show a beneficial effect of vaccination against influenza symptoms but lacked statistical power to examine the effect on complications.

"The available evidence is of poor quality and provides no guidance regarding the safety, efficacy, or effectiveness of influenza vaccines for people ages 65 years or older," Tom Jefferson, MD, of the Cochrane Collaboration in Rome, and colleagues wrote in an article published in The Cochrane Library.
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Outbreaks of 2009 Pandemic Influenza A (H1N1) Among Long-Term--Care Facility Residents --- Three States, 2009

CDC Morbidity and Mortality Weekly Report (MMWR)

Hospitalization and death from seasonal influenza are more common among older adults and in long-term--care facilities (LTCFs) (1). Early data from the 2009 pandemic influenza A (H1N1) outbreak indicated that attack rates among persons aged ≥65 years were lower than in other age groups, and anti-influenza A antibodies that cross-react with 2009 H1N1 could be detected in up to one third of healthy adults aged >60 years (2). Based on these early data and anticipation of limited initial supplies of 2009 H1N1 vaccine, the Advisory Committee on Immunization Practices (ACIP) identified priority groups for vaccination (3), which did not include persons aged ≥65 years who did not have higher risk for influenza or its complications (3). During October and November 2009, CDC received reports of 2009 H1N1 outbreaks in LTCFs in Colorado, Maine, and New York. This report summarizes the three outbreaks, which involved facilities primarily housing older patients. These outbreaks illustrate that, despite the lower risk for infection with 2009 H1N1 among persons aged ≥65 years compared with seasonal influenza, 2009 H1N1 outbreaks still can occur in LTCFs. These outbreaks also underscore the importance of respiratory illness surveillance and recommended infection-control procedures in LTCFs. All health-care personnel should be vaccinated against seasonal influenza and 2009 H1N1. LTCF residents should receive seasonal influenza vaccination, and should be vaccinated against 2009 H1N1 after assessment of vaccine availability at the local level indicates that demand for vaccine among younger age groups is being met (3).

Outbreak Reports:

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High Dose Seasonal Influenza Vaccine Specifically Intended For People Ages 65 And Older Approved By U.S. FDA

The U.S. Food and Drug Administration has approved Fluzone High-Dose, an inactivated influenza virus vaccine for people ages 65 years and older to prevent disease caused by influenza virus subtypes A and B.

People in this age group are at highest risk for seasonal influenza complications, which may result in hospitalization and death. Annual vaccination remains the best protection from influenza, particularly for people 65 and older.

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Related articles by Zemanta

• FDA to Look at New Type of Flu Vaccine (online.wsj.com)
• High-Dose Flu Vaccine Approved for Seniors (blisstree.com)
• FDA Approves A High Dose Seasonal Influenza Vaccine (gloucestercitynews.net)

Hospitalization, Death From H1N1 Influenza Can Occur at Any Age

by Fran Lowry

H1N1 influenza is emerging as an equal-opportunity threat, seriously affecting people of all ages — not just younger people, as had been thought — according to the results of a surveillance study from California published in the November 4 issue of the Journal of the American Medical Association.

"Pandemic influenza A(H1N1) emerged rapidly in California in April 2009," write Janice K. Louie, MD, MPH, from the California Department of Public Health, Richmond, and colleagues. "Preliminary comparisons with seasonal influenza suggest that pandemic 2009 influenza A(H1N1) disproportionately affects younger ages and causes generally mild disease."

However, data on the clinical features and populations at risk for complications from H1N1 influenza infection are still emerging, the authors add.
.................
The highest hospitalization rates per 100,000 were in infants 1 month old (35.8) and 2 months old (21.1). These rates were lower in infants aged between 3 and 12 months, ranging from 4.2 to 12.6 per 100,000.

The median length of stay in hospital was 4 days.

Although infants were hospitalized at greater rates than adults, individuals aged 50 years or older had the highest rate of death once hospitalized, the authors report.

The overall fatality rate was 11%. In children younger than 18 years, the death rate was 7%, and in persons older than 50 years, it was 18% to 20%.
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Flu shots plentiful, doctors urged to get as well as give

Experts predict this year's vaccine formulation will be more protective than last season's. By Susan J. Landers and Kevin B. O'Reilly, AMNews staff. Oct. 13, 2008 in American Medical News. The good news is this year's vaccine is in ample supply. But with it, comes a challenge. Physicians should not only seek to immunize as many patients as possible, but also their staff members -- and themselves. In the 2006-07 flu season, only 42% of health care professionals were vaccinated -- a number that has remained stable for a decade.

For senior citizens, how effective are flu shots? Scientists challenge previous studies

By Melissa Healy, Los Angeles Times Staff Writer September 29, 2008 Among medical researchers and health professionals confidence in flu shot benefits has turned in the opposite direction. After six decades of steadily expanded use among the elderly, flu vaccination for seniors has come under critical scrutiny in several studies. Collectively, they suggest that for those over 65, flu vaccination may confer fewer benefits than have been widely advertised.

Doubts Grow Over Flu Vaccine in Elderly

By BRENDA GOODMAN Published: September 2, 2008, New York Times The influenza vaccine is quickly losing its reputation as an effective way to ward off the virus in the elderly. But should seniors skip it?

Meeting of the National Vaccine Advisory Committee

The meeting will be held on September 16, 2008, from 9 a.m. to 5:30 p.m., and on September 17, 2008, from 9 a.m. to 3 p.m. Topics to be discussed at the meeting include vaccine financing, vaccine stockpile, seasonal influenza and related issues, vaccine safety, vaccine development, and the National Vaccine Plan. Updates will be given by each of the working groups. An agenda will be posted on the NVAC Web site: http://www.hhs.gov/nvpo/nvac prior to September 1, 2008. Public attendance at the meeting is limited to space available.

FDA Approves 2008-2009 Flu Vaccines

The U.S. Food and Drug Administration (FDA) today announced that it has approved this year's seasonal influenza vaccines that include new strains of the virus likely to cause flu in the United States during the 2008-2009 season. This season's vaccines contain three strains of the influenza virus that disease experts expect to be the most likely cause of the flu in the United States. Each season's vaccines are modified to reflect the virus strains most likely to be circulating. The closer the match between the circulating strains and the strains in the vaccines, the better the protection. The FDA changed all three strains for this year's influenza vaccine—an unusual occurrence, as usually only one or two strains are updated from year to year. A list of the strains included in the 2008-2009 vaccine can be found at http://www.fda.gov/cber/flu/flu2008.htm. Of note, two of the three strains recommended for the U.S. this year are now in use for the Southern Hemisphere's 2008 influenza season, which is currently underway. Vaccination remains the cornerstone of preventing influenza, a contagious respiratory illness caused by influenza viruses. According to the CDC, every year an average of 5 to 20 percent of the U.S. population gets the flu, more than 200,000 are hospitalized from flu complications and there are about 36,000 flu-related deaths. Some individuals—the elderly, young children, and people with chronic medical conditions —are at higher risk for flu-related complications. Vaccination of these groups and of health care personnel is critical.