On October 5, 2004, the CDC received formal notice that Chiron Corporation would not be filling its order for flu vaccine due to suspension of the company’s license by the Medicines and Healthcare Products Regulatory Agency (MHRA) in the United Kingdom, where the vaccine is produced. The suspension is for three months and will prevent the use of its vaccine for this season. This will reduce the available vaccine by one half for this flu season. About 55 million flu shots will be available in the U.S. for this season, and there will be an additional one million doses of the nasal spray vaccine.
There was a rumor that partial doses may be recommended, but this is not correct. No data are available to support that a partial dose would provide adequate antibody response. There have been some studies conducted to assess antibody response at one half the dose when given to persons age 18–49. However, the FDA has not approved the vaccine for use at a reduced dose.
Based on the reduced number of doses, the CDC is recommending priority be given to the following persons:
All children aged 6–23 months
Adults 65 and older
Persons 2–64 years with chronic medical conditions
All women pregnant during the flu season
Residents of nursing homes and long-term care facilities
Children six months–18 years on chronic aspirin therapy
Healthcare workers involved in direct patient care
Out-of-home caregivers and household contacts of children under six months of age.
The question of how to define a healthcare worker involved in direct patient care is answered as follows: “Having direct, hands-on or face-to-face contact with patients as part of routine daily activities.” This includes doctors, nurses, others who care for patients, paramedics, triage staff and police. The vaccine is not recommended for healthcare personnel working in offices where patients are not seen or treated, even if the office is located in a hospital or clinic.