By Sheila Kun RN, BSN, MS, CPN, FCCP

Populations at Higher Risk for Medical Complications Attributable to Severe Influenza All persons aged ≥6 months who do not have contraindications should be vaccinated annually. However, vaccination to prevent influenza is particularly important for persons who are at increased risk for severe illness and complications from influenza and for influenza-related outpatient, emergency department, or hospital visits. When vaccine supply is limited, vaccination efforts should focus on delivering vaccination to persons at higher risk for medical complications attributable to severe influenza who do not have contraindications. These persons include (no hierarchy is implied by order of listing):

• All children aged 6 through 59 months;
• All persons aged ≥50 years;
• Adults and children who have chronic pulmonary (including asthma), cardiovascular (excluding isolated hypertension), renal, hepatic, neurologic, hematologic, or metabolic disorders (including diabetes mellitus);
• Persons who are immunocompromised due to any cause (including but not limited to immunosuppression caused by medications or HIV infection);
• Women who are or will be pregnant during the influenza season;
• Children and adolescents (aged 6 months through 18 years) who are receiving aspirin- or salicylate- containing medications and who might be at risk for experiencing Reye syndrome after influenza virus infection;
• Residents of nursing homes and other long-term care facilities; • American Indians/Alaska Natives; and
• Persons who are extremely obese (body mass index ≥40 for adults).

Persons Who Live with or Care for Persons at Higher Risk for Influenza-Related Complications All persons aged ≥6 months without contraindications should be vaccinated annually; however, in addition to persons at higher risk for medical complications attributable to severe influenza, emphasis also should be placed on vaccination of persons who live with or care for those who are at increased risk. When vaccine supply is limited, vaccination efforts should focus on delivering vaccination to persons at higher risk for influenza-related complications, as well as persons who live with or care for such persons, including the following:

• Health care personnel, including all paid and unpaid persons working in health-care settings who have the potential for exposure to patients and/or to infectious materials. These personnel might include (but are not limited to) physicians, nurses, nursing assistants, nurse practitioners, physician assistants, therapists, technicians, emergency medical service personnel, dental personnel, pharmacists, laboratory personnel, autopsy personnel, students and trainees, contractual staff, and other persons not directly involved in patient care but who can potentially be exposed to infectious agents (e.g., clerical, dietary, housekeeping, laundry, security, maintenance, administrative, billing, and volunteers). ACIP guidance for immunization of health care personnel has been published previously;
• Household contacts (including children) and caregivers of children aged ≤59 months (i.e., aged <5 years) and adults aged ≥50 years, particularly contacts of children aged <6 months; and
• Household contacts (including children) and caregivers of persons with medical conditions that put them at higher risk for severe complications from influenza.

Health care personnel and persons who are contacts of persons in these groups (with the exception of those of severely immunocompromised persons who require a protected environment) may receive any influenza vaccine that is otherwise indicated. Persons who care for severely immunocompromised persons requiring a protected environment should receive specific recommended vaccination with the direction from their primary care physician.

Your homework from the Care Ministry this week: determine your risk factor and share the flu vaccination information with a friend.

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