Shimabukuro Tom T, Wortley Pascale M, Bardenheier Barbara, Bresnitz Eddy A, DeBlois Anna M, Hahn Christine G, Mangione Ellen J
Epidemic Intelligence Service, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Public Health Rep. 2007 May-Jun;122(3):311-8. doi: 10.1177/003335490712200304.
To describe state-level actions and policies during the 2004-2005 influenza vaccine shortage and determine whether these or other factors were related to vaccination coverage, we surveyed all state health departments (including the District of Columbia). We included 2004-2005 Behavioral Risk Factor Surveillance System data to examine whether state-level actions, policies, or other factors like vaccine supply were related to changes in vaccination coverage in adults aged > or = 65 years from the previous non-shortage year. We found that 96% (n = 49) of states reported adopting or recommending adherence to the initial national interim influenza vaccination recommendations. Of these, at some point during the season, 22% (n = 11) reported local public health agencies issued prioritization recommendations that differed from the state health department's guidance. Eighty percent (n = 41) initiated at least one emergency response activity and 43% (n = 22) referred to or implemented components of their pandemic influenza plans. In 35% (n = 18), emergency or executive orders were issued or legislative action occurred. In a multivariable linear regression model, the availability and use of practitioner contact lists and having a relatively high vaccine supply in early October 2004 were associated with smaller decreases in coverage for adults aged > or = 65 years from the previous non-shortage season (p = 0.003, r2 = 0.26). States over-whelmingly followed national vaccination prioritization guidelines and used a range of activities to manage the 2004-2005 vaccine shortage. The availability and use of practitioner contact lists and having a relatively high vaccine supply early in the season were associated with smaller decreases in coverage from the previous non-shortage season.
为描述2004 - 2005年流感疫苗短缺期间州一级的行动和政策，并确定这些因素或其他因素是否与疫苗接种覆盖率相关，我们对所有州卫生部门（包括哥伦比亚特区）进行了调查。我们纳入了2004 - 2005年行为危险因素监测系统的数据，以研究州一级的行动、政策或其他因素（如疫苗供应）是否与65岁及以上成年人自上一个非短缺年份以来疫苗接种覆盖率的变化有关。我们发现，96%（n = 49）的州报告采用或建议遵循最初的国家临时流感疫苗接种建议。其中，在该季节的某个时间点，22%（n = 11）报告当地公共卫生机构发布了与州卫生部门指导意见不同的优先排序建议。80%（n = 41）启动了至少一项应急响应活动，43%（n = 22）提及或实施了其大流行性流感计划的组成部分。35%（n = 18）发布了紧急或行政命令或采取了立法行动。在多变量线性回归模型中，2004年10月初从业者联系名单的可用性和使用情况以及相对较高的疫苗供应量与65岁及以上成年人自上一个非短缺季节以来覆盖率的较小下降相关（p = 0.003，r2 = 0.26）。各州绝大多数遵循国家疫苗接种优先排序指南，并采取了一系列活动来应对2004 - 2005年的疫苗短缺。从业者联系名单的可用性和使用情况以及季节早期相对较高的疫苗供应量与自上一个非短缺季节以来覆盖率的较小下降相关。
