Early, intense influenza activity: Information for pharmacists

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The 2012–13 started early and is hitting hard; stay current on the latest information.

Surveillance information

The 2012–13 influenza season in the United States has been characterized by early and intense activity throughout much of the country. The latest influenza surveillance information is available in CDC's FluView weekly report.

Three-step approach

CDC recommends a three-step approach to fighting the flu: vaccination, everyday preventive actions (e.g., avoiding close contact with sick people, covering your nose and mouth with a tissue when you cough or sneeze, frequent hand washing, staying home when sick), and the correct use of antiviral drugs, if prescribed by a physician.

Importance of vaccinating high-risk individuals

CDC continues to recommend influenza vaccination for all people 6 months or older. It remains especially important that people at high risk of influenza complications get vaccinated, including pregnant women, children younger than 5 years (but especially younger than 2 years), adults 65 years or older, and individuals with chronic conditions (e.g., asthma, diabetes, heart disease).

Update on influenza vaccine supply

CDC reported that 145 million doses of influenza vaccine were available as of January 11, 2013; 129.4 million of these doses have been distributed. At this time, although some vaccine providers may have exhausted their vaccine supplies, most providers still have available doses for administration based on a January 10–14, survey from the National Influenza Vaccine Summit. CDC does not have a recommendation to prioritize remaining supplies of vaccine.

Providers interested in ordering additional influenza vaccine can visit the Influenza Vaccine Availability Tracking System to find information regarding distributors and vaccine manufacturers that have vaccine for sale.

APhA seeking input from pharmacists on state of antiviral supplies

APhA is seeking input from pharmacists regarding the current state of antiviral medication supplies across the country. This information will be shared with CDC and other public health partners. Please complete the short, nine-item survey describing the current environment of your practice(s). The results will be reported in the aggregate, and individual responses will be kept confidential. Thank you in advance for your prompt response. (Link to survey: http://fs8.formsite.com/MRothholz2/FluCheck2013/index.html)

HealthMap Vaccine Finder

Providers who have exhausted their influenza vaccine supply should refer patients to the HealthMap Vaccine Finder and should work with other providers in their area, including public health, to identify supplies of vaccines and where patients can be referred.

Influenza antiviral medications

CDC has issued recommendations for clinicians on the use of antiviral medications for treatment and prevention of influenza. The agency also has provided a summary for clinicians.

Update on antiviral availability

On January 10, FDA released information indicating possible intermittent shortages of oseltamivir phosphate (Tamiflu—Genentech) for oral suspension (6 mg/mL 60 mL), as a result of increased demand for the drug. This is the pediatric suspension (liquid). (Note: Influenza antiviral drugs are commercially manufactured, and supplies of these drugs are dependent upon commercial manufacturers.)

Compounding of Tamiflu 75 mg adult capsules to make oral suspension

Instructions for pharmacists are available online on how to compound an oral suspension from Tamiflu 75 mg (adult) capsules. These instructions provide for an alternative oral suspension when commercially manufactured oral suspension formulation is not readily available.

In some cases, clinicians can consider substituting a 30- or 45-mg capsule for children (if dose is appropriate) rather than suspension, particularly if there are spot shortages of suspension. These capsules may be opened and mixed with sweetened liquids, such as regular or sugar-free chocolate syrup, if oral suspension is not available.

What's True About the Flu fact sheet

The Infectious Diseases Society of America has created a What’s True about the Flu fact sheet.

APhA, ACP policies encourage vaccination of health care workers

At the 2011 APhA House of Delegates in Seattle, the Association adopted the following policy:

Requiring influenza vaccination for all pharmacy personnel

APhA supports an annual influenza vaccination as a condition of employment, training, or volunteering within an organization that provides pharmacy services or operates a pharmacy or pharmacy department (unless a valid medical or religious reason precludes vaccination). [J Am Pharm Assoc. 2011;51(4):482–4.]

On January 14, 2013, the American College of Physicians (ACP) approved a policy recommendation that all health care providers (HCPs) be immunized against influenza; diphtheria; hepatitis B; measles, mumps, and rubella; pertussis (whooping cough); and varicella (chickenpox) according to the Advisory Committee on Immunization Practices (ACIP) Adult Immunization Schedule. ACP’s policy exempts HCPs for medical reasons or a religious objection to immunization.

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