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More Influenza Vaccine Doses to Be Shipped This Season, CDC Says

Kate Traynor

The Centers for Disease Control and Prevention (CDC) recently boosted its projection of the total number of influenza vaccine doses to be supplied by manufacturers for the 2003–04 season: from 80–85 million to 86.5–93 million.

CDC's National Immunization Program issued the bulletin below.

Influenza Vaccine Supply and Production

The FDA Approves FluMist

On June 17, 2003, the Food and Drug Administration (FDA) issued a license to Medimmune Inc. to produce FluMist, a live attenuated influenza vaccine administered intranasally. To view the package insert for this product, go to

The Advisory Committee on Immunization Practices (ACIP) will publish recommendations for this new vaccine in the Morbidity and Mortality Weekly Report (MMWR) before the 2003-04 influenza vaccination season begins. For additional information on the approval of FluMist, please see Flu News on the CDC-NIP web site at

Updated Projection for This Year's Influenza Vaccine Supply

The three influenza vaccine manufacturers licensed to produce vaccine for the U.S. market, Aventis Pasteur, Powderject Vaccines (which produces the Evans Vaccines brand), and Medimmune, project an aggregate total of 86.5-93 million doses for 2003. This recent projection remains from 2 to 8.5 million doses below last year's total production but exceeds the estimated 79 million doses that were sold to individuals in 2002.

The AMA Strongly Supports Influenza Vaccination Efforts

In a recent article published in the AMA/Federation News, AMA Executive Vice President and CEO Michael D. Maves, MD, affirmed the AMA's position on influenza vaccination. While addressing attendees at the National Influenza Vaccine Summit in Chicago on May 20, 2003, Maves remarked, "We are committed to working with all of you to support mechanisms to increase influenza vaccine supply and vaccine demand among physicians, other providers, and the public to reach the goals of Health People 2010."

Review the entire article for additional highlights at

Influenza Vaccine Distribution and Administration

This Season, Possible Relaxation of ACIP's Tiered Approach to Vaccination

On June 18, 2003, the ACIP voted to relax the tiered approach to vaccination if, by late summer, vaccine production is proceeding satisfactorily.

If the National Immunization Program (NIP), in consultation with the FDA and the influenza vaccine manufacturers, decides to relax the tiered approach for 2003, an announcement will be published in the MMWR and in a subsequent issue of this bulletin. The CDC and FDA staff will collaborate to draft a process by which such a decision can be made this year.

The Vaccines for Children (VFC) Program Expands to Cover Influenza Vaccine

The ACIP continues to encourage influenza vaccination for children 6-23 months of age and for household contacts and out-of-home caregivers of children under 2 years of age. The Vaccines for Children (VFC) program has expanded to cover VFC-eligible children in these groups during the 2003-2004 flu season.

Influenza Vaccine Communications

  • The Vaccine Information Statement (VIS) for inactivated influenza vaccine is located on the CDC-NIP web site at    
  • A separate Vaccine Information Statement for FluMist will be distributed and posted on the NIP web site in the near future.    
  • An article in the January 8, 2003 Journal of the American Medical Association (JAMA) by William Thompson and colleagues revisits prior estimates of influenza-associated deaths. New analyses of data suggest that, over the past two decades, substantially more influenza-associated deaths occurred among persons over 65 than was estimated previously. Between 1990 and 1999, an average of about 36,000 influenza-associated deaths occurred annually, a substantial increase over the previous estimated average of 20,000.    
  • In the April 3, 2003 issue of the New England Journal of Medicine (NEJM), Kristin Nichol and colleagues address the benefit of influenza vaccination in reducing the risk of cardiovascular hospitalizations among the elderly during influenza season.    
  • Review web site updates, find details about influenza vaccination, and access free promotional and educational materials on the CDC-NIP web site at