|Assess your flu vaccine utilization from the previous flu season and account for any unexpected business changes that may add or subtract from your current usage
Finalize your pre-book and submit
|Select tentative dates for your Flu Vaccination Event
Review your pre-book and make adjustments if necessary
Order flu vaccination supplies (needles, syringes, gloves, alcohol prep pads, etc.)
|Get ready – most flu shots are given in the fall months, so be ready to administer flu vaccines on request
Finalize your Flu Vaccination Event dates after you have scheduled delivery of your vaccine. This will help minimize the need to reschedule due to unexpected delays
|Don’t stop vaccinating – flu activity may not peak until February or March. The CDC recommends continued flu vaccination efforts throughout the season
Plan ahead – the CDC will soon be announcing the strain composition for the upcoming flu season
It’s never too early to start planning next year’s flu pre-book
Healthcare providers play a critical role in preparing for each new flu season. Because of the variation from year-to-year, it’s important to understand the flu vaccine trends including flu supply and current influenza guidelines as you prepare for the upcoming season.
What’s trending? 2017-2018 flu season
- Current flu season “very active”: the CDC is calling the current flu season “very active,” with early signs indicating the potential for it to become “severe”1
- Flu production is up: flu manufacturers’ projected production for the 2017-2018 season is between 151 – 166 million doses for the U.S. market (compared to 145.9 million doses of flu vaccine distributed during 2016-2017)2
- New Aluria recommendations: in June 2017 Afluria® Quad status was updated to recommended for persons 5 years and older (both vials and syringes). Prior season recommendation was persons 9 years and older
- FluMist effectiveness still questionable: the Advisory Committee on Immunization Practices (ACIP) extended its 2016 – 2017 recommendation that FluMist not be used over to the 2017 – 2018 season
- Influenza activity for the prior season (2016-2017)
- Peaked between February 5 and February 25, 2017
- Was longer than the 2015 – 2016 season
- Western states peaked at least 1 month earlier than the rest of the country
- Most viruses were represented in the recommended vaccines
- Strain A(H3N2) was predominant during peak3
- Increase in flu-related hospitalizations: flu-related hospitalization rates have increased over the last 2 decades due in part to the aging population.4 Up to 70% of seasonal flu-related hospitalizations occur among those who are 65 and older5
Most common place of flu vaccination in 20177
National Influenza Vaccination Trends
Influenza Vaccination Rates6
|Children aged 6 months through 17 years||70%||59.3%||59.0%|
|Adults aged 18 years through 64 years||70%||36.5%||37.5%|
|Adults aged 65 and older||70%||63.4%||65.3%|
What’s coming? 2018-2019 influenza outlook
New Vaccine Expected in 2018-2019
|Flulaval® Quadrivalent 0.5mL Prefilled Syringe||6 months and above||10/box||90686||Preservative-free|
- Manufacturer Seqirus has informed McKesson that they will not be accepting pre-books for Fluvirin® Trivalent in the upcoming 2018 – 2019 season, however they maintain a robust influenza vaccine portfolio with brands like Fluad®, Flucelvax® and Afluria® Quadrivalent
- In 2017 – 2018 McKesson experienced a 70% decrease in availability of Trivalent vaccines. Healthcare providers should anticipate very limited Trivalent vaccine in 2018 – 2019 as the market continues to shift towards Quadrivalent
Flu year-round: A look at flu vaccine activities by season
Influenza Vaccine Frequently Asked Questions
Are all flu vaccines the same?
Different flu vaccine preparations have different indications as approved by the FDA.8 Click here to see the CDC’s flu vaccine table for an overview of these indications.
What are some of the differences between Trivalent (TIV) and Quadrivalent (QIV)?
Trivalent contains three strains of influenza virus (two “A” strains and one “B” strain). Quadrivalent contains four strains (two “A” and two “B”).9
What is the difference between Quadrivalent and high-dose vaccines?
Quadrivalent refers to the number of strains of influenza virus contained in the vaccine – four strains – two “A” and two “B”. High dose is a type of vaccine that provides a more robust immune response in patients 65 years and older.
Are there any thimerosal-free or preservative-free influenza vaccines?
Yes. Single dose vials, sprayers, and most pre-filled syringes are preservative-free. (FLUVIRIN® PFS contains 1 mcg or less mercury per 0.5ml dose).
When should I learn about the different flu vaccines offered and the strains they protect against?
Look for the season’s strains in late February/early March. The World Health Organization (WHO) consults with various experts and partners each year in February, before making recommendations for the composition of the seasonal influenza vaccine. Shortly thereafter, the Food and Drug Administration (FDA) likely endorses this recommendation and announces which strains the season’s vaccine will protect against.10
What vaccines are available for people 65 and older?
According to the CDC people 65 years and older can get any injectable vaccine (flu shot) that is approved for use in that age group. However, there are two vaccines designed and indicated specifically for people 65 and older, Fluzone® High-Dose manufactured by Sanofi-Pasteur and Fluad® manufactured by Seqirus.
Ordering flu vaccine
When should I order my flu vaccine?
Because of the lengthy flu vaccine manufacturing and distribution periods, as well as limited quantities, it’s best to pre-book and order your vaccine as early as possible. Typically, you would want to order your vaccine in the spring, shortly after the season’s vaccines and strains are announced by the FDA and CDC.
How much flu vaccine should I order?
Assess your last year’s vaccine usage and make adjustments as necessary. Take into consideration any expected flu surges in your area, as well as your patient population. Certain persons are at a higher risk of medical complications attributable to severe flu, so you should assess your patient population for these persons and include these numbers in your vaccine ordering. Persons at risk include:11
- All children aged 6-59 months
- All persons aged 50 years and older
- Adults and children who have chronic pulmonary (including asthma) or cardiovascular (except isolated hypertension), renal, hepatic, neurologic, hematologic, or metabolic disorders (including diabetes mellitus)
- Persons who have immunosuppression (including immunosuppression caused by medications or by 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 long-term aspirin therapy and who might be at risk for experiencing Reye’s syndrome after influenza virus infection
- Residents of nursing homes and other long-term care facilities
- American Indians/Alaska Natives
- Persons who are obese, with a body mass index of 40 or greater
Why is pre-booking important?
Because production begins so early (it takes at least six months to produce large quantities of influenza vaccine), pre-booking can be helpful to ensure you get the appropriate amount of vaccine for your needs.12 In addition, historical data shows that manufacturers typically waitlist certain vaccines in March. Once a product is waitlisted, there is no guarantee of the delivery date or even that more vaccines will be available. Product may not be readily available to providers who did not take advantage of the pre-book period.
Will pricing be available when I pre-book?
You may pre-book for the next season at any time. Pricing is typically set in January for the coming season. You have until July 13, 2018 to update or cancel pre-books with no penalty when you pre-book with McKesson Medical-Surgical.
Why isn’t my flu vaccine shipped all at once and delivered at the beginning of the season?
It’s difficult for manufacturers to produce sufficient flu vaccine supply all at once, due to the early start and phased approach to vaccine production. According to the CDC, flu vaccine production begins as early as six to nine months before the beginning of vaccine distribution, and yet, even with this early start, it isn’t possible to complete the entire production and distribution process prior to flu season. In addition, the limited number of manufacturing plants in the US, all producing high volumes of vaccine, further contributes to the difficulty of supply. These factors, as well as others including the unpredictability of the flu season, often affect the vaccine distribution process and make it extremely difficult to provide all flu vaccine at once.13
Unless otherwise noted, the recommendations in this document were obtained from: Centers for Disease Control and Prevention. Be advised that information contained herein is intended to serve as a useful reference for informational purposes only and is not complete clinical information. This information is intended for use only by competent healthcare professionals exercising judgment in providing care. McKesson cannot be held responsible for the continued currency of or for any errors or omissions in the information.