Fast Facts for Healthcare Providers - Asthma and Influenza

All Providers can help increase influenza vaccination rates in adults and children with asthma.

What Providers Need to Know about Asthma and Influenza

  • Adults and children with asthma are at high risk for complications from influenza 1,2.
  • 100% of children > 6 months of age with asthma need to be vaccinated yet, 29% of children aged 2-17 years with current asthma were vaccinated in the 2004-2005 influenza season 2.
  • 100% of adults > 18 years of age with asthma need to be vaccinated yet, 35% of adults aged > 18 years with asthma reported having had an influenza vaccination 1.
  • One in 12 New Yorkers has asthma 3,4.

Influenza Vaccination Recommendations

For Children 5

  • All children ages 6 months through 18 years of age.
  • Children and adolescents at high risk for influenza complications should continue to be a focus of vaccination efforts as providers and programs transition to routine vaccination of all children and adolescents. Those at higher risk for influenza complications are:
    • children 6 months of age through 4 years;
    • those who have chronic pulmonary (including asthma), cardiovascular, renal, hepatic, hematological or metabolic disorders (including diabetes mellitus);
    • those who are immunosuppressed;
    • those who have any condition that can compromise respiratory function, the handling of respiratory secretions or that can increase risk for aspiration;
    • those who are receiving long term aspirin therapy;
    • those who are residents of chronic care facilities; and,
    • those who will be pregnant during the influenza season.
  • Children aged < 6 months should not receive influenza vaccination.
  • Household members (e.g., parents, siblings and others residingin the home) and other close contacts (e.g., daycare providers) of children aged < 6 months should be vaccinated.
  • Trivalent inactivated influenza vaccine (TIV) may be used for persons aged ≥6 months, including those with high-risk conditions, such as asthma and those who are pregnant.
  • Trivalent inactivated influenza (TIV) vaccine or live attenuated influenza vaccine (LAIV) can be used when vaccinating healthy, non-pregnant persons and healthy, non-wheezing persons aged 2 through 49 years of age.
  • Children aged 6 months through 8 years of age should receive 2 doses of vaccine (doses separated by > 4 weeks) if they have not been vaccinated previously.
  • Children aged 6 months through 8 years of age who only receive 1 dose in the first year of vaccination should receive 2 doses the following year.

For Adults 5

  • Annual vaccination against influenza is recommended for any adult who wants to reduce the risk for becoming ill with influenza or of transmitting it to others.
  • Vaccination also is recommended for all adults in the following groups because these adults are either at high risk for influenza complications or are close contacts of persons at high risk for influenza complications. These groups include:
    • persons aged >50 years;
    • women who will be pregnant during the influenza season;
    • persons who have chronic pulmonary (including asthma), cardiovascular, renal, hepatic, hematological or metabolic disorders (including diabetes mellitus);
    • persons who have immunosuppression;
    • persons who have any condition that can compromise respiratory function, the handling of respiratory secretions or that can increase the risk for aspiration;
    • residents of nursing homes and other chronic-care facilities;
    • health-care personnel;
    • household contacts and caregivers of children aged <5 years and adults aged >50 years, with particular emphasis on vaccinating contacts of children aged <6 months; and,
    • household contacts and caregivers of persons with medical conditions that put them at high risk for severe complications from influenza.
  • Trivalent inactivated influenza vaccine (TIV) may be used for persons aged ≥6 months, including those with high-risk conditions, such as asthma, and those who are pregnant.
  • Trivalent inactivated influenza (TIV) vaccine or live attenuated influenza vaccine (LAIV) can be used when vaccinating healthy, non-pregnant persons and healthy, non-wheezing persons aged 2 through 49 years.

How to Implement these Recommendations in Your Practice 6

Establish a practice goal and a team to manage the Influenza campaign

  • e.g., 90% of people with asthma in our practice will get vaccinated.

Identify patients in your practice who should get vaccinated

  • Generate a list of patients who need the flu vaccine from your asthma or immunization registry.

Increase demand for the vaccine

  • Send reminders to patients about when, why and where to get vaccinated.

Enhance access to the vaccine

  • Use standing orders.
  • Vaccinate during well and sick visits.
  • Consider "walk-ins" or use of evening and Saturday flu clinic sessions.
  • Continue to promote vaccination throughout the entire flu season.

Measure your vaccination rates

  • Review your vaccination results against your goals.
  • Make improvement changes as necessary.

For more information about the 2008 Recommendations for the Prevention and Control Influenza:

For more information on how to implement these recommendations into your practice:

References

  1. Ford ES, Mannino DM, and Williams SG. Asthma and Influenza Vaccination. CHEST 2003; 124: 783-789.
  2. Influenza Vaccination Coverage Among Children with Asthma – United States, 2004-05 Influenza Season , Morbidity and Mortality Weekly Report, March 9, 2007 / Vol. 56 / No. 9.
  3. National Asthma Survey – New York State (NAS-NYS) 2002-2003.
  4. Behavioral Risk Factor Surveillance System (BRFSS) – 2006.
  5. CDC MMWR Recommendations and Reports. Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices . July 17, 2008/57; 1-59.
  6. National Foundation for Infectious Diseases. Influenza and Children with Asthma: Call to Action. 2005.