State Health Commissioner Novello Takes Further Action to Protect New Yorkers Most Vulnerable to the Flu

Dr. Novello Testifies at a Public Hearing on the Department's Latest Actions in Series of Efforts to Address the Flu Vaccine Shortage

October 20, 2004 -- In an effort to address the national influenza (flu) vaccine shortage and further ensure that available vaccine supplies reach those individuals who are most at risk for flu-related complications, State Health Commissioner Antonia C. Novello, M.D., M.P.H, Dr.P.H., today announced that New York State has made the U.S. Centers for Disease Control and Prevention (CDC) flu vaccine recommendations the 'standard of care' in New York State.

Today, Dr. Novello provided testimony at a public hearing hosted by New York State Senator Kemp Hannon, Chairman of the Senate Health Committee, on the Department's latest actions in a series of efforts to address the flu vaccine shortage, a national issue that is impacting all states.

The State Health Department is emphasizing that all health care providers must strictly adhere to the CDC's recommendations for flu vaccination during this flu season.

"It is imperative that health care providers statewide comply with the federal government's guidelines and make sure that only those individuals who are most at risk for complications from the flu receive the vaccine," Dr. Novello said.

Dr. Novello stressed, "New York State physicians, health professionals and our health care institutions are the best in the world. Time and time again they have proven their dedication and commitment to providing the very highest levels of service and to adhere to the standards of care without question. New York's doctors have done so thus far under difficult circumstances, and I expect that they will continue to do so."

In the event that violations of the standard of care are identified, the State Health Department may take actions against health care facilities, ranging from the issuance of a citation to the assessment of regulatory action, including fines. In cases in which the violations are egregious, the health care professional in question will be referred to the State Office of Professional Medical Conduct.

"Our establishment of the CDC guidelines as the standard of care in New York is as important for patients and the public as it is for our physicians and institutions. By understanding what we consider as the appropriate standard of care, patients will be more informed about their own decision to seek a flu shot, and will better understand the guidance and advice their health professional provides to them, including whether or not they will need a flu shot," Dr. Novello said.

Immediately after the shortage became known, Dr. Novello sent an alert to all health care providers and organizations requesting critical data, such as the amount of vaccine currently on hand, and their projected need to fully vaccinate all high risk individuals pursuant to the CDC guidelines. New York's assessment has been shared today with the CDC and local health departments and will help the federal government in its efforts to determine priority needs for flu vaccine and the redirection of those supplies to states. The assessment helps identify where the most need is and how best to direct flu shots to New Yorkers most at risk for complications from influenza.

New York State is awaiting additional direction from the CDC on its decision to redirect the remaining 22.4 million doses of flu vaccine supplies.

In New York, as in states nationwide, the vast majority of flu vaccine is not purchased by the State Health Department — approximately 90 percent — is sold directly to health care providers, including hospitals, community health clinics, nursing homes, home health care agencies and private physicians, as well as other entities such as pharmacies and private businesses.

The following CDC recommendations for influenza vaccination are now the standard of care in New York State:

Priority groups for influenza vaccination have been identified and include:

  • All children aged 6-23 months;
  • Adults aged 65 years and older;
  • Persons aged 2-64 years with underlying chronic medical conditions;
  • All women who will be pregnant during the influenza season;
  • Residents of nursing homes and long term care facilities;
  • Children aged 6 months to 18 years on chronic aspirin therapy;
  • Health care workers providing direct patient care; and
  • Out-of-home caregivers and household contacts of children under 6 months old.

Currently CDC estimates that during the 2004-05 flu season somewhere between 42 and 50 million people who meet the high risk, or high priority criteria will request vaccination. However, the expectation nationally is that the demand may be higher than usual this year because of the present vaccine shortage.

The DOH is working closely with the Pharmaceutical Society of the State of New York and the State Board of Pharmacy in the State Education Department to fully ascertain how much flu vaccine is currently in stock at chain store pharmacies and independent drug stores in New York State.

In addition, those businesses that provide flu shots to employees are expected to comply with the federal recommendations and prioritize vaccine for individuals in high risk categories. Businesses in New York with excess flu vaccine supplies are urged to contact their county health departments to coordinate a way to redirect those vaccine supplies to people who need it most. Licensed professionals, other than doctors, who are involved in employee vaccination programs and do not comply with the standard of care will be referred to the State Education Department's Office of Professional Discipline.

The Department is now monitoring flu activity and vaccine supplies throughout New York State by using the State's innovative Health Emergency Response Data System (HERDS) to collect the vaccine information from hospitals.

New York's HERDS is a comprehensive, interactive database, which includes geographic information and provides health officials with online, real time data describing available hospital beds, medical supplies, personnel, numbers, status and immediate care needs of ill or injured persons, along with other urgent information to facilitate a rapid and effective emergency response.

Additional State Response Activities Underway:

Allegations of Price Gouging: To address concerns about possible price gouging, the Department is working closely with the State Consumer Protection Board and appropriate law enforcement agencies to identify and investigate allegations of price gouging. Those found in violation will be prosecuted by the appropriate law enforcement agency to the fullest extent of the law.

Persons who become aware of potential practices of price gouging should contact the State Consumer Protection Board at 1-800-697-1220. Consumers can also file a complaint in writing through the Board's web site at

Vaccine Educational Materials: The Department is also pursuing enhanced strategies to further educate New Yorkers about the flu vaccine shortage and ways to reduce their risk if they cannot get a flu shot. The educational campaign reinforces the following messages:

  • There is a severe shortage of flu vaccine - not everyone will be able to get a flu shot;
  • For most people the flu is an annoyance, not a severe health threat;
  • People who are in a priority risk group should continue to seek vaccine - be patient but persistent in your efforts to get a flu shot;
  • There is still time to get a flu shot; and
  • If you cannot get a flu shot, there are still ways to reduce your risk — frequent hand washing cannot be overstressed as a simple means to avoid contracting or transmitting the flu. Also, individuals who are ill with flu-like symptoms should stay home from work or school.

The Department has made the following education materials available to reinforce risk strategies:

  • Hand washing and respiratory hygiene: "Your Health is in Your Hands and "Don't Spread it Around" posters in English, Spanish, Chinese and Russian.
  • What will work at work campaign: Poster and paycheck attachments promoting hand and respiratory hygiene; staying home when you are sick; and practicing health behaviors that boost the immune system.
  • Public Service Announcements (PSAs): Two radio PSAs have been scripted and will be produced shortly: a "Save vaccine — Save Lives" spot promoting deferral of vaccination for healthy adults, and a hygiene spot. Separate tags will reference "Your State" or "Your Local" Health Department. The "local" versions will be distributed electronically to local health departments by the State.

The poster materials will be distributed in bulk to target audiences and will be available for downloading from the Department's public web site at