BOX 4-1

Advisory Committee on Immunization Practices (ACIP) Recommendations

Initial Target Groups (estimated 159 million Americans) (CDC/ACIP, 2009)

ACIP recommended that initial vaccination efforts focus on persons in the following five target groups (order does not indicate priority):

  • Pregnant women,

  • Persons who live with or provide care for infants younger than age 6 months (e.g., parents, siblings, and daycare providers),

  • Healthcare and emergency medical services personnel,

  • Persons ages 6 months to 24 years, and

  • Persons ages 25 to 64 years who have medical conditions that put them at risk for influenza-related complications.

Subset Target Groups (estimated 42 million Americans)

ACIP recommended that the following subset of the initial target groups receive priority for vaccination if supply of the vaccine initially available was not adequate to meet demand for vaccination among the five target groups listed above (order does not indicate priority):

  • Pregnant women,

  • Persons who live with or provide care for infants younger than age 6 months (e.g., parents, siblings, and daycare providers),

  • Healthcare and emergency medical services personnel who have direct contact with patients or infectious materials,

  • Children ages 6 months to 4 years, and

  • Children and adolescents ages 5 to 18 years who have medical conditions that put them at risk for influenza-related complications.

Prioritizing Within Initial Target Groups

ACIP provided both an initial set of target groups and a subset of those groups; jurisdictions were free to decide whether to focus initially on the broader set or on the subset. However, Utah’s deputy director for public health practice, Teresa Garrett, said, “We were almost forced into moving to the subgroups just because of what we had—not necessarily because of what we wanted to do and where we wanted to go first, but because of what was physically in our possession.” The first deliveries of vaccine to many places were LAIV nasal spray formulations that were contraindicated for many members of the target groups. Because of this practical consideration, in many jurisdictions initial efforts focused primarily on healthcare workers and pediatric patients without contraindica-



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