Abstract
To describe state-level actions and policies during the 2004–2005 influenza vaccine shortage and determine whether these or other factors were related to vaccination coverage, we surveyed all state health departments (including the District of Columbia). We included 2004–2005 Behavioral Risk Factor Surveillance System data to examine whether state-level actions, policies, or other factors like vaccine supply were related to changes in vaccination coverage in adults aged ≥65 years from the previous non-shortage year. We found that 96% (n=49) of states reported adopting or recommending adherence to the initial national interim influenza vaccination recommendations. Of these, at some point during the season, 22% (n=11) reported local public health agencies issued prioritization recommendations that differed from the state health department's guidance. Eighty percent (n=41) initiated at least one emergency response activity and 43% (n=22) referred to or implemented components of their pandemic influenza plans. In 35% (n=18), emergency or executive orders were issued or legislative action occurred.
In a multivariable linear regression model, the availability and use of practitioner contact lists and having a relatively high vaccine supply in early October 2004 were associated with smaller decreases in coverage for adults aged ≥65 years from the previous non-shortage season (p=0.003, r2=0.26). States overwhelmingly followed national vaccination prioritization guidelines and used a range of activities to manage the 2004–2005 vaccine shortage. The availability and use of practitioner contact lists and having a relatively high vaccine supply early in the season were associated with smaller decreases in coverage from the previous non-shortage season.