Approaches for improving influenza prevention and control.

Despite efforts to increase the number of doses of influenza vaccine produced and distributed in the United States, there have been disruptions in the production and distribution of the trivalent influenza vaccine during five of the last six years. These delays and shortages have highlighted some of the limitations of our vaccine supply system and have contributed toward concerns that the nation is inadequately prepared to respond to an influenza pandemic. However, these challenges have also provided an opportunity to focus attention on the importance of influenza, as well as the need for improving influenza vaccine production processes, expanding disease surveillance efforts, strengthening public health– private provider relationships to facilitate vaccine distribution and redistribution, and other strategies for improving vaccination coverage levels. These actions are not only important during interpandemic years but also essential for pandemic planning and preparedness. Influenza is a serious disease. In the United States, interpandemic or seasonal influenza and its complications are associated with an average of 36,000 deaths each year and more than 200,000 hospitalizations. More than 90 percent of these deaths and approximately half of the hospitalizations occur among persons 65 years of age or older. The annual economic toll of influenza has been estimated at between $2 and $3 billion per year in direct medical costs. The severity and impact of the next pandemic, whether from the highly pathogenic avian influenza A (H5N1) virus or another influenza virus, cannot be predicted. However, model-