Influenza remains a major health problem in the United States, resulting each year in an estimated 36,000 deaths and 200,000 hospitalizations.4 Those who have been shown to be at high risk for the complications
of influenza infection are children 6 to 23 months
of age; healthy persons 65 years
of age or older; adults and children with chronic diseases, including asthma, heart and lung disease, and diabetes; residents
of nursing homes and other long - term care facilities; and pregnant women.4 It is for this reason that the Centers for Disease Control and Prevention (CDC) has recommended that these groups, together with health care workers and others with direct patient - care responsibilities, should be given priority for influenza vaccination this season in the face
of the current shortage.1 Other high - priority groups include children and teenagers 6 months to 18 years
of age whose underlying medical condition requires the daily use
of aspirin and household members and out -
of - home caregivers
of infants less than 6 months old.1 Hence, in the case
of vaccine shortages resulting either from the unanticipated loss
of expected
supplies or from the emergence
of greater - than - expected global influenza activity — such as pandemic influenza, which would prompt a greater demand for vaccination5 — the capability
of extending existing vaccine
supplies by using alternative routes
of vaccination that would require smaller doses could have important public health implications.