October 8, 2004

Dear Colleagues:

On October 5, 2004, the Chiron Corporation announced that none of its influenza vaccine (Fluvirin®) would be available for distribution in the United States for the 2004-05 influenza season. This will reduce by approximately one half the expected supply of injectable influenza vaccine available this year in the U.S. Hopkins receives the majority of its vaccine supply (about 25,000 doses) from this vaccine manufacturer. This shortage will significantly affect the availability of vaccine for our institution. While we are attempting to obtain adequate supplies of flu vaccines from other sources, we must take immediate measures to ensure that the vaccine we now have is used in the most judicious manner to protect patients and healthcare workers.

We will prioritize vaccinating healthcare workers with daily direct patient contact or those employees at risk for exposure to influenza in the clinical laboratory. Vaccination will begin at the end of October. We will offer vaccine to additional healthcare workers as it becomes available. The following Johns Hopkins Hospital and University employees with direct patient contact or exposure to influenza will be vaccinated in the first round:

Housestaff, clinical fellows, nurse practitioners and physician assistants with daily patient contact with first priority to
1. Emergency Department
2. Departments of Medicine, Pediatrics, Oncology, Bone Marrow and Solid Organ transplant services and OB/GYN

Clinical nursing staff working in
1.Emergency Department
2.Inpatient Medicine, Pediatrics, Oncology, Bone Marrow and Solid Organ Transplant and OB/GYN floors
3.Oncology, Moore, and Internal Medicine Clinics

Attending physicians with daily patient contact in
1.Emergency Department
2.Inpatient Medicine, Pediatrics, Oncology, Bone Marrow and Solid Organ Transplant and OB/GYN floors
3.Oncology, Moore, and Internal Medicine Clinics

Personnel in the Virology laboratory
Personnel in Respiratory Therapy, Phlebotomy, Physical Therapy, Radiology, Echocardiography and Transport who travel regularly to inpatient floors

We strongly encourage all employees, including those in the groups listed above, to obtain vaccine from their healthcare providers or other sources prior to the end of October if they are able. We particularly recommend that employees who are in high-risk groups (chronic heart or lung conditions, including asthma, diabetes, chronic kidney disease, weakened immune system (such as from HIV or AIDS) contact their healthcare providers for vaccine.

As more vaccine becomes available we will expand the vaccination campaign to include additional healthcare workers with clinical and patient care responsibilities. Currently we cannot offer vaccine to employees working outside of the healthcare setting. Be assured that we are doing all in our power to obtain adequate supplies of flu vaccine so that we can resume our regular practice of inoculating all employees who request vaccinations. We are working on plans that include alternatives to the vaccine and will help reduce exposure to influenza. We are also working closely with federal, state and local authorities. In the meantime, we ask for your patience and understanding during this vaccine shortage. This is a changing situation, and you will be updated periodically.

Sincerely,

Edward D. Miller, M.D.