Background papers providing critical appraisal of the evidence and tentative recommendations prepared by the chapter author were pre-circulated to the members. Consensus was reached on final recommendations. Reliability of test results when conducted by non-laboratory trained persons is unknown. Data from cohort analytic studies support vaccination of elderly persons living in institutions, persons with chronic heart or pulmonary conditions, diabetes and those who are immunocompromised. In elderly persons, live-attenuated vaccines offer no advantages over inactivated vaccines in terms of antibody response or immunologic memory.
Little evidence exists that adverse effects of vaccination affect patient compliance.
An RCT of vaccination of health care providers reported a minimal reduction in symptoms. Although efficacious, vaccination of the general population is not thought to be cost-effective. Citations in support of individual recommendations are identified in the guideline text. This report was externally peer-reviewed. The National Advisory Committee and the ACIP also recommended amantadine to prevent illness and to reduce severity and duration of illness.