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Am Fam Physician. 2009;80(9):913-914

Organizations Encourage Seasonal Flu Vaccine, H1N1 Vaccine for Pregnant Women

The American Academy of Family Physicians (AAFP) and seven other national organizations with an interest in maternal and infant health are raising awareness about the risks of influenza during pregnancy. The organizations issued a joint statement urging pregnant women to be vaccinated against the seasonal influenza and the novel influenza A (H1N1) viruses. Evidence has shown that there are increased risks for pregnant women who become ill with H1N1 infection. For this reason, pregnant women are one of the high-risk groups the Centers for Disease Control and Prevention (CDC) and the AAFP have prioritized to receive the new vaccine. There is additional evidence showing that the recommendation of a physician can affect whether a woman is immunized during pregnancy. A study from the Rhode Island Department of Health found that 62.9 percent of pregnant women who were offered the influenza vaccine or whose physicians recommended they get the vaccine did so during the 2005–2006 and 2006–2007 flu seasons. The first wave of H1N1 vaccine was delivered to vaccination sites the week of October 5, 2009. The CDC plans to give weekly updates on the amount of vaccine available for ordering and how much is shipped to each state or large city. Updates will be given every Friday through media briefings or postings on the CDC's Web site. For more information, visit or

Physician Workforce Report Addresses Planning, Distribution, and Funding Needs

A recent report from the AAFP recommends comprehensive changes that must be made to secure a family physician and primary care workforce that meets the country's needs. The report highlights national physician workforce planning, medical specialty distribution, graduate medical education funding, and medical education policy as areas in need of reform. According to the report, family physicians need to provide at least 30 percent of ambulatory patient care in the United States to ensure health care access for all Americans; to meet the needs of underserved patients; and to meet the demands for services posed by an aging population. The report estimates that tens of thousands of additional family physicians are needed by 2020 to accomplish these goals. The AAFP makes several specific recommendations for achieving workplace reform, including establishing a national commission to address health workforce issues; creating a 10-year plan that targets 50 percent of all U.S. physicians to practice in primary care specialties; expanding medical schools to target rural and underserved primary care practice; and increasing funding for Title VII of the Public Service Act to support family medicine departments. For more information, visit or

AAFP Focuses on Education in Second Phase of Pertussis Awareness Campaign

The AAFP has launched the second phase of its pertussis vaccination awareness campaign, “Vaccination Matters: Help Protect Families from Whooping Cough.” The new phase, aimed at consumer education, began with a nationwide media tour that included interviews with (then) AAFP President Ted Epperly, MD, of Boise, Idaho, and former AAFP Board Director Virgilio Licona, MD, of Fort Lupton, Colo. According to CDC statistics, only 2 percent of adults received the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) from 2005 through 2007. Additionally, a survey from the AAFP found that 76 percent of respondents did not know that pertussis remains widespread in the United States, and 61 percent did not know a vaccine is available. In 2006, the CDC's Advisory Committee on Immunization Practices first recommended that adults 19 to 64 years of age receive a single booster dose of Tdap to replace the tetanus and diphtheria toxoids vaccine (Td) if patients received their last dose of Td 10 or more years earlier, and had not previously received Tdap. For more information, visit

Survey Shows Medical Students Consider EHR Systems a Priority in Future Careers

An electronic health record (EHR) system will be a key part of medical students' future practices, according to the fourth annual Future Physicians of America survey conducted by Epocrates Inc. Respondents consisted of 1,005 medical students who use the company's mobile software. Of these, 90 percent said it was important or very important to have an EHR system wherever they decide to practice. Jason Mitchell, MD, assistant director of the AAFP's Center for Health Information Technology (IT), said medical students typically have access to EHR systems during their training programs, which allows them to see the process efficiencies achieved through health IT. According to data compiled by the Center for Health IT, 53 percent of AAFP members surveyed in 2008 indicated they were in the process of implementing an EHR system or already had a fully implemented system in their practices. Mitchell said this number has increased steadily since 2003. For more information, visit

Online Resource Offers Coding Instructions for H1N1 Vaccine Administration

To help physicians stay up-to-date with current coding instructions for H1N1 vaccine administration, the AAFP has added a page on its Web site with information from the nation's largest payers. After the U.S. Food and Drug Administration's (FDA's) recent approval of four H1N1 vaccines, the Centers for Medicare and Medicaid Services created a unique Healthcare Common Procedure Coding System (HCPCS) code, G9141, specifically to cover administration of the H1N1 vaccine. In addition, the American Medical Association's Current Procedural Terminology (CPT) Editorial Panel has approved a new code, 90470, to report intramuscular or intranasal H1N1 immunization administration, including counseling. Although Medicare requires that physicians submit code G9141, other payers, including CIGNA, Humana, and Aetna, have announced they will accept G9141 or 90470. Physicians will be paid the same amount regardless of which code they use. Payers say it is not necessary to report a code for the vaccine itself because the federal government is providing the vaccine free of charge. For more information, visit

AAFP Launches Consumer Alliance Program, Announces First Corporate Grant

The AAFP has announced a corporate partnership with The Coca-Cola Co., in which the beverage company will provide a grant for the AAFP to develop consumer education content on its consumer health and wellness Web site, This is the first partnership for the AAFP's Consumer Alliance program. The new content, which will focus on beverages, sweeteners, and sugar-free alternatives, is expected to appear on the Web site in January 2010. In addition to creating content for, the AAFP will work with Consumer Alliance partners to create programs and materials to educate consumers and health professionals about making healthy food and beverage selections, increasing physical activity, achieving emotional well-being, and promoting other aspects of a healthy lifestyle. The partnerships will not include an endorsement of any brand, product, or service, and the AAFP will maintain editorial control of all materials related to the partnerships. For more information, visit

CDC Recommends Physicians Recall Children in Need of Hib Booster Dose

As the nation's supply of Haemophilus inflenzae type b (Hib) vaccine increases, the CDC and the AAFP are encouraging physicians to recall children who have not received a booster dose. In August 2009, the FDA approved Hiberix as a booster dose for children 15 months to four years of age. In the September 18, 2009, Morbidity and Mortality Weekly Report, the CDC recommends a physician-initiated notification process for offices with a sufficient supply of vaccine. If the supply is inadequate to recall all affected patients, physicians should provide the booster dose at the child's next regularly scheduled visit. For more information, visit

Change in Heparin Manufacturing Decreases Unit Dose Potency

The FDA is alerting physicians about a change in heparin manufacturing that likely will decrease the potency of the anticoagulant by 10 percent. According to FDA officials, the U.S. Pharmacopeia (USP) monograph for heparin has been revised, in part, because of product contamination in 2007 and 2008 that was associated with adverse events, including deaths. The primary changes to the monograph include the implementation of a new USP reference standard and test method that is used to determine the potency of the drug. Unlike the previous test method, the new method is able to detect impurities. The monograph change synchronizes the USP unit dose with the World Health Organization's International Standard unit dose. Heparin products that use the new USP unit were expected to be available on or after October 8, 2009, but older versions of the drug likely will still be in circulation. The FDA has asked manufacturers to label new heparin products in a manner that will help differentiate them from the old products. For more information, visit


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