The Task Force on Adult Immunization has supported the broadening of indications for influenza vaccine and has specifically focused on improving immunization rates among adults. Our editorial on adult immunization introduced the third edition of the book Guide for Adult Immunization [1] in which details of specific recommendations for vaccination are presented. The first priorities for influenza immunization are the following: 1) all persons who are at increased risk for influenza-related complications [all persons 65 years or older and younger persons with high-risk conditions], as well as residents of nursing homes and other long-term care facilities; and 2) healthy persons (health care workers, home care providers) who, if infected with influenza virus, can transmit infection to persons at high risk.

Dr. Bloomfield will be pleased to note that the recommendations also include consideration of influenza immunization for 1) persons who provide essential community services [to minimize the disruption created by influenza outbreaks], 2) any person who wishes to reduce the risk for influenza infection, and 3) international travelers (especially if they are traveling to areas where influenza outbreaks are probable). In one instance [2], a person with influenza on an aircraft with limited provisions for auxiliary ventilation spread the infection to an estimated 72% of exposed persons.