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HHS Releases Guidance for Use and Stockpiling of Antiviral Drugs for Pandemic Influenza


Health care workers and emergency services personnel who could have direct contact with individuals who are ill during an influenza pandemic should be protected with antiviral drugs throughout the pandemic, even before these workers are exposed or become ill themselves, according to guidance released today by the U.S. Department of Health and Human Services.

Stockpiling these antiviral drugs and planning for their use is the responsibility of employers as part of comprehensive pandemic preparedness, the guidance said.

The guidance also recommends preventive antiviral drug use for certain individuals following exposure to someone who is sick with pandemic influenza. These individuals include people with weakened immune systems, as well as for health care and emergency services workers such as law enforcement, firefighters, and emergency services personnel who do not routinely come in contact with ill people, and for residents in nursing homes, prisons, and other group residential settings if an outbreak of pandemic illness occurs in the facility.

HHS continues to recommend using antiviral drugs to treat people with pandemic influenza illness as a way to slow the spread of pandemic disease. National and state antiviral drug stockpiles, intended primarily for these uses, contain enough antiviral drugs for more than 72 million people.

By placing responsibility on employers, the new antiviral drug guidance highlights the importance of preparedness within both the public and private sectors.

“Planning and preparing for a pandemic influenza requires action by every part of society, including individuals and families, communities, and private sector employers as well as all levels of government,” said Dr. Craig Vanderwagen, HHS assistant secretary for preparedness and response, a rear admiral in the U.S. Public Health Service. “Employers will play a key role in protecting employees’ health and safety, which in turn reduces the impact of a pandemic on the nation’s health, the economy and society.”

In a related document, HHS provided recommendations for employers to consider broadly, suggesting that antiviral drugs may be part of a comprehensive pandemic preparedness plan and describing how an antiviral drug strategy could be implemented.

“Businesses should have a plan in place for responding immediately at the first sign a pandemic to be sure the business can protect the health of the workforce and continue to operate,” Vanderwagen said. “Employers may want to consider stockpiling antiviral drugs as one part of that plan.”

Using antiviral drugs may provide an additional layer of protection during a pandemic, along with advising sick employees to stay home and promoting changes in behaviors and work practices to reduce close contact between people and to improve hygiene, such as hand washing.

The HHS guidance recommends that employers have a clear understanding of the legal, regulatory, ethical, logistical, medical and economic issues involved in ordering, storing, securing, and dispensing prescription medications. The guidance also urges employers to work with their health providers or health services, and state and local health departments, to plan any stockpiling of antiviral drugs.

Federal officials developed the new guidance with major input from state, local, territorial, and tribal public health experts. Proposed guidance was shared broadly with health care and emergency services organizations, and other businesses, and further input was received during a public comment period; antiviral drug manufacturers were not involved in the development of the new guidance.

The guidance is not intended as a mandate, but provides recommendations for a prudent approach to planning for and responding to an influenza pandemic. Today’s guidance and accompanying considerations for employers replaces the previous antiviral drug use recommendations that are included in the 2005 HHS Pandemic Influenza Preparedness and Response Plan.
For a copy of the guidance, visit


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