1. Influenza and Older Adults
Title page
April 19, 2017
Hello, my name is [insert name], and I’ll be speaking with you today about the flu and what makes it such a serious and dangerous infectious disease. We’ll also discuss why vaccination is critically important to preventing the flu and what we can do to protect ourselves, our families, and our communities.
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2. Overview of Today’s Presentation
The important flu information everyone needs to know
The CDC recommends flu vaccination for everyone age 6 months and older1
Annual vaccination best way to avoid getting the flu1
The flu can be life-threatening, especially in older adults1
Our immune system weakens with age2
There is a higher dose flu vaccine option specifically for adults age 65 and older2
Helps generate a stronger immune response2
Before we get started, I’d like to briefly introduce some of the topics we’ll be discussing.
First, we’ll review the most important information that everyone should be aware of when it comes to the flu.
Realizing how dangerous the flu is, the Centers for Disease Control and Prevention, also known as the CDC, recently expanded their recommendations for annual flu vaccination to include almost everyone age 6 months and older.1
The flu is especially dangerous for older adults, because our immune system weakens as we age.2
Fortunately, a flu vaccine option has been developed specifically for adults age 65 and older. 2 This higher dose option has the same safety profile as the standard vaccine and helps the body generate a stronger immune response despite the age-related decline of our immune systems. 2
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References:
Centers for Disease Control and Prevention (CDC). Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR. 2011;60(33):
CDC. Fluzone High-Dose Seasonal Influenza Vaccine. Accessed May 29, 2012.
References:
1. Centers for Disease Control and Prevention (CDC). Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR. 2011;60(33): CDC. Fluzone High-Dose Seasonal Influenza Vaccine. Accessed May 29, 2012.

3. What is Influenza?
Influenza, also called the flu, is a common respiratory infection1
Symptoms include: high fever, headache, fatigue, cough, sore throat, runny or stuffy nose, and body aches1
The flu is a serious and potentially life-threatening disease, especially for adults age 65 and older2
Nation’s seventh leading cause of death, combined with pneumonia, among adults 65 and older3
Pneumonia is the most frequent complication of the flu4
The flu, also known as influenza, is a common respiratory infection caused by several related viruses.1
As anyone who has had the flu will tell you, the symptoms can be severe and include high fever, headache, fatigue, cough, sore throat, runny or stuffy nose, and body aches.1
Influenza is not your common cold; it is a serious and potentially life-threatening disease, especially for adults age 65 and older. 2 In fact, combined with pneumonia, it is the nation’s seventh overall leading cause of death among adults 65 and older. 3 Pneumonia is the most frequent complication of the flu.4
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References:
Centers for Disease Control and Prevention (CDC). Influenza symptoms. Accessed May 29, 2012.
CDC. Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR. 2011;60(33):
CDC. Deaths: Preliminary Data for National vital statistic reports. Accessed May 29, 2012.
CDC. Epidemiology and Prevention of Vaccine-Preventable Diseases. Accessed May 29, 2012.
References:
1. Centers for Disease Control and Prevention (CDC). Influenza Symptoms. Accessed May 29, CDC. Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR. 2011;60(33): CDC. Deaths: Preliminary Data for National vital statistic reports. Accessed May 29, CDC. Epidemiology and Prevention of Vaccine-Preventable Diseases. Accessed May 29, 2012.

4. Types of Flu Three types of influenza virus: A, B, and C1
Only types A and B cause seasonal influenza1
Type A affects people of all ages2
Type B primarily affects children2
Type C generally has few or mild symptoms1
Different strains of influenza type A and B virus can circulate from year to year and cause illness3,4
There are many human and animal flu strains, however only a few predominate and cause human disease
You may be surprised to learn that there are three different types of flu, types, A, B, and C. 1 Only types A and B cause seasonal influenza or have the ability to cause illness in humans. 1 Type C has few or mild symptoms.1
Influenza Type A affects people of all ages while Type B primarily affects children.2
Within these different types of flu, there are individual viruses called “strains.” Because Type A and B strains cause seasonal influenza, vaccination is recommended to protect against illness.3,4
There are many human and animal flu strains, however only a few predominate and cause human disease.
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References:
Centers for Disease Control and Prevention (CDC). Types of Influenza Viruses. Accessed May 29, 2012.
CDC. Epidemiology and Prevention of Vaccine-Preventable Diseases. Accessed May 29, 2012.
CDC. Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR. 2011;60(33):
CDC. Selecting the Viruses in the Seasonal Influenza (Flu) Vaccine. Accessed May 29, 2012.
References
1. Centers for Disease Control and Prevention (CDC). Types of Influenza Viruses. Accessed May 29, CDC. Epidemiology and Prevention of Vaccine-Preventable Diseases. Accessed May 29, CDC. Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR. 2011;60(33): CDC. Selecting the Viruses in the Seasonal Influenza (Flu) Vaccine. Accessed May 29, 2012.

5. Types of Flu
Scientists predict which strains will circulate and should be included in the flu vaccine each year1,2
The seasonal vaccine contains 3 strains1
Two type A strains1
One type B strain1
The 2009 H1N1 virus was a new type A strain1
It has been included in seasonal flu vaccines since its appearance1
The strains are studied as they spread around the world.1,2 Scientists use the information gained from these studies in order to predict the strains that will affect the U.S. each flu season.1,2 Those strains are then identified and included in that year’s flu vaccine. 1,2
For example, when the 2009 H1N1 flu virus first appeared it was similar to other type A strains, however it was different enough to spread quickly and cause a flu pandemic in the US.1 It has been included in the seasonal flu vaccines since its appearance.1
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References:
CDC. Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR. 2011;60(33):
CDC. Selecting the Viruses in the Seasonal Influenza (Flu) Vaccine. Accessed May 29, 2012.
References:
1. The Centers for Disease Control and Prevention (CDC). Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR. 2011;60(33): CDC. Selecting the Viruses in the Seasonal Influenza (Flu) Vaccine. Accessed May 29, 2012.

6. Why We Need Annual Flu Vaccination
Flu strains change genetically over time1
New vaccines are developed each flu season to account for new strains resulting from these genetic changes, or different strains predominating in causing disease1
Even when there is no strain change in the vaccine, immunity to the virus gradually wanes1
You may be asking yourself why you need to get vaccinated each and every year, and there are several reasons for this.
The flu virus has the ability to mutate.1 These mutations can give the flu the ability to evade our immune systems or the immunity provided by previous vaccines and make us sick.1
As mentioned earlier, as strains travel around the world and these mutations take place, a new flu vaccine must be developed each year in order to ensure we can be protected against the latest strains.1
The World Health Organization monitors the circulating flu virus globally and each year makes a recommendation of the flu strains to include in the vaccine based on their prediction of the most likely strains to be in circulation.2 Most years one or more strains are changed in the annual vaccine.1
Even when there is no strain change in the vaccine, immunity to the virus gradually wanes.1 Thus for the best protection, the Centers for Disease Control recommends that everyone 6 months of age and older get a flu shot each year.1
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References:
Centers for Disease Control and Prevention (CDC). Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR. 2011;60(33):
CDC. Selecting the Viruses in the Seasonal Influenza (Flu) Vaccine. Accessed May 29, 2012.
References:
1. Centers for Disease Control and Prevention (CDC). Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR. 2011;60(33):

7. The Flu Season
In the United States, the flu season takes place during the fall and winter1
Flu season usually runs from October through May1
Peaks in January or February1
While the specific timing varies, the flu season takes place in the fall and winter, most often from October through the end of May.1 Most seasonal flu activity peaks in January or February.1
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References:
Centers for Disease Control and Prevention (CDC). Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR. 2011;60(33):
References:
1. Centers for Disease Control and Prevention (CDC). Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR. 2011;60(33):

8. How the Flu Spreads The flu is easily passed from person to person1
Transmitted through coughing, sneezing, or contact with an infected person or surface1
The flu can survive hours on most surfaces2
The flu can spread to others up to 6 feet away1
Symptoms of the flu appear 1-4 days after infection1
Influenza can be spread 1 day before and as many as 7 days after symptoms begin1
The flu is easily spread from person to person through coughing and sneezing or contact with fluid from an infected person’s nose or mouth.1 The flu can be spread to others up to six feet away.1 The flu can also be spread through contact with an infected surface.2 In fact, the flu virus can live for hours on most surfaces.2
Once inside your body, the flu takes 1 to 4 days to start producing symptoms.1 During that time, influenza can be spread to others 1 day before and as many as 7 days after symptoms begin.1
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References:
Centers for Disease Control and Prevention (CDC). How flu spreads. Accessed May 29, 2012.
U.S. Department of Health & Human Services. Workplace Safety & Health Issues - FAQs. Accessed May 29, 2012.
References:
1. Centers for Disease Control and Prevention (CDC). How Flu Spreads. Accessed May 29, U.S. Department of Health & Human Services. Workplace Safety & Health Issues - FAQs. Accessed May 29, 2012.

9. Preventing the Flu
Annual influenza vaccination is the best way to prevent the flu1
The following hygiene measures can help prevent the spread of the flu
Cover your nose and mouth when you cough or sneeze2
Use a tissue instead of a handkerchief to blow your nose2
Wash hands often with soap and water2
Use alcohol-based hand rubs, when soap and water are unavailable2
Avoid touching your face; especially your eyes, nose, and mouth1
Limit contact with others when sick2
Annual influenza vaccination is the best way to prevent the flu.1
There are also some hygiene measures we can take to keep ourselves from getting sick or spreading it to others. 1 These include:
Getting an annual influenza vaccination.2
Covering your nose and mouth when you cough or sneeze.2
Using a tissue instead of a handkerchief to blow your nose to help avoid spreading germs.2 When you are using a tissue, throw it away as soon as possible.2
Washing hands often with soap and water or using alcohol-based hand rubs when soap and water are unavailable.2
Avoid touching your face, especially your eyes, nose, and mouth.2
And finally, limiting contact with others when sick. 2 For example, if you have a fever, stay home for at least 24 hours after your fever is gone.2
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References:
Centers for Disease Control and Prevention (CDC). Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR. 2011;60(33):
CDC. CDC Says “Take 3” Actions To Fight The Flu. Accessed May 29, 2012.
References:
1. Centers for Disease Control and Prevention (CDC). Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR. 2011;60(33): CDC. CDC Says “Take 3” Actions To Fight The Flu. Accessed May 29, 2012.

10. High-Risk Groups for Influenza
Older adults, young children, and pregnant women1
People who live in facilities, like a nursing home1
People with chronic health conditions, like asthma, diabetes, and heart disease1
American Indians and Native Alaskans1
People who are morbidly obese1
People with a weakened immune system due to disease or medication, such as people with HIV or AIDS, or cancer1
While anyone can get the flu, there are certain groups that are at greater risk. 1 Older adults are the most vulnerable to flu-related illness, but young children and pregnant women are also high-risk.1
Other groups include:
People who live in facilities, like a nursing home.1
People with chronic health conditions like asthma, diabetes, and heart disease.1
American Indians and Native Alaskans.1
People who are morbidly obese, which is defined as having a body mass index (BMI) of greater than 40.1
People with a weakened immune system due to disease or medication, such as people with HIV or AIDS, or cancer.1
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References:
Centers for Disease Control and Prevention (CDC). Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR. 2011;60(33):
References:
1. Centers for Disease Control and Prevention (CDC). Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR. 2011;60(33):

11. Flu in Older Adults
People 65 years of age and older are hardest hit by the flu and its complications1
6 out of 10 of the 226,000 flu-related hospitalizations each year1
9 out of 10 of the 3,000-49,000 annual flu-related deaths1
No matter how healthy or young a person looks or feels, older adults are more vulnerable to the flu because with advancing age the immune system weakens2
The body is less able to fight infection from the virus2
Fewer antibodies are produced in response to vaccination as compared to younger people2
As I mentioned, people 65 years of age and older are the most vulnerable to the flu and its complications. There are approximately 220,000 flu-related hospitalizations in the U.S. each year and more than 6 out 10 cases are among older adults. Furthermore, of the 3,000 to 49,000 flu-related deaths that occur each year in the U.S., about 9 out 10 cases are among older adults.1
Clearly, people 65 years of age and older are disproportionately affected by the flu. But why?
There are a few reasons why the flu is more severe in older adults, but key among them is that the immune system weakens with age. The older immune system does not produce as high of an antibody response following vaccination as a younger immune system does. Antibodies are the body’s defense to help protect against infection. Studies have shown that the lower levels of antibodies increase the risk of catching the flu.2
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References:
Centers for Disease Control and Prevention (CDC). What You Should Know and Do this Flu Season If You Are 65 Years and Older. Accessed May 29, 2012.
CDC. Fluzone High-Dose Seasonal Influenza Vaccine. Accessed May 29, 2012.
References:
1. Center s for Disease Control and Prevention (CDC). What You Should Know and Do this Flu Season If You Are 65 Years and Older. Accessed May 29, CDC. Fluzone High-Dose Seasonal Influenza Vaccine. Accessed May 29, 2012.

12. Influenza Complications
Most common in older adults, people with pre-existing medical conditions and young children1
Serious complications include:
Pneumonia1
Inflammation of the heart1
Worsening of chronic conditions:1
Asthma, COPD
Heart failure, heart attack, and stroke
Diabetes
Kidney disease
The flu is so dangerous because it can cause serious complications and can worsen chronic diseases, particularly for those who are at greater risk.1
Serious complications can include: Pneumonia and/or inflammation of the heart.1
Worsening of chronic conditions such as: Asthma, COPD, heart failure, heart attack and stroke, diabetes, and kidney disease.2
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References:
1. Centers for Disease Control and Prevention (CDC). Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR. 2011;60(33):
References:
1. Centers for Disease Control and Prevention (CDC). Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR. 2011;60(33):

13. Flu in Older Adults
Adults over age 65 are also more likely to have other chronic medical conditions, which increases the risk of complications associated with the flu1,2
Nationwide, 91 percent of adults 65 years of age and older have at least one chronic condition and 76 percent have two or more1
Additionally, as we age, the likelihood of developing other chronic medical conditions increases. Having one or more underlying chronic condition further increases the risk of influenza-related complications.1
A large majority of older adults have at least one chronic medical condition that increases their risk of flu-related complications or death. Some of these conditions, such as heart disease, diabetes, and COPD, are quite common, so the danger is very real.1,2
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References:
1. Steven Machlin, MS, Joel W Cohen, PhD, Karen Beauregard, MHA. MEPS Statistical Brief #203. Health Care Expenses for Adults with Chronic Conditions
2. Centers for Disease Control and Prevention (CDC). Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR. 2011;60(33):
References:
1. Steven Machlin, MS, Joel W Cohen, PhD, Karen Beauregard, MHA. MEPS Statistical Brief #203. Health Care Expenses for Adults with Chronic Conditions Centers for Disease Control and Prevention (CDC). Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR. 2011;60(33):

14. Influenza Vaccination
Annual flu vaccination is the best way to help prevent the flu1
Vaccination is safe and effective1
People can get immunized as vaccine becomes available1
The Centers for Disease Control and Prevention (CDC) recommends annual vaccination for everyone age 6 months and older1
Vaccination is especially important for adults 65 and older2
Not only is annual influenza vaccination safe and effective, it is the best way to avoid catching the flu each season.1 And people can and should get vaccinated as soon as vaccine is available because it takes two weeks to build protection.1
In fact, the CDC recommends influenza vaccination for almost everyone 6 months of age and older to help protect them from infection, but it is especially important for adults over the age of 65 to get the flu vaccine each and every year.1,2
Despite the CDC recommendations, a third of people 65 and older have not been vaccinated, well below public health goals of 90 percent vaccination coverage.3
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References:
1. Centers for Disease Control and Prevention (CDC). Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR. 2011;60(33): CDC. What You Should Know and Do this Flu Season If You Are 65 Years and Older. Accessed May 29, HealthyPeople.gov. Immunization and Infectious Diseases. Accessed May 25, 2012.
References:
1. Centers for Disease Control and Prevention (CDC). Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR. 2011;60(33): CDC. What You Should Know and Do this Flu Season If You Are 65 Years and Older. Accessed May 29, 2012.

15. Flu Vaccine Options for Adults 65 and Older
Adults over the age of 65 have two options available to help protect against influenza1
The traditional flu shot, and1
A higher dose flu shot designed specifically for those over the age of 65 to address the age-related decline of the immune system1
The higher dose flu shot triggers the body to produce more antibodies against the flu virus than would be produced by the traditional flu shot1
Both the traditional and higher dose flu vaccines are administered by an injection (shot) in the arm1
In recent years many new flu vaccine options have been introduced, so no matter what your age there are flu vaccines specific to meet your needs.
Adults over the age of 65 have two options available to help protect against influenza.1
The traditional flu shot is available, and a higher dose flu shot designed specifically for those over the age of 65 is widely available as well.1
As I mentioned earlier, our immune system weakens as we age, and we do not produce as many protective antibodies as we did when we were younger.
For that reason, a higher dose influenza vaccine has been developed to address the age-related decline of our immune systems to generate a greater immune response following immunization in adults 65 and older.1
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References:
Centers for Disease Control and Prevention (CDC). Fluzone High-Dose Seasonal Influenza Vaccine. Accessed May 25, 2012.
References:
1. Centers for Disease Control and Prevention (CDC). Fluzone High-Dose Seasonal Influenza Vaccine. Accessed May 25, 2012.

16. You Can’t Get the Flu From the Flu Shot
The flu vaccine is made from a small piece of the killed flu virus, so it can’t cause the flu1
Some people may experience flu-like or cold-like symptoms following the flu shot because: 1
They were exposed to the flu prior to receiving the shot1
The immune response to the vaccine triggers some symptoms similar to the disease1
Some may have soreness, mild pain, swelling, fever, headache, fatigue, and muscle pain following a flu shot1
Side effects vary and usually disappear in a few days1
Individuals with severe hypersensitivity to eggs, those who have had a previous vaccine-associated allergic reaction, or those who have developed Guillain-Barre Syndrome within six weeks of a previous flu shot should avoid immunization1
A common misconception is that you can get the flu from the flu shot, but the truth is the flu shot cannot give you the flu.1
In fact, because the flu vaccine is made from a small piece of the flu virus that’s been killed, it’s impossible for it to cause the flu.1
Some people experience flu-like or cold-like symptoms following the flu shot either because they were exposed to these diseases prior to receiving the shot or because the immune response to the vaccine triggers some symptoms similar to the disease. That said, these symptoms are generally mild.1
You may have soreness, mild pain, swelling, fever, headache, fatigue, and muscle pain following a flu shot. Side effects may vary and usually disappear in a few days.1
Individuals with severe hypersensitivity to eggs, those who have had Guillain-Barre Syndrome, or those who have had a previous vaccine-associated allergic reaction should avoid immunization.1
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References:
Centers for Disease Control and Prevention (CDC). Seasonal Influenza (Flu) – Q & A. Accessed May 29, 2012.
References:
1. Centers for Disease Control and Prevention (CDC). Seasonal Influenza (Flu) – Q & A. Accessed May 29, 2012.

17. Covered by Medicare Part B
Take advantage of this Medicare benefit to help keep you healthy
Medicare Part B covers all influenza vaccination options currently licensed by the Food and Drug Administration and recommended for people 65 years of age and older1
Both vaccine options are covered by Medicare Part B, Medicare Supplement Plans and most private insurers with no copay1
You may be asking yourself if the higher dose option is covered by Medicare Part B, and the answer is yes.1 In recognition of the high burden of flu in older adults, both vaccine options are covered by Medicare Part B, Medicare Supplement Plans and most private insurers with no copay.1
Take advantage of this Medicare benefit to help keep you healthy!
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References:
1. U.S. Department of Health & Human Services. Seniors. Accessed May 29, 2012.
References:
1. U.S. Department of Health & Human Services. Seniors. Accessed May 29, 2012.

18. Other Things You Can Do To Stay Healthy
Getting vaccinated is the BEST way to avoid the flu.
Avoid close contact.
Stay home when you are sick.
Cover your mouth and nose.
Clean your hands.
Avoid touching your eyes, nose or mouth.
Practice other good health habits.
Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.
If possible, stay home from work, school, and errands when you are sick. You will help prevent others from catching your illness.
Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick.
Washing your hands often will help protect you from germs. If soap and water are not available, use an alcohol-based hand rub.
Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.

19. CLEAN HANDS SAVE LIVES
Keeping our hands clean is one of the most important things we can do to save lives!

20. When to Wash Your Hands Before, during, and after preparing food
Before eating food
Before and after caring for someone who is sick
Before and after treating a cut or wound
After using the toilet
After changing diapers or cleaning up a child who has used the toilet
After blowing your nose, coughing, or sneezing
After touching an animal or animal waste
After handling pet food or pet treats
After touching garbage 20

21. Proper Handwashing Technique
Wet your hands with clean, running water (warm or cold) and apply soap.
Rub your hands together to make a lather and scrub them well; be sure to scrub the backs of your hands, between your fingers, and under your nails.
Continue rubbing your hands for at least 20 seconds. Need a timer? Hum the "Happy Birthday" song from beginning to end twice.
Rinse your hands well under running water.
Dry your hands using a clean towel or air dry them.

22. What about Hand Sanitizer?
Washing hands with soap and water is the best way to reduce the number of germs on them. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Alcohol-based hand sanitizers can quickly reduce the number of germs on hands in some situations, but sanitizers do not eliminate all types of germs. 
Hand sanitizers are not effective when hands are visibly dirty.

23. Where Can I Learn More?
Visit and Ask your health care provider about the influenza vaccination option that is right for you!
As a next step, it’s important to speak with your health care provider to determine if the higher dose flu vaccine is right for you.
You can also learn more by visiting the Flu + You website at ncoa.org/Flu or picking up Flu + You educational materials in the back of the room.
Remember, by getting vaccinated you aren’t only protecting yourself, but friends and family too!1
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References:
Centers for Disease Control and Prevention (CDC). Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR. 2011;60(33):

24. Questions?
That concludes our presentation for today. Are there any questions?
[If there are no questions or the Q&A has ended continue below.]
Thank you for your time today.
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