Health Management Training to Enhance Influenza Vaccine Immunogenicity

General Inclusion criteria are the following:

• age 50 years or older
• Infectious Disease tests - negative HIV test; hepatitis B surface antigen; anti-hepatitis C virus (HCV)
• Routine Laboratory tests
• able and willing to complete the informed consent process
• able and willing to participate for the planned duration of the study, including availability for follow-up telephone contact

General Exclusion criteria

• self report of any medical conditions for which the Center for Disease Control (CDC) states should not be vaccinated with IIV
• self-reported vaccination with the seasonal influenza vaccine for the current 2010-2011 influenza season (vaccination with the H1N1 influenza vaccine before, during, or after the study will not be exclusionary)
• history of hypersensitivity to any influenza vaccine components including thimerosal or egg
• history of Guillain-Barre syndrome
• self-reported treatment with immunomodulator/immunosuppressive drugs (interleukins (IL), corticosteroids (oral or inhaled)), G(M)- cerebrospinal fluid (CSF)) in 4 weeks before enrollment or self reported history of IL-2 administration within 5 years
• self-reported use of theophylline preparations or warfarin because of the theoretical possibilities of enhanced drug effects and toxicities following influenza vaccination
• any clinically significant abnormalities found during a routine physical examination
• self-reported history of any autoimmune disease
• acute febrile illness on the day of intended immunization - immunization deferred until illness resolved
• self report of current alcohol, substance abuse, or systemic/psychiatric illness that potentially could interfere with compliance and ability to make study visits (such as severe attention deficit hyperactivity disorder (ADHD) and current major depressive episode)