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Planning for the 2005-2006 Influenza Season

Planning for the 2005-2006 Influenza Season. National Vaccine Advisory Committee February 8, 2005 Washington, DC Lance E. Rodewald, MD Director, Immunization Services Division National Immunization Program, CDC. Topics. Lessons to apply Steps being taken Questions for discussion.

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Planning for the 2005-2006 Influenza Season

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  1. Planning for the 2005-2006 Influenza Season National Vaccine Advisory Committee February 8, 2005 Washington, DC Lance E. Rodewald, MD Director, Immunization Services Division National Immunization Program, CDC

  2. Topics • Lessons to apply • Steps being taken • Questions for discussion

  3. Key Lessons from Previous Seasons • Maximize available information • Plan for multiple contingencies • Plan around limitations • Recommendations • Delivery system • Plan with stakeholders

  4. 2005-06 Influenza Season Planning Group Scope – next season; non-pandemic Charge Identify priority activities for CDC Determine who will lead / produce the activity Develop time line Monitor completion Comprehensive and strategic representation Primary planning group for CDC

  5. Scenarios as Basis of Plans • Variables • Number of manufacturers • Vaccine type • Production projections • Licensure status • Scenario output • Timing, number, type of doses available • Rough probability of occurrence

  6. Production Projection Monitoring • Critically important activity • NVPO to lead monitoring with FDA and CDC • Sequential milestones drive projections and allow more efficient planning • Information must be actionable

  7. Prioritization Recommendations for Influenza Vaccine • Last season, priorities developed in an emergency ACIP session • Priorities were important and effective, but imperfect • Flexibility for local circumstances turned out to be crucial • Widespread desire to create prioritizations ahead of time

  8. Prioritization Considerations and Process • ACIP considering evidence for groups • Hospitalization rate • Mortality rate • Group size • Usual coverage achieved • Vaccine effectiveness • Studying multi-tiered approach • Emphasizing role for LAIV • Presentation for ACIP vote this week • Weighing publication options

  9. Vaccine Pre-Booking • Non-binding orders • Helps manufacturers determine their market size • Influences vaccine contracts, such as CDC’s contract • Has had problems with double booking in the past

  10. Vaccine Distribution Policies • Predominant strategy is partial orders to all customers • Advantage: more vaccination early • Was important last season • Timing and prioritization important • Manufacturers and distributors have their own policies • Tracking of distribution – role of information

  11. Planning for IND Vaccine in Routine Program • Challenges • IND not optimized for routine use • Need to use IRB • Need for Co-PIs to expand access • Insurance carriers experience limited • Public and provider acceptance unknown • Planning strengths • Example INDs to modify • Identification of many set-up problems

  12. Contracting for Vaccine • Estimations of need • Public / private balance of purchase • Stockpiling strategy

  13. Monitor Antigen-Sparing Studies • Several under study / review • Some can impact the coming season • Important to develop new knowledge needed for future years

  14. Other Activities • Communications • Antiviral medication • Infection control • Evaluation • Monitoring legislative endeavors

  15. What Could Better Planning Improve? • Contracting • Pre-book and distribution • IND vaccine use • Recommendations • Communication

  16. Questions for Consideration (1) • What influenza vaccine environmental changes would more effectively promote vaccine use? • What strategies should be used to ensure a safety net for influenza vaccine supply? • How can IND vaccine be used most effectively?

  17. Questions for Consideration (2) • What are the optimal roles for local / state / federal public health, and how can they be seamlessly integrated? • How can we enhance public health’s responsiveness to crises?

  18. Extra slides

  19. Long-Term Considerations • Solidifying vaccine financing • Increasing number of mfgs • Supporting effective public health immunization workforce • Pandemic influenza

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