Pandemic Influenza Vaccine Distribution Selected Updates

1. Pandemic Influenza Vaccine Distribution Selected Updates Pandemic Influenza Vaccine: Doses Administered and Safety Training Conference Toscha Stanley, MHSA Immunization Services Division Centers for Disease Control and Prevention (CDC) August 21, 2008

2. Vaccination periods • Five vaccination periods (take into account both timing and supply) • Preparation period • Pre-pandemic influenza vaccination period • Manufacturing period • Early pandemic influenza vaccination period • Later pandemic influenza vaccination period

3. Vaccine distribution • Initial demand expected to exceed supply • When (demand >>> supply): allocation “push” model • When (demand > supply): may transition to “pull” model • Vaccine distribution will be monitored via CDC’s FluFinder • States will be able to access FluFinder data for their individual state through the CDC secure data network

4. Direct distribution • Manufacturer ships vaccine to states using its established distribution channels (commercial shipper or 3rd party distributor) • May involve single or multiple manufacturers depending on the current state of domestic manufacturing capacity

5. Ship-to site 1 (50%) Ship-to site 1 (60%) POD POD POD POD POD POD Ship-to site 2 (25%) Ship-to site 2 (30%) POD POD POD POD POD POD Ship-to site 3 (10%) Ship-to site 3 (25%) POD POD POD POD POD POD State B (2% of U.S. supply) State A (4% of U.S. supply) Vaccine manufacturer A Needle/syringe manufacturer CDC and HHS Vaccine manufacturer B 3rd party distributor Direct distribution: Pre-pandemic influenza vaccine distribution with multiple manufacturers jointly supplying states

6. Ship-to site 1 (50%) Ship-to site 1 (60%) POD POD POD POD POD POD Ship-to site 2 (30%) Ship-to site 2 (25%) POD POD POD POD POD POD Ship-to site 3 (10%) Ship-to site 3 (25%) POD POD POD POD POD POD State A (4% of U.S. supply) State B (2% of U.S. supply) CDC and HHS Needle/syringe manufacturer Vaccine manufacturer A Direct distribution: Pandemic influenza vaccine distribution with a single manufacturer

7. Operations at the state level • State-designated ship-to sites must be capable of: • Receiving • Storing • Securing • Repackaging • Allocating to PODs • Follow-on distribution to PODs • Allocation, distribution, and administration within a state will be a state and local function

8. Ship-to sites • Total # of Pre-pandemic vax ship-to sites = 623 • Total # of Pandemic vax ship-to sites = 976 1 site2-10 sites>10 sites Pre-Pandemic 43 9 10 Pandemic 38 8 16 • Federal ship-to sites

9. POD 1 POD 2 Single central ship-to site Vaccine, adjuvant, needles and syringes POD 3 POD 4 POD 5 State X: Single central ship-to site with direct shipment to PODs

10. POD 1 Regional sub-ship-to site #1 POD 2 Vaccine manufacturer or distributor Single Central ship-to site POD 3 POD 4 Regional Sub-ship-to site #2 POD 5 State Z: Single ship-to site with regional sub-ship-to sites within the state

11. POD 1 Ship-to site #1 POD 2 Ship-to site #2 Vaccine, adjuvant, needles and syringes POD 3 POD 4 Ship-to site #3 POD 5 State Y: Multiple ship-to sites with direct shipment to PODs

12. The findings and conclusions in this presentation have not been formally disseminated by CDC and should not be construed to represent any agency determination or policy.

13. Extra Slides

14. Ship-to site 1 (50%) Ship-to site 1 (60%) POD POD POD POD POD POD Ship-to site 2 (25%) Ship-to site 2 (30%) POD POD POD POD POD POD Ship-to site 3 (10%) Ship-to site 3 (25%) POD POD POD POD POD POD State A (4% of U.S. supply) State B (2% of U.S. supply) Centralized Distribution Option Vaccine manufacturer A CDC and HHS Central distributor Needle/syringe manufacturer Vaccine manufacturer B Centralized distribution: Multiple manufacturers and multiple products