Brandon Rector MSW Vaccine Distribution Manager Immunization Branch

1. Brandon Rector MSWVaccine Distribution ManagerImmunization Branch Predicting the Future Seasonal Flu Update 2011-2012

2. What is this? Some kind of frickin’ conspiracy?

3. ACIP Recommendations • NCIP Coverage Criteria • Ordering Information • Distribution Process • Tips for a Smooth Flu Season • Removing Expired Flu from NCIR

4. Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010 PREVENTION AND CONTROL OF INFLUENZA WITH VACCINES “Routine influenza vaccination is recommended for all persons aged ≥6 months.” Vaccine Information Statements and the recommendations of the Advisory Committee on Immunization Practices are available at: http://www.cdc.gov/vaccines

5. 2011 – 2012 NCIPCoverage Criteria • all VFC-eligible children 6 months through 18 years of age • Any individual attending a North Carolina university or college (regardless of insurance status) • Health care workers (regardless of insurance status) • Any uninsured (and non-Medicaid) patient who will be pregnant during the flu season and who is being served by the health department in any capacity

6. What is VFC-Eligible? • Medicaid • Uninsured • American Indian/Alaskan Native • Underinsured Note: Children whose health insurance covers vaccinations are not eligible for VFC vaccines, even when a claim for the cost of the vaccine and its administration would be denied for payment by the insurance carrier because the plan’s deductible had not been met or because the insurance did not cover the total cost of the vaccine.

7. What is a Healthcare Worker? Because of their contact with patients or infective material from patients, many health care workers (HCWs)(e.g., physicians, nurses, emergency medical personnel, dental professionals and students, medical and nursing students, laboratory technicians, hospital volunteers, and administrative staff) are at risk for exposure to and possible transmission of vaccine-preventable diseases. Maintenance of immunity is therefore an essential part of prevention and infection control programs for HCWs. Optimal use of immunizing agents safeguards the health of workers and protects patients from becoming infected through exposure to infected workers. Immunization of Health-Care Workers Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Hospital Infection Control Practices Advisory Committee (HICPAC) December 26, 1997 / Vol. 46 / No. RR-18

8. NCIP Flu VaccineOrdering Pattern

9. Flu Vaccine Offered by NCIP

11. NC Provider Orders Summary

12. Borrowing from your state supply? No. “Seasonal influenza vaccine is not eligible for borrowing, since there is no guarantee that the influenza vaccine can be replaced within the same season. “ -Vaccines For Children Operations Guide

13. Distribution of Vaccine • As vaccine becomes available, we make every effort to ship vaccine to as many different providers, provider types, provider sizes, and geographical locations as possible • Shipments will be small in August and September • It is unwise to schedule clinics before you have vaccine on hand. • Providers serve patients best if they have the capability to provide outreach to high-risk individuals or individuals with limited access to care when small amounts become available. • Vaccine will not sit at McKesson if there is a North Carolina provider in need. Don’t let vaccine sit in your refrigerator if there are North Carolina children in need.

14. Distribution of Vaccine(visual representation) AUG SEPT OCT NOV

15. Timing of Vaccine • Manufacturers ship to McKesson according to federal contract stipulations

16. Timing of Vaccine • Shipment to McKesson from the manufacturer (1-2 days); • Receipt of doses at the distribution center (1 day); • Update of CDC’s allocation functionality (1-2 days); • Placement of orders by NC (2 days); • Shipment of doses to provider (3-4 days).

17. Maximizing Flu Season • Use pre-printed form • Order carefully • Use NCIR and use it correctly • Mass Vaccination Screen • Eliminate missed opportunities • Watch your LAIV expiration dates • Keep vaccinating

18. Expired Flu Vaccine --------------------------- Windows Internet Explorer --------------------------- Lot Number: UT3564BA Vaccine Name: Influenza, seasonal, preservative free Trade Name: Fluvirin Pres-Free Expiration Date: 06/30/2011 All expired state-supplied inventory must be transferred to the state. Please transfer this inventory to the State via the manage transfer menu option. Note: There are additional expired lots in inventory. -------------------------- OK ---------------------------

19. Make a Transfer 2 1

20. Transfer all Expired

21. Transferring Expired • Save • Packing List • Ship • Ship

22. All Done!

23. Wasted/Expired Form 3 2 1 http://bit.ly/materialsrequest

24. Print Resources • http://www.cdc.gov/flu/freeresources/print.htm NOT YET UPDATED FOR 2011-12 • VIS: http://cdc.gov/vaccines/pubs/vis/ • Recommendations: http://cdc.gov/vaccines/pubs/ACIP-list.htm

25. H1N1 – A continuing legacy • H1N1 was one of the three strains of influenza included in the 2010-2011 vaccine, and will be again in the 2011-2012 influenza vaccine

26. ACIP Recommendations • NCIP Coverage Criteria • Ordering Information • Distribution Process • Tips for a Smooth Flu Season

27. Thank you.Brandon Rectorbrandon.rector@dhhs.nc.gov919-707-5553NC Immunization Help Deskncirhelp@dhhs.nc.gov1-877-873-6247