2007 National Health Policy Conference Preparing to Protect: Flu Vaccines from Production to Consumption A Public Health Perspective Daniel Hopfensperger Program Manager Wisconsin Immunization Program

Wisconsin Immunization Program Annual Influenza Vaccine Activities  Develop and distribute an annual Influenza Vaccine Prioritization Plan  Plan co-signed by: - Program Chief Medical Officer - Chair of the WCIP - MD from the WI Adult Imm Coal  Provide local health departments (LHDs) with information on MMCAP Contract  Inform LHDs of the amount of influenza vaccine shipped to health care providers in their area - by provider type only

Wisconsin Immunization Program Annual Influenza Vaccine Activities  Purchase and distribute influenza vaccine to private providers enrolled in the Vaccines for Children (VFC) Program - vaccine for individuals <18 years of age meeting VFC eligibility criteria  Purchase and distribute influenza vaccine to LHDs through VFC and Public Health Act 317 funding - vaccine for individuals <18 years of age - provide template medical order

Estimated Size of ACIP Recommended Groups Slide Compliments of the CDC

Cumulative Monthly Influenza Vaccine Distribution Doses (Millions) * * November doses as of 11/24 Slide Compliments of the CDC

Monthly Influenza Vaccine Distribution Doses (Millions) * As of 11/24 Slide Compliments of the CDC

Distribution by Provider Type - WI

Source: Unpublished data from a Gallup telephone survey conducted on behalf of CDC in Slide Compliments of the CDC

US adults’ reported place they received their most recent influenza vaccination by age group and high- risk* conditions, BRFSS 2002 † Total Yrs Yrs HR ≥65 Yrs Other¶ *High-risk due to diabetes and/or asthma † Interview during Jan 02 – Dec 02 ¶ Other: without diabetes and asthma

Vaccination Venues  What do we know? – It is our best understanding of the data about where adults receive vaccinations that all providers/venues serve at least some high risk patients as well as their household contacts – Achieving vaccination of the majority of currently recommended individuals in a given season will require broad access to vaccine in a variety of settings – The need for many settings will become even more critical in the setting of recommendation for universal vaccination Slide Compliments of the CDC

Distribution by Provider Type - WI

What we’re hearing from providers  Why are the grocery stores getting vaccine before we are?  Perceived inequity in vaccine distribution  Many LHDs have scheduled clinics in late Oct. and Nov. and then need to cancel.  Inability for LHDs to hold planned mass clinic exercises as part of pandemic influenza and BT preparedness

What we’re hearing from providers  Loss of the public’s trust  Fear of large amounts of vaccine left over at the end of the season  Press releases that state there is plenty of vaccine are confusing to the public when they cannot easily access immunization services  Billing problems with individuals on MediCare Managed Care Plans

Daniel Hopfensperger, Manager Wisconsin Immunization Program Ph #