Pertussis/Flu Update 12/6/2011 CDPH Immunization Branch These slides are posted on the Immunization Coordinators’ website

2011 CA Flu Program Vaccine Update Formulation Doses Shipped Reserve doses ? Fluvirin (vials) 249,600 Shipped in full No FluLaval (vials) 155,000 Fluarix (syringes) 20,000 LAIV (Flumist) 66,310 Yes Contact Nisha if you need additional doses of LAIV

CDPH Flu Program Guidelines Once you have offered flu vaccine to those 60 years and older, you may offer your remaining doses to those who request them. Screening for VFC eligibility Yes, if giving VFC supplies at a clinic No, if non-VFC supplies only, such as 317-funded LAIV or state-purchase vaccine.

Tracking state-purchased vaccine shipments Logon to http://izcoordinators.org/adultflu/login.php same address where you confirmed state flu allocations Click on “processed orders”

VFC Flu 2011-2012: Supplemental Ordering Over 1.6M flu doses have been ordered by VFC providers this season Shipped doses represent 92% of State’s pre-booked VFC Supply 1.5 M doses shipped from initial order confirmations 153,420 doses have been ordered through Supplemental Ordering (~10% of total doses shipped from initial orders)

VFC Flu 2011-2012 Supplemental Ordering Supply: All formulations are currently available Supplemental orders: Processed Mondays & Wednesdays Requested doses ship in full Provider Communications: FAX notice on supply availability sent to all provider last week

(Prioritized for pregnant teens) VFC Flu 2011-2012 Product Age Group Initial Orders / Pre- booked Doses - Shipped in Full Supplemental Order Fulfillment Fluzone® PF Pediatric, 0.25mL single dose syringes Sanofi Pasteur 6-35 months   600,000 663 Supplemental Orders 41,950 Doses Fluzone® 10 dose vials (5mL) Sanofi Pasteur 3-18 years   500,000 795 Supplemental Orders 56,060 Doses Fluarix 10 pack - 1 dose syringes (0.5mL) GSK 3-18 years (Prioritized for pregnant teens) 300,000 576 Supplemental Orders 31,140 Doses FluMist Live Intranasal Spray 10 pack-1 dose syringes MedImmune Healthy 2-18 years 440,000 498 Supplemental Orders 24,270 Doses

FluMist Replacement Program LAIV lots expire as soon as 12/2011. Expiration dates printed on sprayer label Providers may request replacement no later than 15 days prior to the expiration date Final Deadline 1/31/2012 Requests or Questions: Call 1-877-633-7375

Flu Educational Resources National Influenza Vaccine Week (NIVW): December 4-10, 2011 – www.cdc.gov/flu/nivw Flu Vaccine Finder Widget – Flu.gov Other flu educational materials – EZIZ.org The flu vaccine: How well does it work? A recent study in the British medical journal The Lancet has raised questions about the efficacy of the seasonal influenza vaccine. To respond to those questions, the CDC has developed the FAQ document, “How Well Does The Flu Vaccine Work?” It is the kind of information you’ll want to share with others. Feel free to embed the “flu vaccine finder” on your organization’s website. Go to Flu.gov to access widget. Other flu materials, such as this poster are available for download on flu page on EZIZ.org.

AB 354 Communications “Template PBE Follow-up Letter of Students with Exemptions” Certificate of Appreciation Template “Thank You!” web banner

AB 354 Communications Certificate of Appreciation to Schools Posted on 7th-12th grade reporting website Will be emailed to school listserve

Preliminary National Flu Survey Results 11/1-13/2011 – CDC >6 months: 36% vaccinated (vs. 32% in 11/2010) Adults: 36% (vs. 34% in 11/2010) Setting: 55% @ medical setting; 21% retail; 16% work Retail: 21% in 2011 vs. 18% 2010 vs. 7% 2006-07 63% of health care workers (vs. 56% in 11/2010) 43% of pregnant women (similar to 11/2010) Children: 37% (vs. 31%) Setting: 90% in medical setting; 5% at school By race/ethnicity Hispanic - 43% Non-Hispanic White - 33% Black - 35%

Preliminary Reporting Through 12/2/11 5,687 schools (~75%. ) 2 Preliminary Reporting Through 12/2/11 5,687 schools (~75%?) 2.7 M students (~84%) Students Status Number Percent Tdap 2,645,700 97.8% Permanent Medical Exemption 4,296 0.2% Personal Beliefs Exemption 56,620 2.1% Students Enrolled 2,706,616 100.0%

CDPH messages to schools Thanks for your efforts 7th-12th grade reporting deadline 12/1/11 Optional brief survey on AB 354 implementation Unused Tdap stickers and PBE forms Schools with 7th graders – keep for next years Schools without 7th graders – keep a small amount for transfer students, redistribute remainder locally via district, LHD or other. Optional change of status template message for families with exemptions at ShotsforSchool.org Ongoing: encourage 6th graders to get check-up with Tdap this fall School employees to get Tdap

Maxim Tdap Clinic Update AVAILABILITY ENDS 12/31/11 Please send in requests for Maxim clinics now! ~9,000 doses remain on the contract Tdap doses in CAIR: Age 11-81K vs. Age 16-155 K Plan clinics for current 6th graders Contacts of infants at birth hospitals or other locales Others? Please schedule clinics so that the minimum of 40 persons can be reached

10/25-26 ACIP Meeting - votes HPV vaccine (females HPV4 or 2; males HPV4) Ages 11-12 – routine for females and males Ages 13-21 – catch-up for females and males Ages 22-26 Females – catch-up for all females Males – catch-up for MSM, immunosuppressed; permitted for all Already available for VFC-eligible males HBV vaccine Adults with diabetes

Contract Updates Length of contracts is 2 years. SOW approved by CMU on 11/3. Contracts sent to LHDs Awaiting approval of SOW for registry contracts (San Diego/San Joaquin).

Budget (In)flexibility All budget flexibility language has been removed from contracts. NO transfers between line items allowed. Amendments are only way to transfer funds between line items.

LHD Allocations/Guidelines AB354 vaccine rules have expired No longer allocating and tracking Tdap vaccine. Refer to the Eligibility Guidelines sent out recently for who can be immunized at LHD clinics. VFC providers should provide all ACIP recommended vaccines during clinic visits.

Ongoing Calls >1 call per month to discuss IZ issues. Next call 1/10/12. 2 PM Agenda for calls Updates on current issues Opportunity to ask questions. Please let us know topics you’d like covered.

On-line Ordering It’s Here!

VFC Online Ordering Launched to all VFC Providers 11/16/2011 The site had been in the works since November 2010 Beta tested it with IZ Coordinators & VFC Office Staff Implemented in April 2011 for use in VFC Office Opened access to LHDs in May 2011 Restructured VFC Central Office order processing procedures to adjust to receiving orders through dual modes: FAX & electronically Developed an Admin End to assign and process orders

VFC Online Ordering Total orders entered in the system since April: 11,038 Total Orders submitted since the system’s soft launch (10/31/2011): 1,419 442 entered directly by providers (31%) 977 entered by VFC Staff (69%)

VFC Online Ordering LHD & Provider Feedback A survey at the end of order submission prompts providers to provide feedback on the site, overall experience, ease of use, and any issues encountered A follow up survey will be administered at a later time (after providers have used the system a numbered of times) Feedback has been provided by LHD via survey & regional IZ Coordinators meetings Thanks!

VFC Online Ordering Survey Results Total Respondents to Survey: 108 as of 12/6/11 Feedback: Suggestions for Improvement Save & pre-populate previously entered Lot Numbers and Expiration Dates Option to save order entered and return to saved order Align fields with headings Certain brand automatically selected if no other brand is available Auto-tab through expiration dates Date field for Transfers and Returns Visuals: bolder texts and borders

VFC Online Ordering Survey Results Issues Did not receive confirmation email Expiration date: MM/DD/YYYY vs. MM/YYYY Time consuming the first time How to report Doses Administered if transitioning between brands (ex: Gardasil and Cervarix) Printing order confirmation page – prints too big or only half the page

VFC Online Ordering Survey Results Additional Comments: “This is better than faxing because the confirmation is quick. We know for sure you received the order without us having to call in a couple of days to confirm the order.” “Once I understood how to use it, it was easy.” “Its nice that we fill the same form and submit it online.” “Since it was a new experience, it just took a little getting used to it.”