Influenza Vaccine Distribution 2006-07 National Immunization Conference March 6, 2007 Eddie L. Wilder, Lisa Galloway, Jeanne Santoli Immunization Services Division National Center for Immunization and Respiratory Diseases Centers for Disease Control and Prevention

Historical Perspective Tracking the distribution of flu vaccines began in 2004 flu season 2004 flu season – shortage; Chiron 2005 flu season – capacity restored; timing 2006 flu season – strain change; timing

2006/7 Flu Season Meeting in April 2006 to discuss issues with stakeholders Received pre-booking data from limited sources on August 17, 2006 Began tracking distribution of flu data from manufacturers and distributors on September 1, 2006 Tracking distribution data began much earlier in the 2006/7 flu season than in the 2005/6 flu season.

Tracking Flu Distribution Data Aide in visibility of flu vaccine distribution Available to state and local grantees Data mapped to common variables Internal order identifier State where flu vaccines are distributed Zip code where flu vaccines are distributed National Drug Code (NDC) of vaccine distributed Number of doses distributed Type of provider where vaccines are distributed

Provider Types Corporation/Occupational Health Corrections Distributors Federal Government Hospitals/EDs/Dialysis Centers Long Term Care Military Other Private Other Public Pharmacy Private Providers State/Local Health

Distribution Reports Data management Received weekly from distributors and manufacturers ASD Healthcare Cura Script FFF Enterprises Henry Schein/GIV McKesson Physician Sales and Service (PSS) Seacoast Medical GSK MedImmune Novartis Sanofi pasteur

collect and distribute the flu distribution data? How is CDC going to collect and distribute the flu distribution data?

FLU DISTRIBUTION DATA FLOW DISTRIBUTOR FLU STAKEHOLDERS FLU FINDER

Questions?

Cumulative Monthly Influenza Vaccine Distribution (01/12/2007) 102.5 83 81.2 Doses (Millions) This graph, produced by Greg Wallace at CDC, shows the timing of influenza vaccine distribution by month for 2000, 2002, 2004, and 2005. The white dotted oval will help you to focus on the month of October, a time when vaccination activities are solidly underway and when delays in vaccine arrival begin to become increasingly problematic. The light blue line represents 2000, a season in which there was a delay that resulted in only about 30% of doses being delivered by the end of October. In contrast, the orange line represents 2002, a season in which nearly 100% of doses were distributed by the end of October. The most recent season, shown in yellow, falls somewhat between 2000 and 2002 in terms of vaccine availability during October.

Distribution by HHS Region Region I: CT, ME, MA, NH, RI, VT Region II: NY, NJ, PR, VI Region III: DE, MD, PA, VA, WV, DC Region IV: AL, FL, GA, KY, MS, NC, SC, TN Region V: IL, IN, OH, MI, MN, WI Region VI: AR, LA, NM, OK, TX Region VII: IA, KS, MO, NE Region VIII: CO, MT, ND, SD, UT, WY Region IX: AZ, CA, HI, NV, Pacific Islands (6) Region X: AK, ID, OR, WA

Influenza Vaccine Distribution by HHS Region Doses/1,000 Population Doses distributed as of 1/12/2007

Influenza Vaccine Distribution by Provider Type Million

Source: Unpublished data from a Gallup telephone survey conducted on behalf of CDC in 2005.

How does Distribution of Vaccine Compare with Self-reported Vaccination Sites? Comparison is difficult due to differences in categories We don’t know the final destination of 16% of doses Comparison of selected categories reveals similarities Provider type % of total doses distributed % of Adults reporting vaccination at this site (2005) Private practice 42% 39% Hospital 9.8% 6% State/local public health 12.4% 8%

Percentage of Influenza Vaccine Doses Received by a Distributor by HHS Region