Pertussis/Flu Update 4/12/2011 CDPH, Immunization Branch

AGENDA Opening Remarks Influenza Update AB 354 Discussion

Influenza Update

LHD Influenza Purchase 2011-2012 CDPH has identified funds for the limited purchase of influenza vaccine for the 2011-2012 season.  CDPH State Purchase: Afluria: 193,230 doses CDPH Federal Purchase: Flulaval: 155,000 doses Fluarix: 20,000 doses Flumist: 30,000 doses

Comparing Flu Vaccine Purchase 2010-2011 2011-2012 Multidose Vials 600,000 348,230 Single Dose syringes 40,000 20,000 Nasal Sprayers 225,000 30,000

VFC Flu Purchase Fluzone 0.25ml: 600,000 doses Fluzone MDV: 500,000 doses Fluarix PF: 300,000 doses Flumist: 440,000 doses

AB 354 Update Share materials @ Regional Forums, IZCoordinators.org How are we doing? 9 CAIR Regions (1 County data missing) Tdap doses in persons 10-18 years >760K - ~37% (20%-49%) – undercounting? ~12K doses per week added to CAIR Kaiser Permanente 60-75%

Data: British Columbia Centre for Disease Control

Working with Schools School is out for summer in <2 months!!! Scan local school websites, messaging Promote Spring Break immunization New CDPH checklist – www.shotsforschool.org More CDPH “Open Houses” – 4/26, 5/2 2-3PM Remind schools to start collecting records now! What are their plans? Continue to work with your County Office of Education Health Officers connect with County Superintendents CDE video forthcoming – Superintendent Torlakson to schools

Messages for Schools Review the message from State Superintendent Torlakson about the importance of the new Tdap vaccine requirement Continue alerting parents and students to the following messages: If you haven’t already, get your Tdap shot Check in with your doctor Spring Break a good time for a Tdap visit Get a record of the Tdap booster from your doctor to share with school Bring your immunization record to school!

Messages for schools Post messages above and downloadable electronic banners on your school’s Websites, emails and electronic newsletters Marquee or billboard 2011-2012 Calendar Report Cards and other notices Student newspapers, newsletters PTA, Community partners’ communications

Messages for Schools Develop your record collection systems and begin collecting Tdap records as soon as possible. Instruction parents about when and how to submit Tdap records Update phone and electronic messaging to reflect this information Develop process and instructions for submitting records from students who get Tdap during summer  

Materials for Schools – Tdap Sticker Tdap Blue Card Stickers and PBE forms Any schools that haven’t received? Contact field reps if more needed 13

School Software Systems Systems that are testing capacity to print an accurate, formatted Blue Card with Tdap information, check off ‘sticker’ box if appropriate dose given Aeries*, GENESIS, Power School Systems attempting to develop a Tdap Blue Card Infinite Campus Systems considering modifications eSchoolMAX, IEM, SchoolPlus

Messages for providers View the free CME webcast: www.uctv.tv/capertussis/. Send reminder and recall phone calls and notices NOW to patients who have not yet received a Tdap booster including those who have received Td but not Tdap. Order enough Tdap and other adolescent vaccines; ensure you have adequate refrigerator storage – for many clinics, multiple orders will be indicated. Immunize with Tdap NOW (SPRING BREAK) & at every opportunity e.g., sports physicals & visits for mild illness or injury Give other recommended immunizations and care

Messages for providers Provide clear and accurate documentation about Tdap immunization to your patients and their schools. CAIR – consider printing Blue Card for patients Provider form – EZIZ and LHDs now, other sites soon New CDPH flyer shortly Have parents check with their child’s school about how they should provide the Tdap documentation. Post downloadable electronic banners on your practice’s website and in electronic newsletters to help notify your patients.

Provider Documentation Option Simple option for providers to clearly record Tdap information to assist schools Similar format to Yellow Card and Tdap Sticker Sponsored by AAP-CA /CAFP. Also includes Permanent Medical Exemption documentation Available at EZIZ (password-protected) AAP-CA LHDs Field reps, VFC reps Consider sending to your pediatric providers

Provider Documentation Options Template available from CDPH

Provider Kit

Upcoming AB 354 Communications Radio PSA Television PSA Outdoor Advertising CDE to Produce Video with Torlakson

AB 354 Vaccine Distribution Guidelines Basic principles: Whenever possible, immunization with Tdap should occur in the medical home at the same time that comprehensive adolescent care is also being provided. This ideal may not always be possible because of the large number of adolescents affected by the new requirement and the increasingly brief implementation period. Doses of Tdap vaccine purchased with federal 317 funds should be reserved for underserved adolescents without a medical home or ready access to immunization.

Administration of Vaccines VFC Providers (Public and Private): Tdap Only: April 18-September 17th Must follow all other VFC requirements: VFC Screening Storage and Handling Administration Fee Guidelines Etc.

LHD Clinics VFC Screening must be done at all clinics. May immunize patients that aren’t eligible for VFC because they receive a mixture of VFC/317 vaccine. Outreach clinics should be targeted at underserved populations.

LHD Tracking and Allocations 317 doses will be allocated for the time period of April 18 through September 17th, 2011. The 317 Tdap doses can be used for regular clinics and any additional clinics in support of AB 354. LHDs must document Tdap doses administered to VFC eligible and non-VFC eligible children at regular and outreach clinics. LHDs will be expected to submit this information every two weeks to an online system.

LHD Tracking and Allocations CDPH will update LHD’s should additional doses become available. LHDs should make contingency plans on how additional doses could be utilized if available. LHDs are expected to plan to utilize all of their allocations for their routine clinics and to implement AB 354 or else promptly release back to CDPH any doses that cannot realistically be administered.

Q&A Q: Does the allocation include adults? A: Yes, this would include all Tdap doses, including adults. Q: How will we know if our request for additional doses is approved? A: Once all LHDs confirm their allocations, we will notify you if the additional doses are available.

Q&A Q: What happens if we use our allocation before September 17th? A: It is possible that those LHDs will have to move to immunizing VFC eligibles only. However, we will make every effort to shift doses from places where they aren’t being fully used to avoid that situation. Q: We also immunize adults. Can we turn away insured adults? A: According to the guidelines, LHDs may immunize anyone that shows up to their clinic and then refer them back to their medical home. However, it is left to their discretion whether they actually want to administer that first dose or just immediately refer to their provider if they are insured.

Initial Projections: www.izcoordinators.org/tdap2011

Biweekly Reporting: www.izcoordinators.org/tdap2011

Maxim Tdap Clinic Update 35,827 doses remaining on the contract Remaining doses are allocated to interested LHDs and based on population distribution (35 LHDs will receive an allocation) Clinic dates can be scheduled beginning April 18 Requests will be submitted in the same way as before Guidance document and allocations were sent out last week.