Balancing Act: Launching Pentacel during the Hib Shortage Jan Hicks-Thomson, MSW, MPA Washington State Department of Health.

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Presentation transcript:

Balancing Act: Launching Pentacel during the Hib Shortage Jan Hicks-Thomson, MSW, MPA Washington State Department of Health

Problems Identified Concern Disease Concern Missed Doses Extra Visits Wait Lists Limiting Shots Extra Work Worried Parents

Response No New Doses No ACIP Change “Enough” Listen Respond Transfer Reallocate Guidance from VAC

Was the Allocation Enough? 87,000 (projected births 08) x3 (shortage series) 261,000 (sub-total) % 12 (monthly average) %) x.90 (expected rate) 19,574 (calculated need) Order HistoryBirth Cohort

Spreading the News at Light Speed Communication

Support Tools

Population Based 2 Product Allocation CountyJanuary TotalActHibPentacel Adams1200 Asotin2100 Benton - Franklin Chelan - Douglas Clallam19090 Clark Benton-Franklin Hib Order TrackingJanuary ActHibPentacel Total Monthly Allocation Balance (MUST BE ≥ 0) PINProvider NameApproved Delos, Reyes C Richland Family Medicine Chou, H.D Ahart, S Columbia Family Medicine3020 Allocation Strategy

Overlay High Volume Providers PINName Monthly Hib Pediarix Inventory MALLARD PEDIATRICS MARINER PEDIATRICS- PINELAKE139not entered GRIFFEY PEDIATRICS SOUNDER MEDICAL YELLING PEDIATRICS OLYMPIC PRACTICE GENOME KIDS CLINIC SEAHAWKS CLINIC - Lake Stevens100not entered SEAHAWKS CLINIC - Silver Lake100not entered BUNKO PEDIATRICS250484

Clallam Jefferson Grays Harbor Pacific Whatcom 1 Skagit 3 Snohomish 6 King 23 Pierce Lewis Mason Cowlitz Thurston 2 Clark 5 Skamania Klickitat Yakima 2 Kittitas Chelan Douglas Grant Okanogan Ferry Stevens Pend Oreille Spokane 2 Lincoln Adams Whitman Franklin Benton Walla Walla 1 Columbia Garfield Asotin Kitsap 9 Counties 45 Provider Sites Beginning Provider Participation

Hib Containing Vaccine Before and After Pentacel May 2008 – Feb

Clallam 5 Jefferson 1 Grays Harbor 2 Pacific Whatcom 10 Skagit 6 Snohomish 32 King 171 Pierce 49 Lewis 1 Mason 1 Cowlitz 2 Thurston 15 Clark 26 Skamania 1 Klickitat Yakima 19 Kittitas Chelan / Douglas 6 Grant 4 Okanogan 2 Ferry Stevens Pend Oreille Spokane 16 Lincoln Adams1 Whitman 2 Benton / Franklin 24 Walla Walla 5 Columbia Garfield Asotin Kitsap 10 Island 1 N.E. Tri 1 27 Counties 413 Provider Sites Wahkiakum Ending Provider Participation

Trouble Shooting Single Dose Disease Risk New Vaccine Medical Errors Inventory Management Lot Numbers

Vaccine Supply Issues Pentacel, Hep. B and Pediarix July 2008 – Feb 2009

Inventory Management Pediarix Inventory: February # Providers Inventory (doses) 2> <100 Hepatitis B Back-Orders Week# Providers 3/16/0920 3/20/0960 Through MayNormal Supply? Summer 2009Spotty Supply? Fall 2009Normal Supply?

How Are We Doing? Year All Cases Type B Up to Date Ages B Type Cases mos , 3, 14 mos N/AN/A 20092UKUKUK HiB Disease Reported in Washington

How Are We Doing? Born 11/1/07 to 3/31/08 Receiving 1, 2, and 3 doses by 9 months of age DoseHibPCV %96.7% 1 & 282.4%85.1% 1, 2 & 355%64% Children w/ 2 or more immunizations. Getting Kids Vaccinated in Washington Registry Recorded Doses Area3 Hib3 IPV4 Hib Adams89%90%4% Grant88%89%8% Chelan90%89%11% Douglas92% 14% Based on Immunization Registry Data

National Immunization Survey Results Washington State NIS Rates and Rankings, Vaccine Difference, RateRankRateRankRateRank 4+DTaP80.9± ± ±7.3 ↑ 8 3+Polio85.1± ± ±6.6 ↑ 1 1+MMR90.5± ± ±5.2 ↑ 3 3+Hib90.1± ± ±5.6↑ 17 3+HepB85.0± ± ±6.1 ↑ 1 1+Var84.0± ± ±6.4 ↑ 1 4+PCV73.8± ± ±8.2 ↓ 6 4:3:1:3:3:169.0± ± ±8.5 ↑ 14 4:3:1:3:3:1:464.6± ± ±8.8 ↑ 5

Held our own with rates! How Are We Doing? Implementation – System Indicators Successful Integration Within Reason of ACIP Balance with CDC Reports Responsive to Providers Never over Allocation Secured Additional Vaccine

Acknowledgements Mike Bin Wendy Bowman Chris Halsell Flo Zikas Janna Bardi Lin Watson Contact: Jan Hicks-Thomson, MSW, MPA Blessed are the Balanced, for they shall outlast us all!