1. 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

2. 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

3. 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

4. Estimated Size of ACIP Recommended Groups Slide Compliments of the CDC

5. Cumulative Monthly Influenza Vaccine Distribution Doses (Millions) 8381.2 97.0* * November doses as of 11/24 Slide Compliments of the CDC

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

7. Distribution by Provider Type - WI

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 Source: Unpublished data from a Gallup telephone survey conducted on behalf of CDC in 2005.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

9. US adults’ reported place they received their most recent influenza vaccination by age group and high- risk* conditions, BRFSS 2002 † Total 18-64 Yrs 18-64 Yrs HR ≥65 Yrs Other¶ *High-risk due to diabetes and/or asthma † Interview during Jan 02 – Dec 02 ¶ Other: without diabetes and asthma

10. 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

11. Distribution by Provider Type - WI

12. 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

13. 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

14. Daniel Hopfensperger, Manager Wisconsin Immunization Program Ph # 608-266-1339 E-Mail hopfedj@dhfs.state.wi.us