1. Pertussis/Flu Update 9/14/2010
CDPH, Immunization Branch

2. AGENDA Overview: Dr. Gil Chavez/Dr. John Talarico
Pertussis Disease: Kathleen Harriman/Kathleen Winter
Maxim Contract Update: Nisha Gandhi
Tdap Expansion Program Update: Maria Volk
Pertussis Campaigns/Materials: Tiffany Sutter
LHD Clinics/Activities: Open Discussion
Influenza Update: Dr. Rob Schechter/Nisha Gandhi

3. California Pertussis Cases – 2010
To date (9/14/2010), there have been 4,017 confirmed, probable and suspect cases of pertussis reported in 2010 for a state rate of 10.3 cases/100,000.
3,985 of reported cases had disease onset in 2010
183 new cases have been reported this week, compared to 234 in the prior week
Approximately 65% of cases have been classified as Confirmed, 20% Probable and 15% Suspect.
This is the most cases reported in 55 years since there were 4,949 cases reported in 1955 and the highest incidence in 48 years since there were 10.9 cases/100,000 in  Previously, the peak was in 2005 when there were 3,182 cases reported.
196 (11.2%) cases have been hospitalized (of the 1,751 cases with known hospitalization information).
115 (57%) of hospitalized cases were infants <3 months of age and 146 (74%) were infants <6 months of age.
113 (77%) of the hospitalized infants <6 months of age were Hispanic.

4. California Pertussis Cases
9 deaths have been reported; 8 (89%) were Hispanic infants.  Eight fatalities were infants <2 months of age at time of disease onset and had not received any doses of pertussis-containing vaccine and the remainder was an ex-28 week preemie that was 2 months of age and had received the first dose of DTaP 11 days prior to disease onset.  The majority of infant cases in 2010 have occurred in infants <3 months of age.
Rates are highest in infants <6 months of age (184 cases/100,000), in children aged 7-9 years (33 cases/100,000) and adolescents aged years (24 cases/100,000).The majority of adolescent cases are in year-olds.
Overall rates by race/ethnicity are highest in whites (9.8/100,000), however age-specific rates indicate that the highest rates are seen in Hispanic infants <6 months of age (229/100,000).
The median case rate by county is 9.1 cases per 100,000 (range 0-128).

5. Vaccine Efficacy Study
CDC is working with 15 counties on study.
Gaining provider participation in the pilot is going slowly.
Working on re-working letter to try to increase participation.

6. Maxim Tdap Clinics CDPH will supply vaccine directly to Maxim
Contract currently allows up to 90,000 persons to be vaccinated with Tdap vaccine
Contract ends September 30, 2010-pursuing an extension.
274 Clinics Scheduled (9/13)
Approximately 18,153 doses administered (9/13)

7. Tdap Expansion Program
680 organizations enrolled in program.
Approximately 137,000 doses approved.
New end date: December 31, 2010.
Applicants have been notified that the date is extended.
Still accepting new applicants.

8. Overall Tdap Vaccine Distribution

9. Ordering Tdap for LHDs
In order to assure adequate supply and fast processing of orders, please keep the following in mind:
Place your order as quickly as possible if you are planning a special Tdap clinic or will be expanding clinic hours to accommodate public demand
Submit Tdap orders in the normal VFC Vaccine Order Form - although not routinely encouraged, given the current situation you may submit supplemental orders for Tdap outside of your clinic’s Order Frequency.
Keep in mind that we are again furloughed 3 Fridays a month!

10. Processing Timelines Normal Orders: 10-15 business days
Urgent Orders: 3-4 business days. Please indicate on your cover sheet and notify your Field Representative if you need an urgent order.
Immediate Vaccine Need: If you have ordered vaccine for a clinic and demand is larger than anticipated, please notify your Field Rep as soon as possible. We will attempt to locate additional vaccine for you-as best we can.
Unless there is an immediate need and it is indicated on the order form, we will not be routinely placing LHD orders as emergency orders.

11. I & E Updates Statewide radio campaign started English and Spanish
September 6–26
Spanish Tv PSA in production
Ready September 23
Media Buy TBD
Archived webinar available tomorrow 11

12. QUESTIONS?

13. Influenza Update

14. “State Purchased” Adult Flu Products
Brand name/ Trade name
Packaging
Age Indication
Manufacturer
Doses Ordered
Doses Shipped
Fluzone®
10 dose vials
6 months +
Sanofi Pasteur
300,000
295,250
(replaces CSL)
Fluarix® Preservative-free
5 pack - 1 dose syringe
3 years +
GlaxoSmithKline
40,000
FluLaval
10 dose vial
18 years +
FluMist Virus Vaccine Live, Intranasal
Intranasal Spray 10 pack-1 dose
2-49 years
Medimmune Vaccines, Inc.
225,000
62,000
 TOTAL DOSES
865,000
652,500

15. LHD Flu/Pneumo/Tdap
Flu Packet materials posted on IZ Coordinator website
Reminder-please let outside providers know that they are receiving state-purchased flu product.
Half of the pneumo orders were placed on backorder. They have been released and should be arriving shortly.
Tdap orders for flu clinics were placed last week.

16. VFC Flu Shipments Round 1-Shipments: Ordered 8/25
Products: FluMist & sanofi MDV
All orders less than 100 doses have shipped in full
Orders over 100 doses have been partially fulfilled
Most orders shipped within 3-4 day of order transmission
Round 2-Shipments: Ordered 9/1
Products: sanofi 0.5mL PF (syringes and vials)
All orders less than 100 doses have shipped in full.

17. VFC Flu Shipments Round 3-Shipments: Ordered 9/9
Products: sanofi MDV
Approximately another 25% of total confirmed doses shipped.
Vaccines arriving this week
Round 4-Shipments: This week
Products: Flumist
Approximately another 25% of total confirmed doses will be shipped.
Expected to arrive week of Sept. 20th

18. (some doses expected late Sept/early Oct)
VFC Flu Vaccine Supply
Brand
Manufacturer
Packaging
Age Group
% doses Received
Fluzone®
PF Pediatric Dose
Sanofi Pasteur
10 pack - 1 dose syringes (0.25mL)
6-35 months 0%
(some doses expected late Sept/early Oct)
10 dose vials (5mL)
3-18 years
56%
Fluzone® PF
 Sanofi Pasteur
10 pack - 1 dose syringes (0.5mL)
(Prioritized for pregnant teens)
29%
10 pack - 1 dose vials (0.5mL)
FluMist Vaccine, Live Intranasal
 MedImmune
Intranasal Spray 10 pack-1 dose
Healthy
2-18 years
59%

19. Distinguishing VFC vs. State Flu Doses
Confirmation
Separate confirmation sent to all sites receiving State Influenza Program doses
Order Transmission
Set days for VFC and State Influenza Program Order Transmissions to CDC
M-T: State Flu order transmission (SFOT) days
W-Th: VFC Flu order transmission (VFOT) days
Shipment Packing Slip
Cannot be used to distinguish supply

20. VFC Supplemental Ordering
VFC has additional doses of all products available for supplemental ordering.
Targeting to open it in October once more doses have shipped.
VFC Providers will not be able to order additional doses of a product until they have received their initial allocation (product by product-don’t have to wait until all products are received).
Providers will be asked to provide doses administered when re-ordering.

21. Flu Contest Flu media event on Thursday, September 16
Video & print contest September 15–November 7
Cdphfilmfest.org

22. Flu Vial Chart

23. Flu Dosing Chart
Download from eziz.org (Vaccine Admin or Flu Materials pages)

24. Miscellaneous flu items
ALA’s Flu Vaccine Finder
FluBusters