1. Pertussis/Flu Update 7/12/2011
CDPH, Immunization Branch

2. AGENDA Opening Remarks Influenza Update AB 354 Discussion
VFC Online Ordering

3. Influenza Update

4. National Supply for
Supply is expected to total million doses
in   The information below was provided
by each manufacturer at the National Influenza Vaccine Summit.
Manufacturer
Doses
Doses
Delivery Date
GSK
32 Million
35-37 Million
Late July through October
Medimmune
16 Million
Early July
Merck/CSL
7 Million
15 Million
Early August
Novartis
35 Million
30-35 Million
Sanofi
70 Million
Late July/early August
TOTAL
160 Million
Million
Most will have all doses out by October

5. 2011-2012 Flu Season Late summer-fall availability of vaccine
3 strains unchanged
Recommended for everyone 6 months and older
CSL received warning letter from FDA
CDPH Guidelines
Continue to prioritize 60+
School-based clinics
LHDs will have a mixture of VFC and 317 vaccine
Screen for VFC eligibility
On-line confirmation of state-purchased vaccine completed
Flu Packet on Coordinators website later this summer

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

7. Comparing Flu Vaccine Purchase
Multidose Vials
600,000
348,230
Single Dose syringes
40,000
20,000
Nasal Sprayers
225,000
30,000

8. 2011-2012 State Budget $7.3 M restored to GF for vaccine purchase
Not designated as one-time
Funding at least for flu vaccine

9. VFC Flu 2011-2012 Vaccine Order Confirmations
VFC On-line Flu Order Confirmation System
Available June 27th to July 20th, 2011
Access via MyVFCVaccines
Deadline for confirming doses allocated is July 20th, 2011.

10. Order Confirmation Process
Next steps after VFC’s Order Confirmation System has closed (Late July/early August):
VFC will review brand allocation requests, and approve/modify them according to available vaccine supply.
Final brand allocation will be loaded in the system.
Providers will receive final order confirmation (Total doses by Age group and brand allocation numbers)
Unconfirmed requests will be released into a general vaccine inventory for supplemental ordering.
All orders remain in queue until vaccine supply becomes available.

11. Order Confirmation Process
All orders remain in queue until vaccine supply becomes available.
Preliminary Shipping Schedule for MedImmune doses to CDC:
~20% doses Mid August, followed by ~25% early Sept.

12. Access to VFC’s Flu Order Confirmation

13. Step 1: Verification of Practice Information (including E-mail address)

15. Step 2: Review Allocations
VFC + School-based Clinics

16. Step 3: Preview & Submit Allocations

17. Final Step: Order Confirmation

18. 2011 Flu Vaccine Supply Brand Manufacturer Packaging Age Group Doses
Fluzone® PF Pediatric
Sanofi Pasteur
10 pack - 1 dose syringes (0.25mL)
 6-35 months
600,000
Fluzone®
10 dose vials (5mL)
 3-18 years  
500,000
 Fluarix
  GSK
10 pack - 1 dose syringes (0.5mL)
 3-18 years
(Prioritized for pregnant teens)
300,000
FluMist Vaccine,
Live Intranasal
 MedImmune
Intranasal Spray 10 pack-1 dose
Healthy
2-18 years
440,000

19. SB 614 modification? School organizations proposing change to Tdap law
10 school day extension at start of school year
January 1, 2012 effective date
Up to 30 calendar day extension at start of year
No resources for additional Tdap immunization
Remaining steps to become law
Assembly Vote
Senate Vote
Governor
SB 614 updates at

20. SB 614 modification?
Whether or not the legislation should become law, please continue with all efforts to protect students with Tdap ASAP -- before the start of school year
Pertussis transmission continues at high levels
Adolescents remain at risk of becoming ill and spreading pertussis in our communities
Remaining needs for immunization and bringing documentation to school require a sustained effort throughout the summer whether or not additional time becomes available for implementation
CDPH will prepare messages and materials to reflect any change in the law

21. 7/11/11 Tdap Coverage in 10-18 years by CAIR region/county
Tdap doses Coverage Rate
Northern (INNC) 29, %
North CV (SFT) 26, %
Central CV (RIDE) 66,556
South CV (CVIIS) 98, %
Bay Area 184, %
Central Coast 41, %
LA - Orange 299, %
Inland Empire 89, %
San Diego 128, %
Imperial ,389
Total 975,119

22. Numbers still needing immunization?
If coverage rate… Students needing Tdap 50% 1.45 M 60% 1.16 M 70% 0.87 M 80% 0.58 M 90% 0.29 M 95% 0.15 M LHDs, 4/18 – 7/1 ~0.06 M

23. What’s your summer and back-to-school plan?
LHD Schools Vaccinators

24. Pertussis cases by month of onset --California, 2010

25. Messages for providers - Act now Pertussis isn’t taking summer vacation
Keep track of which patients have and haven’t received Tdap.
Immunize your patients with Tdap NOW if they haven’t had it yet.
Use every opportunity to provide routine adolescent care, including Tdap and other recommended vaccines.
Provide clear documentation of Tdap immunization that your patients can bring to school.

26. Messages for providers - Act now Pertussis isn’t taking summer vacation
Print and send reminders to your patients about Tdap by letter, postcards, telephone, s and clinic displays.
Limited supplies free from CMA Foundation
                                                                    
Anticipate a rush of last-minute Tdap appointments before the first day of school,
Apply seasonal flu vaccine strategies to Tdap: e.g., drop-in visits, special clinic hours.
Reduce the rush and protect your patients by immunizing now!
Ensure that you have adequate vaccine supplies and proper storage for them.

27. Materials for Schools Tdap Blue Card Stickers and PBE forms
Contact Branch or field reps if more needed 27

28. Messages for schools - Act now Pertussis isn’t taking summer vacation
Continue alerting parents and students:
If you haven’t already, get your Tdap shot
Check in with your doctor
Get a record of the Tdap booster from your doctor to share with school
Get your immunization record to school!
Post messages and downloadable electronic banners on school’s
Websites, s and electronic newsletters
Marquee or billboard, Calendar
Report Cards, PTA notices

29. Messages for Schools Collect Tdap records as soon as possible.
Staffing and systems for collecting records
During summer vacation
Leading up to first day of school
Clear instructions for parents about when and how to submit Tdap records
Systems that can print an accurate, formatted Blue Card with Tdap information, including check off box if appropriate dose given
Aeries, Power School

30. Information, please Experience to date at year-round schools
Let us know about exemplary
CHCs / RHCs
health plans
other community partners!
What factors have increased turnout for your Tdap clinics?
CDPH links to LHDs – update your clinic information on your local links
Providers not giving Tdap?

31. AB 354 Communications Potential NIAM “Back to School” Campaign
AB 354 Hotline in the works
Facebook Ads (Mid-June to July 1)

32. AB 354 Communications
60 & 30 sec Video PSA –TV ready version available (request by ing
CMA Foundation – Free copies of reminder recall cards, flyers and tent cards - Visit ShotsForSchool.org ‘Provider Info’ page for details.

33. Summary from 5 Reporting Periods
317 doses administered << initial projections.
VFC administration: 37,614 doses (63%)
317 administration: 21,815 (37%)
Doses unused in April/May can be used in coming months.

34. LHD Tdap Allocations
Use of CAIR for tracking VFC vs. non-VFC Tdap doses? Instructions on using lot #s to track were sent out. Additional options for running reports – contact Nisha if you would like a CAIR-generated report

35. Maxim Tdap Clinic Update
Summary of clinics scheduled (as of 7/12/11)
June 33, July 6, August 68
Reminders:
Send county staff to Maxim clinics
VFC screening can occur at Maxim clinics by LHD staff only
Maxim nurses not accustomed to large-scale clinics - share basic principles of mass vaccination clinics with Maxim nurses before clinic starts
VFC doses administered by Maxim can now be reported on the same page as Tdap administration by LHDs