1. Pertussis/Flu Update 6/21/2011
CDPH, Immunization Branch

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

3. Influenza Update

4. 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

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

6. Looking ahead to fall Late summer- fall availability of vaccine
3 strains will be unchanged
Recommended for all > 6 months
No reports of production delays yet
CDPH Guidelines
Continue to prioritize 60+
School-based clinics
LHDs will have a mixture of VFC and 317 vaccine
Will need to screen for VFC eligibility
On-line confirmation of state-purchased flu vaccine now live

7. 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

8. Governor’s May Revise Budget
Flu vaccine money was included in May Revise Budget.
Will not know if it will be reinstated until the budget is passed.
The funding would be for flu vaccine.

9. VFC Flu 2011-2012 Vaccine Order Confirmations
VFC On-line Flu Order Confirmation System will be available 6/22/2011
Access to the system will be through MyVFCVaccines
Providers will have approximately 4 weeks to review and submit allocations
Confirmation deadline is set for 7/15/2011

10. Order Confirmation Process
Providers will have ~3 weeks to review, edit, and submit allocations.
VFC will review submitted numbers, brand allocation requests, and approve them according to demand and available vaccine supply
Unconfirmed request will be released into a general vaccine inventory for supplemental ordering.
Providers will receive an with final order confirmations (brand allocation numbers) late July 2011.
All orders remain in queue until vaccine supply becomes available.

11. Access to VFC’s Flu Order Confirmation

12. Step 1: Verification of Practice Information

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

14. Step 3: Preview & Submit Allocations

15. Final Step: Order Confirmation

16. 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

17. 6/13/11 Tdap Coverage in 10-18 years by CAIR region/county
Tdap doses Coverage Rate
Northern (INNC) 26, %
North CV (SFT) 24, %
Central CV (RIDE) 60,994
South CV (CVIIS) 90, %
Bay Area 176, %
Central Coast 39, %
LA - Orange 278, %
Inland Empire 77, %
San Diego 120, %
Imperial ,747
Total 606,144

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

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

20. 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.

21. 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.

22. Materials for Schools Tdap Blue Card Stickers and PBE forms
Contact Branch or field reps if more needed 22

23. 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

24. 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

25. Information, please Let us know about exemplary CHCs / RHCs
health plans,
other partners!
What factors have increased turnout for your Tdap clinics?
How have you been distributing stickers and forms to private schools? Via County Office of Education?
CDPH links to LHDs – update your clinic information on your local links
Providers not giving Tdap?

26. Legislative modification?
School organizations have proposed modifying Tdap law to permit 10 day extension at start of school year
IZ Branch is interested in how partners feel about such a change and the likely consequences
May aspects unclear – stay tuned for more information

27. AB 354 Communications Radio PSA – posted on ShotsForSchool
Video PSA – posting this week
Outdoor Advertising
Potential NIAM Communications Push – please fill out survey ASAP

28. What’s New on ShotsForSchool.org
Spanish Parent FAQs
New Rule Flyer – Chinese, Vietnamese, Cambodian
AB 354 Ticker Messages

29. Summary from 3 Reporting Periods
317 doses administered << initial projections.
VFC administration: 30,273 doses (63%)
317 administration: 17,669 (37%)
( 84,436 projected for April-mid June)
Doses unused in April/May can be used in coming months.

30. LHD Tdap Allocations Report your Tdap vaccine usage every two weeks.
By VFC vs. non-VFC, routine vs. outreach clinics
 Allocations deducted from reported 317 vaccine administration, not from orders
Orders include both VFC- and 317- eligible patients
Current balance of allocation doses given and doses remaining listed on the reporting page. 
May use IZB vaccine tracking form or your own system to count doses for reporting. 
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 – stay tuned

31. Maxim Tdap Clinic Update
May/June clinics have administered 4757 doses (10,018 doses allocated for these clinics)
Turnout at May and June clinics are not meeting projections
Reminders:
We strongly encourage you to send county staff to Maxim clinics
VFC screening can occur at Maxim clinics but by LHD staff only
Maxim nurses not accustomed to large-scale clinics, so we encourage sharing basic principles of mass vaccination clinics with Maxim nurses before clinic starts
VFC doses administered by Maxim can not be reported on the same page as Tdap administration by LHDs

32. School Report in CAIR Presented by: Cecilia Sandoval, MPH
Tuesday, June 21, 2011

33. Topics Covered Introduction to the new School Report in CAIR
Accessing the School Report
Explanation of option #1
Explanation of option #2
Accessing the upload manual for option #2.
Accessing training modules 14 and 15 for detailed instructions on how to run both options.
Contacting the CAIR Help Desk

34. School Report in CAIR
Designed to assist schools in determining whether students have received the vaccines required for school entry.
Applies to the Kindergarten requirements and to the new Tdap law for 7th-12th graders.
Provides two options
Option #1: creating your own list in CAIR
Option #2: uploading a list of students to CAIR (Tdap req. only).
Housed within the CAIR application, making it easier for users to access.

37. Option #1 Allows users to create a student list in CAIR.
Generates the school report and Blue cards for the students found in CAIR and listed in the report.
Gives users the option of printing all the Blue Cards or accessing the Blue Card for individual students.
There is greater search flexibility since the user creates the list and is able to use different search parameters.
Convenient for students with misspelled names, hyphenated or two last names.
May create list for Kindergarten or a Tdap report for 7th-12th graders.

39. Option #2
Requires that the user uploads a student list file in .CSV format to CAIR.
Upon uploading CAIR evaluates the file to make sure it is in the correct format and that information is not missing.
Great option for large schools or school districts needing to match many students. Only available for the Tdap Match /7th-12th grade requirement.
Returns a file with any matches found in 24 hours.
Please note: this file contains EXACT matches only and does not allow users to print the Blue Card for students in the list.

41. New Look for CAIRWeb.org

45. Questions?
Help desk contact information:
Available Monday-Friday, 8:00 am to 5:00 pm

46. VFC’s On-Line Ordering
Now available to LHDs
All vaccine orders should be submitted through this system
Phased Introduction to VFC Providers
 Phase 1: Local Health Departments, effective June 7th, 2011. 
Phase 2: Mid July all VFC providers
Please share your feedback soon after submitting your first order
Survey included in the communication