1. Pertussis/Flu Update 4/12/2011
CDPH, Immunization Branch

2. AGENDA
Opening Remarks
Influenza Update
AB 354 Discussion

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. VFC Flu Purchase Fluzone 0.25ml: 600,000 doses
Fluzone MDV: 500,000 doses
Fluarix PF: 300,000 doses
Flumist: 440,000 doses

7. AB 354 Update Share materials @ Regional Forums, IZCoordinators.org
How are we doing?
9 CAIR Regions (1 County data missing)
Tdap doses in persons years
>760K - ~37% (20%-49%) – undercounting?
~12K doses per week added to CAIR
Kaiser Permanente 60-75%

8. Data: British Columbia Centre for Disease Control

9. Working with Schools School is out for summer in <2 months!!!
Scan local school websites, messaging
Promote Spring Break immunization
New CDPH checklist –
More CDPH “Open Houses” – 4/26, 5/2 2-3PM
Remind schools to start collecting records now!
What are their plans?
Continue to work with your County Office of Education
Health Officers connect with County Superintendents
CDE video forthcoming – Superintendent Torlakson to schools

10. Messages for Schools
Review the message from State Superintendent Torlakson about the importance of the new Tdap vaccine requirement
Continue alerting parents and students to the following messages:
If you haven’t already, get your Tdap shot
Check in with your doctor
Spring Break a good time for a Tdap visit
Get a record of the Tdap booster from your doctor to share with school
Bring your immunization record to school!

11. Messages for schools
Post messages above and downloadable electronic banners on your school’s
Websites, s and electronic newsletters
Marquee or billboard
Calendar
Report Cards and other notices
Student newspapers, newsletters
PTA, Community partners’ communications

12. Messages for Schools
Develop your record collection systems and begin collecting Tdap records as soon as possible.
Instruction parents about when and how to submit Tdap records
Update phone and electronic messaging to reflect this information
Develop process and instructions for submitting records from students who get Tdap during summer

13. Materials for Schools – Tdap Sticker
Tdap Blue Card Stickers and PBE forms
Any schools that haven’t received?
Contact field reps if more needed 13

14. School Software Systems
Systems that are testing capacity to print an accurate, formatted Blue Card with Tdap information, check off ‘sticker’ box if appropriate dose given
Aeries*, GENESIS, Power School
Systems attempting to develop a Tdap Blue Card
Infinite Campus
Systems considering modifications
eSchoolMAX, IEM, SchoolPlus

15. Messages for providers
View the free CME webcast:
Send reminder and recall phone calls and notices NOW to patients who have not yet received a Tdap booster
including those who have received Td but not Tdap.
Order enough Tdap and other adolescent vaccines; ensure you have adequate refrigerator storage – for many clinics, multiple orders will be indicated.
Immunize with Tdap NOW (SPRING BREAK) & at every opportunity
e.g., sports physicals & visits for mild illness or injury
Give other recommended immunizations and care

16. Messages for providers
Provide clear and accurate documentation about Tdap immunization to your patients and their schools.
CAIR – consider printing Blue Card for patients
Provider form – EZIZ and LHDs now, other sites soon
New CDPH flyer shortly
Have parents check with their child’s school about how they should provide the Tdap documentation.
Post downloadable electronic banners on your practice’s website and in electronic newsletters to help notify your patients.

17. Provider Documentation Option
Simple option for providers to clearly record Tdap information to assist schools
Similar format to Yellow Card and Tdap Sticker
Sponsored by AAP-CA /CAFP.
Also includes Permanent Medical Exemption documentation
Available at
EZIZ (password-protected)
AAP-CA
LHDs
Field reps, VFC reps
Consider sending to your pediatric providers

18. Provider Documentation Options
Template available from CDPH

19. Provider Kit

20. Upcoming AB 354 Communications
Radio PSA
Television PSA
Outdoor Advertising
CDE to Produce Video with Torlakson

21. AB 354 Vaccine Distribution Guidelines
Basic principles:
Whenever possible, immunization with Tdap should occur in the medical home at the same time that comprehensive adolescent care is also being provided. This ideal may not always be possible because of the large number of adolescents affected by the new requirement and the increasingly brief implementation period.
Doses of Tdap vaccine purchased with federal 317 funds should be reserved for underserved adolescents without a medical home or ready access to immunization.

22. Administration of Vaccines
VFC Providers (Public and Private):
Tdap Only: April 18-September 17th
Must follow all other VFC requirements:
VFC Screening
Storage and Handling
Administration Fee Guidelines
Etc.

23. LHD Clinics VFC Screening must be done at all clinics.
May immunize patients that aren’t eligible for VFC because they receive a mixture of VFC/317 vaccine.
Outreach clinics should be targeted at underserved populations.

24. LHD Tracking and Allocations
317 doses will be allocated for the time period of April 18 through September 17th, 2011.
The 317 Tdap doses can be used for regular clinics and any additional clinics in support of AB 354.
LHDs must document Tdap doses administered to VFC eligible and non-VFC eligible children at regular and outreach clinics.
LHDs will be expected to submit this information every two weeks to an online system.

25. LHD Tracking and Allocations
CDPH will update LHD’s should additional doses become available. LHDs should make contingency plans on how additional doses could be utilized if available.
LHDs are expected to plan to utilize all of their allocations
for their routine clinics and to implement AB 354
or else promptly release back to CDPH any doses that cannot realistically be administered.

26. Q&A Q: Does the allocation include adults?
A: Yes, this would include all Tdap doses, including adults.
Q: How will we know if our request for additional doses is approved?
A: Once all LHDs confirm their allocations, we will notify you if the additional doses are available.

27. Q&A Q: What happens if we use our allocation before September 17th?
A: It is possible that those LHDs will have to move to immunizing VFC eligibles only. However, we will make every effort to shift doses from places where they aren’t being fully used to avoid that situation.
Q: We also immunize adults. Can we turn away insured adults?
A: According to the guidelines, LHDs may immunize anyone that shows up to their clinic and then refer them back to their medical home. However, it is left to their discretion whether they actually want to administer that first dose or just immediately refer to their provider if they are insured.

28. Initial Projections: www.izcoordinators.org/tdap2011

29. Biweekly Reporting: www.izcoordinators.org/tdap2011

30. Maxim Tdap Clinic Update
35,827 doses remaining on the contract
Remaining doses are allocated to interested LHDs and based on population distribution (35 LHDs will receive an allocation)
Clinic dates can be scheduled beginning April 18
Requests will be submitted in the same way as before
Guidance document and allocations were sent out last week.