2. OVERVIEW OF THE NATIONAL INFLUENZA VACCINE SUMMIT Dennis J. O’Mara Associate Director for Adult Immunization Immunization Services Division National Immunization Program Centers for Disease Control and Prevention Department of Health and Human Services NVAC, Washington, D.C. June 3, 2003

3. 2003

4.  Summit conceived in response to delays in influenza vaccine production and distribution in 2000  Co-sponsored by AMA and CDC  1st two Summits: March and August 2001  3rd Summit in May 2002  4th Summit in May 2003 History of the National Influenza Vaccine Summit

5. The Summit is...  An annual meeting  A concept  An informal, action-oriented organization  A resource

6. Composition of the Summit (1)  Vaccine Manufacturers  Vaccine Distributors  Federal Agencies  Professional Medical Organizations  Public Health  Hospitals  Pharmacists

7. Composition of the Summit (2)  Community Immunization Providers  Occupational Health Providers  Business  Private Insurance and Managed Care  Long-term Care  Quality Improvement Organizations  Consumers

8. The 2003 Summit: Attendees  About 100 individuals attended  54 organizations represented  12/14 categories well-represented  2 categories (consumer groups and business) need more representation

9. The 2003 Summit: Agenda  Plenary updates  Future directions in vaccine production  Influenza pandemic planning  Breakout sessions by working group

10. Previously-Existing Summit Working Groups  Communications  Community-based Vaccination Providers  Occupational Vaccination Providers  Payment Issues  Vaccine Distribution

11. New Summit Working Groups  Consumers’ Issues  Vaccine Reallocation  Physicians’ Issues  Long-Term Care

12. Addressing the 50 Summit Recommendations: Process  One lead group/organization per recommendation  Other groups/organizations in support as needed  Collaboration as appropriate  Periodic updates on progress collected and posted on AMA’s Summit website

13. Examples of Progress To Date on 2002 Recommendations  Medicare vaccine administration rates increased by an average of 94%  National Influenza Vaccination Catch- up Fortnight  Elimination of Medicare CPT Code for whole-cell influenza vaccine  Updated draft influenza vaccine storage and handling guidelines

14. Examples of Future Plans from Summit Working Groups (1)  Coordinated promotion/information campaigns for providers and consumers  Coordinated campaign to promote extending the influenza vaccine campaign  List of provider vaccine ordering strategies

15. Examples of Future Plans from Summit Working Groups (2)  Vaccine reallocation model practices database  Provider organization messages to members re: purchasing vaccine this year  Vaccine distribution system matrix

16. The Dual Challenge We Face  To increase demand for and uptake of vaccine to approach true need  To increase vaccine supply to approximate the (growing?) demand  To increase demand for and uptake of vaccine to approach true need  To increase vaccine supply to approximate the (growing?) demand

17. Influenza Vaccine Risk and Target Groups, U.S., 2002 Group Estimated Population (MILLIONS) Increased risk* 83 (+2) Target** 102 Others aged 2-49 years 101 All persons aged >5 mos. 286 *Includes children aged 6-23 months as of 7/1/02; 2 million children turn 6 months during Oct.-March **Includes health care personnel, household contacts of persons at increased risk (persons with medical indications, aged 65 or older, or aged <2 years), and other persons aged 50-64 years PRELIMINARY ESTIMATES (1997-2001 National Health Interview Survey, 2000-2002 Census estimates)

18. Groups at Increased Risk from Influenza, U.S., 2002 Group Est. Population (MILLIONS) Aged >64 years 36 Chronic illness Aged 50-64 years (30%) Aged 19-49 years (14%) Aged 6 mo.-18 years (11%) 39½ 13 18 8 Pregnant women 2 Other children 6-23 months 5½ Total at increased risk* 83 (+2) *Includes children aged 6-23 months as of 7/1/02; 2 million children turn 6 months during Oct.-March PRELIMINARY ESTIMATES (1997-2001 National Health Interview Survey, 2000-2002 Census estimates)

19. Influenza Vaccine Target Groups*, U.S., 2002 Group Est. Population (MILLIONS) Health care personnel <65 7 Household contacts** Aged 50-64 years (33%) Aged 19-49 years (35%) Aged 2-18 years (45%) 75½ 10 38 28 Other persons aged 50-64 19½ Total, other target groups 102 *Includes household members, but not out-of-home caretakers, of children aged <2 years **Based on Monte Carlo imputation of increased risk status using 2000 NHIS; does not include household contacts of children born during influenza season PRELIMINARY ESTIMATES (1997-2001 National Health Interview Survey, 2000-2002 Census estimates)

20. Influenza Vaccine Doses Produced for the U.S. Market, 1999-2002 * Year Number Doses Produced 199977.2 Million 200077.9 Million 200187.7 Million 200295.0 Million * Data provided by manufacturers producing influenza vaccine for the U.S. market.

21. Increase Vaccine Demand/Uptake  Increase Capacity of the Delivery System -Get more providers vaccinating -Get providers vaccinating more -Determine vaccination opportunities based on community and provider norms

22. Community/Provider Influenza Vaccination Norms  What are the current community coverage levels?  Who vaccinates?  Where/when do they vaccinate?  What is the vaccination-seeking behavior of the population? and…

23. Community Influenza Vaccination Norms  What is the general health care seeking behavior of the population?  What is the population’s perception of health care and providers?  What is the correct balance of vaccine delivery between: -Fixed health facilities -Non-traditional sites

24. Increase Vaccine Supply MMaximize existing production capacity BBring new manufacturers to the market EEmploy new or improved vaccine production technology

25. A Vision of the Future of the National Influenza Vaccine Summit  Remains a permanent but informal organization at the national level  Works year-round on the issues  Flexible — can respond to contingencies  Could expand attention to broader array of adult vaccination issues

26. Dennis J. O’Mara Assoc. Director Adult Immunization ISD / NIP / CDC 1600 Clifton Road NE · MS E-52 Atlanta, GA 30333 Telephone:404-639-8820 Fax:404-639-8615 E-mail:djo1@cdc.gov AMA Summit Web Site: http://www.ama-assn.org/ama/pub/article/1826-6268.html