Wednesday, December 30, 2009

Important updates for Vaccine Administrators

Maine CDC/DHHS Update on 2009 H1N1 Influenza Virus
December 30, 2009


H1N1 Vaccine Supply and Prioritization
We expect to have close to 700,000 cumulative doses of H1N1 vaccine in the state by January 4th – enough for more than half of the state’s population.

The nasal spray vaccine is generally more available than injectable vaccine. We request that nasal spray vaccine be given to anyone who is eligible to receive it. The nasal spray vaccine is a safe and effective vaccine option for healthy people ages 2 through 49 years old who are not pregnant. For more information on nasal spray vaccine, please see our Fact Sheet at: http://www.maine.gov/dhhs/boh/maineflu/LAIV_factsheet.pdf.

We have and expect sufficient supplies to meet the demand for vaccine on a weekly basis, but it often takes 7-10 days to replenish a health care provider’s vaccine supply. Additionally, we have experienced delays in distributing vaccine the past two weeks primarily due to federal CDC holiday shipping schedules and to some degree the state shutdown day. We expect these delays to dissipate the first week of January, though snowstorms in Maine or on the East Coast can also cause some delays.

We are extremely grateful for the thousands of Maine health care providers who have been offering vaccine to their patients and volunteering with many vaccination efforts. We hope to continue and even increase these efforts now that more vaccine is flowing into the state, since this is our window of opportunity to protect people before the next wave of H1N1 infection and as H1N1 continues to circulate. Our first priority is to make sure traditional health care providers (hospitals, private practices, health centers, home health agencies, municipal health departments) have sufficient vaccine. We are also increasingly distributing vaccine to other health care providers, such as those in employment and in retail settings. Offering vaccine in these other settings will help serve many people who may have difficulty seeking vaccine in traditional health care settings and will help reduce the burden on traditional health care providers.

Important Information for Vaccine Administrators
Vaccination is the best way to protect patients and to slow down the circulation of the virus, which will also help to prevent changes in the virus. Maine CDC encourages all appropriately licensed health care providers to register for, order, and offer H1N1 vaccine to their patients, including those health care providers in non-traditional settings for vaccine, such as specialists and those providing care for populations who may not seek vaccine, such as those with serious mental illness.

For health care providers to receive vaccine for the first time to administer to patients there is a simple two-step process:
1. Register for a PIN: http://www.maine.gov/dhhs/boh/maineflu/h1n1/provider-agreement-2009-2010.shtml.
2. Once the PIN is received, place an order for vaccine:http://www.maine.gov/DHHS/boh/maineflu/h1n1/health-care-providers.shtml.

Please note that all H1N1 vaccine providers and/or administrators must submit the vaccine administration data into Maine CDC’s weekly vaccine reporting system. The weekly vaccine reporting form can be found at: http://www.maine.gov/dhhs/boh/maineflu/h1n1/health-care-providers.shtml. Detailed instructions are also available at: http://www.maine.gov/dhhs/boh/maineflu/h1n1/H1N1-Weekly-Reporting-Form-instructions.pdf.

If a health care provider is already registered but is running low on H1N1 vaccine, the provider should:
Confirm that you have placed orders for all the vaccine you need. You may order more by completing this form: http://www.maine.gov/dhhs/boh/maineflu/h1n1/hc-providers/h1n1-vaccine-orderform.shtml.
It often takes 7-10 days to replenish a health care provider’s vaccine supply. If you have acute vaccine needs or other related concerns or questions, email flu.questions@maine.gov or call the Immunization Program at: 287-3746 or toll free at 1-800-867-4775 Monday – Friday 8 am – 5 pm.

If local vaccine supplies are not sufficient while awaiting more vaccine, Maine CDC recommends focusing the limited supply on those patients in the five high priority groups (pregnant women, people ages 6 months through 24 years-old, people 25 through 64 years-old with an underlying medical condition, caregivers and household contacts of infants younger than 6 months, and health care workers). Patients can also be referred to public clinics which can be found by calling 211 or checking www.maineflu.gov.

When a health care provider’s vaccine supply is sufficient, we recommend offering vaccine to every patient at every visit, so long as there are no contraindications for receiving vaccine. It is important to take advantage of this window of opportunity (declining disease burden and expanded vaccine supply) to encourage vaccine. Health care providers who have sufficient supplies and no longer need vaccine that is being shipped to them should contact their local vaccine coordinator to arrange for redistribution.

Vaccine Coordinators:

District 1 – York: Sharon Leahy-Lind, 490-4625, sharon.leahy-lind@maine.gov

District 2 – Cumberland: Becca Matusovich, 797-3424, becca.matusovich@maine.gov

District 3 – Western Maine: MaryAnn Amrich, 753-9103, maryann.amrich@maine.gov
(Franklin, Oxford, and Androscoggin counties)

District 4 – Mid Coast: Jen Gunderman-King, 596-4278, jennifer.gunderman-king@maine.gov
(Waldo, Knox, Lincoln, and Sagadahoc counties)

District 5 – Central Maine: Sue Lee, 592-5634, susan.j.lee@maine.gov
(Somerset and Kennebec counties)

District 6 – Penquis: Jessica Fogg, 592-5633, jessica.fogg@maine.gov
(Penobscot and Piscataquis counties)

District 7 – Downeast: Al May, 263-4975, alfred.may@maine.gov
(Washington and Hancock counties)

District 8 – Aroostook: Stacy Boucher, 592-5632, stacy.boucher@maine.gov

Tribal Vaccine Coordinator: Jerolyn Ireland, 532-2240, Ext. 15, jireland@maliseets.com

Vaccine Return:
The only vaccines that should be returned are those that arrive non-viable or appear to be damaged during transit. Providers with concerns about vaccine viability during transit from the McKesson Distributor should call 877-836-7123 immediately upon receipt of the package.

Once a provider takes receipt of the vaccine as a usable product, it is that provider’s responsibility to ensure proper disposal of any damaged, expired, or un-used vaccine unless it has been recalled. Health care providers who have sufficient supplies and no longer need vaccine they receive should contact their local vaccine coordinator (listed above) to arrange for redistribution.

Vaccinating Small Children:
Due to national production delays and the recent recall of 0.25 mL pre-filled syringes, Maine CDC makes the following recommendations for vaccinating small children:
Use the Sanofi or CSL multidose vial for all children ages 6 months to two years of age
Use the nasal spray vaccine for healthy children ages two years and older, when available and appropriate
Use the Sanofi or CSL multidose vial for children ages two and older who are not eligible to receive nasal spray vaccine, or when nasal spray is unavailable

Vaccine Dose Spacing and Administration:
Those who have questions about H1N1 vaccine dose spacing and administration with seasonal flu or other vaccines should consult this table from US CDC: http://www.cdc.gov/H1N1flu/vaccination/dosespacing_admin.html.

Additional vaccine-related information for health care providers, including information on billing and consent forms can be found on our web site at: www.maineflu.gov or specifically on: http://www.maine.gov/DHHS/boh/maineflu/h1n1/health-care-providers.shtml.


To read the full weekly update: http://www.maine.gov/tools/whatsnew/attach.php?id=87323&an=2

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