Maine Earns More Recognition For Its Success in Vaccination

There’s no disputing that 2015 was the best year in Maine’s history when it comes to vaccination rates. 

In August, the United States Center for Disease Control and Prevention tapped Maine as number one in the nation for vaccination rates for children age 19 to 35 months and recently, the National Center for Immunization and Respiratory Diseases presented the Maine Immunization Program with six additional awards for its high level of vaccination coverage for virtually all ages. 

Maine reached the Healthy People 2020 goals for vaccination in children age 19-35 months, adolescents age 13 to 17 and for influenza vaccine for children from age 6 months to 17 years. 

In addition, Maine was cited for having the highest pneumococcal vaccination coverage among high-risk adults age 18 to 64, and earned Most Improved honors for that same population, as well as children 19-35 months. 

“This recognition means that the hard work of our staff , medical providers, school personnel and our many partners from Kittery to Fort Kent is paying off,’’ said Maine Immunization Program Manager Tonya Philbrick. “Parents are receiving the information they need to make informed decisions, and people are taking action to protect themselves against the flu, pneumonia and other diseases. Maine’s intense effort through many different initiatives has made a difference. While there’s more work to be done, I could not be happier with the results.” 

A key to the success has been communication with the more than 400 providers who are registered with the Maine Immunization Program and offering free vaccine to their eligible patients. Many receive practice-level data around vaccination rates and all have access to county-level data for comparison. The program also partners with more than with more than 130 schools and school districts to hold on-site influenza vaccination clinics. 

“While these awards are presented to our program, the credit must be shared with many other partners within state government and in the private sector,’’ said Kenneth Albert, Director and Chief Operating Officer for the Maine CDC. “This success serves as striking example of how a coordinated public health effort can yield amazing results.” 

The mission of the Maine Immunization Program is to reduce or eliminate all vaccine preventable diseases, and immunizations are the single most important way to protect against serious and sometimes deadly diseases. 

To learn more about how to receive free vaccine for your child, ask your health care provider, contact the Maine Immunization Program at 1-800-867-4775 or visithttp://www.immunizeme.org

Twelve ways to have a healthy holiday season

US CDC offers 12 simple tips for staying health this holiday season and all year long:

1. Wash hands often to help prevent the spread of germs. It's flu season. Wash your hands with soap and clean running water for at least 20 seconds.
2. Manage stress. Give yourself a break if you feel stressed out, overwhelmed, and out of control. Some of the best ways to manage stress are to find support, connect socially and get plenty of sleep.
3. Don't drink and drive or let others drink and drive. Whenever anyone drives drunk, they put everyone on the road in danger. Choose not to drink and drive and help others do the same.
4. Bundle up to stay dry and warm. Wear appropriate outdoor clothing: light, warm layers, gloves, hats, scarves and waterproof boots.
5. Be smoke-free. Avoid smoking and secondhand smoke. Smokers have greater health risks because of their tobacco use, but nonsmokers also are at risk when exposed to tobacco smoke.
6. Fasten seat belts while driving or riding in a motor vehicle. Always buckle your children in the car using a child safety seat, booster seat or seat belt according to their height, weight, and age. Buckle up every time, no matter how short the trip and encourage passengers to do the same.
7. Get exams and screenings. Ask your health care provider what exams you need and when to get them. Update your personal and family history. Get insurance from the Health Insurance Marketplace if you are not insured.
8. Get your vaccinations. Vaccinations help prevent diseases and save lives. Everyone 6 months and older should get a flu vaccine each year.
9. Monitor children. Keep potentially dangerous toys, food, drinks, household items and other objects out of children's reach. Protect them from drowning, burns, falls and other potential accidents.
10. Practice fire safety. Most residential fires occur during the winter months, so don't leave fireplaces, space heaters, food cooking on stoves or candles unattended. Have an emergency plan and practice it regularly.
11. Prepare food safely. Remember these simple steps: Wash hands and surfaces often, avoid cross-contamination, cook foods to proper temperatures and refrigerate foods promptly.
12. Eat healthy, stay active. Eat fruits and vegetables which pack nutrients and help lower the risk for certain diseases. Limit your portion sizes and foods high in fat, salt and sugar. Also, be active for at least 2½ hours a week and help kids and teens be active for at least 1 hour a day.

For more information, go to: http://www.cdc.gov/features/healthytips/index.html

Child immunization rates

A recent U.S. CDC report shows that Maine’s vaccination rates for 19-35-month-olds are the best in the nation. 

These results are a cause for celebration and reflect an effective partnership that has been built across the state to address this important health issue. Our success can be attributed to the hard work of clinicians, partners, educators and funders who have collectively made the vaccination of Maine’s children a public health priority.

Maine CDC is proud of this accomplishment and looks forward to working with our partners to build upon this success in the coming year.

Additional information is available in these PowerPoint slides.

Influenza Vaccine Coverage Among Health Care Workers

Each influenza season, health care workers (HCW) become infected with the flu, an infectious respiratory illness caused by influenza viruses. The Advisory Committee on Immunization Practices (ACIP) recommends that HCW receive the influenza vaccine annually. All health care facilities in the state are required to report data on influenza vaccine coverage among their employees to Maine CDC annually.

Maine CDC worked in collaboration with hospitals for the past 3-4 years to improve HCW vaccination rates. Each year, Maine CDC analyzes data on flu vaccine rates reported by the hospitals and compares it to the state average. The result of the analysis is illustrated graphically and shared with each hospital.

Over the past three years, the vaccination rate among HCW in Maine has steadily improved from a statewide average of 65.2% in 2011-12 to 77.1% in 2011-12 to 84.2% in the 2012-13 season. We hope that health care facilities will keep working with their staff and continue this upward trend. 

To see the graphical results over the last three years, go to: http://go.usa.gov/b4eA

Immunization recommendations

Each year, the Advisory Committee on Immunization Practices (ACIP) develops recommendations for routine use of vaccines in children, adolescents, and adults in the US. This year, for the first time, recommended immunization schedules for children and adolescents up to age 18 and adults age 19 and older are being published together. Updated schedules are available at http://www.cdc.gov/vaccines/schedules/


The MMWR for children and adolescent immunization schedules is available at http://go.usa.gov/4yJk


The MMWR for adult immunization schedules is available at http://go.usa.gov/4yJP


Adult vaccination is critical to public health. Far too few adults are fully vaccinated, leaving themselves and others at risk of vaccine preventable diseases, including pneumococcal disease, whooping cough, and shingles.


US CDC has issued an MMWR describing the status of vaccination of US adults in 2011. For more information, read the MMWR at http://go.usa.gov/4yzB

Universal childhood immunizations

Public Law 2009-595 went into effect on January 1. This law reinstated the universal status of childhood immunizations in Maine. As part of this legislation the Maine Vaccine Board (MVB) was formed to help the State of Maine reinstate its universal purchase of vaccines for children under age 19. The MVB assures the necessary flow of vaccine purchase funds by collecting payments from health plans, insurance companies, and other payers and remitting the funds to the state. Through the Maine CDC's Childhood Vaccine Program, the State purchases vaccines at favorable rates and distributes them to providers at no charge.

 

This means that all Advisory Committee on Immunization Practices (ACIP) recommended vaccines are now available to all Maine children under age 19 at no cost to the child’s family or to providers in the State of Maine.

This program has many benefits for Maine citizens:

• reduces out-of-pocket vaccine costs for parents
• improves vaccination rates in Maine children
• lowers costs of vaccines through a public-private partnerships
• lowers vaccine costs in provider offices
• improves vaccine access by creating a single-tier system in provider offices
• most importantly, will improve vaccine rates by offering combination vaccines to reduce missed opportunities.

For more information: http://www.mevaccine.org/

National Immunization Awareness Month

We all need immunizations (also called vaccines or shots) to help protect us from serious diseases. Shots can prevent infectious diseases like measles, diphtheria, and rubella. But people in the U.S. still die from these and other vaccine-preventable diseases. It’s important to know which shots you need and when to get them.

Everyone age 6 months and older needs a seasonal flu shot every year. Other shots work best when they are given at certain ages. Here are some general guidelines:

• Children need a series of shots from birth to age 6.
• Pre-teens need recommended shots at age 11 or 12.
• All adults need a booster shot every 10 years to help protect against tetanus and diphtheria.

We are seeing many cases of pertussis (whooping cough) in Maine right now. Pertussis is a highly communicable, vaccine-preventable disease that can last for many weeks. Immunity to pertussis following infection is not lifelong. Persons with a history of pertussis should continue to receive pertussis-containing vaccines according to the recommended schedule. Because vaccination is not 100% effective and immunity wanes over time, even fully vaccinated persons can become infected with pertussis. However, unvaccinated children have an 8 times higher risk of becoming infected with pertussis than fully vaccinated children. Furthermore, vaccinated children who do get infected with pertussis have milder symptoms, shorter duration of illness, fewer severe outcomes (including hospitalization) and are less infectious than their non-vaccinated counterparts. Therefore, vaccination remains the most effective way to prevent pertussis.

 

Talk to your doctor or nurse to find out which immunizations you need. For more information, visit
www.immunizeme.org 

 

If you choose not to vaccinate, understand the risks and responsibilities.

New immunization recommendations

 

In early February 2012, Morbidity and Mortality Weekly Report (MMWR) published the Advisory Committee on Immunization Practices (ACIP) recommended childhood, adolescent, and adult immunization schedules for 2012.  Childhood, adolescent and teen, and adult schedules are available online at http://www.cdc.gov/vaccines/recs/schedules/default.htm.

Maine Immunization Program advises health care providers to use these schedules for 2012.  The program has mailed childhood and adolescent schedules in poster size, which are the most popular, to all pediatric and family medicine providers in the state. Providers may order additional wall size or wallet size childhood immunization schedules by clicking the link “Order Brochures, Pamphlets, VIS, and More” at http://go.usa.gov/EBU

Due to funding limits, the program will not provide the catch-up schedule for children ages 4 months through 18 years and the adult schedule available.  Instead, the program asks providers to print these from the US CDC link above.

If you have any questions regarding any vaccine schedules, please call 1-800-867-4775 and ask for a health educator to help you.

Influenza Update 10/27/11

Maine CDC reminds everyone to take everyday preventive measures against influenza:

•           Wash your hands

•           Cover your cough

•           Stay home when ill

•           Get vaccinated - a searchable county listing of flu clinics is available at http://www.211maine.org/flu-clinics/

Surveillance

Maine CDC reported no flu activity for the week ending Oct. 22. Weekly updates on flu activity in Maine are available at http://www.maine.gov/dhhs/boh/influenza_surveillance_weekly_updates.shtml

Weekly updates for the US are available at http://www.cdc.gov/flu/weekly/summary.htm and international updates are available at http://www.cdc.gov/flu/international/activity.htm.

Maine CDC issued a health alert on Oct. 19 about a human case of novel influenza virus of swine origin.  US CDC confirmed the novel strain in a child from Cumberland County.  A primary care provider evaluated the child, and provided treatment.  The child was not hospitalized. 

Maine CDC recommends the following for healthcare providers:

•           Maintain a heightened awareness for influenza-like illness (ILI) defined as fever greater than 100° with cough or sore throat, in the absence of another known cause.

•           Consider influenza testing by PCR for:

o          patients with ILI with recent exposure to pigs

o          patients with ILI who are hospitalized

o          patients with ILI who have died

o          patients where a diagnosis of influenza would affect clinical care, infection control, or management of contacts

•           Consider use of antivirals to quickly limit potential human transmission

•           Vaccinate patients and healthcare workers as a primary strategy to prevent influenza

Please report any cases of laboratory positive influenza to Maine CDC by fax (1-800-293-7534) or by phone through our 24-hour Disease Reporting and Consultation Hotline (1-800-821-5821).  All influenza A rapid positive tests should be confirmed by PCR.

Vaccination

Maine CDC has already distributed almost 190,000 doses of state-supplied influenza vaccine to registered providers for the 2011-2012 season.

Nearly 80 school districts are offering school-located flu vaccine clinics (SLVC) again this year. Almost 270 clinics are registered. A list of participating schools is posted at http://www.maine.gov/dhhs/boh/maineflu/flu-clinics.shtml

Schools offering vaccine to students may also provide state-supplied flu vaccine to staff and their dependents to make school clinics more simple, sustainable, and consistent with past practices.  Maine CDC will be evaluating the sustainability of this approach for future years. Schools wishing to provide state-supplied flu vaccine to staff and their dependents must be registered through the SLVC process and report vaccine usage through ImmPact2.  The letter regarding roster billing for staff vaccinations at school clinics and the roster form are both available in the SLVC toolkit at www.maineflu.gov. 

US CDC updates

US CDC has updated the following information on its website:

•           vaccineeffectiveness

•           vaccineeffectiveness Q&A for health professionals

•           seasonalflu vaccine dosage and administration Q&A 

School-based flu vaccine clinics

Maine CDC has received a two-year, $1.25 million cooperative agreement award from US CDC to enhance the sustainability of school-located vaccination. School-located vaccination clinics (SLVC) were first broadly implemented in Maine in response to the 2009 H1N1 flu pandemic. Since then, schools and health care providers in many communities around the state have worked together to continue to offer influenza vaccine to students and staff members in the school setting. SLVC can provide low-cost and convenient opportunities for families to have their children vaccinated each year. In addition, achieving high immunization rates in schools can reduce the number of days that students and staff are absent during the flu season and improve the learning environment.

CDC now recommends that all people over six months of age receive an annual flu vaccine as the best way to prevent influenza. Unlike adults, children have few opportunities to get a flu shot, and primary care doctors may not be able to accommodate the high demand for vaccine in their offices. Maine’s influenza immunization rates among children for the 2010-11 season were well above the national average, but too many Maine children still go without an annual flu shot. Providing vaccines to children in the school setting is a strategy that can improve access and decrease financial barriers that some children may face in getting the flu vaccine.

Among the strengths that were noted in the review of this application were the success of previous years’ SLVC; the use of Maine’s immunization registry system, ImmPact2; and the strengths of the partnerships that have been developed at the local level.

In the 2010-11 school year, more than 350 SLVC were held statewide. Clinics were run by school nurses, hospitals, health centers, visiting nurses’ associations, and primary care practices. Maine CDC recognizes the many organizations and individuals who have worked hard at implementing school vaccination. Funds from this cooperative agreement will be used to further these efforts by:

1.) increasing and supporting SLVC over the next two years;

2.) improving mechanisms of insurance reimbursement to schools and health care providers who provide flu shots in the school setting; and

3.) evaluating the impact of school clinics and developing plans for long-term sustainability beyond the funding period.

More information on specific funding initiatives and opportunities related to this cooperative agreement will be forthcoming. General information on influenza in Maine is accessible at www.maineflu.gov.

An online toolkit for SLVC with registration forms, guidance documents, and sample materials has been posted at http://www.maine.gov/dhhs/boh/maineflu/h1n1/educators.shtml#schoolclinics

Influenza Update

There were four new outbreaks of influenza in the week ending March 19, compared with nine the previous week. There has been one pediatric influenza-associated death reported from York in a vaccinated child. Flu continues to be widespread in Maine.

Vaccination is still recommended for those who have not been vaccinated this season. One flu vaccine is protective for the entire flu season, and a second dose is not recommended for adults, even if they were vaccinated early in the fall.

Two doses of flu vaccine are only recommended for young children who have never been vaccinated before. Children younger than 9 who have never had a seasonal flu vaccine should receive two doses, spaced at least 4 weeks apart.

Weekly updates on flu activity are available

• For Maine
  
• For the US
  
• For the world
  

Influenza Update 3/3/11

Surveillance

Flu is widespread in Maine. In the week ending Feb. 19, there were 12 new outbreaks – 10 in long term care facilities, 1 in a K-12 school, and 1 in an institution.

Weekly updates on flu activity are available

• For Maine: http://www.maine.gov/dhhs/boh/influenza_surveillance_weekly_updates.shtml
• For the US: http://www.cdc.gov/flu/weekly/summary.htm
• For the world: http://www.cdc.gov/flu/international/activity.htm

The January 31 Health Alert on influenza is available at: http://www.maine.gov/tools/whatsnew/attach.php?id=191687&an=2

Vaccination

Some people have expressed concern about needing a second flu vaccine if they were vaccinated early in the fall. One flu vaccine is protective for the entire flu season and a second dose is not recommended for adults.

An MMWR from August 2010 notes that “additional vaccine doses during the same season do not increase the antibody response” and that the “frequency of breakthrough infections is not known to be higher among those who were vaccinated early in the season.”

Two doses of flu vaccine are only recommended for young children who have never been vaccinated before. Children younger than 9 who have never had a seasonal flu vaccine should receive two doses, spaced at least 4 weeks apart.

It is not too late to be vaccinated against the flu this season. To obtain flu vaccine, contact your health care provider, or look up clinics at www.flu.gov or www.211maine.org

Update on Vaccine Preventable Diseases

Recommended Immunization Schedules for Children

Advisory Committee on Immunization Practices (ACIP) has issued its annual Recommended Immunization Schedules for Persons Aged 0 Through 18 Years: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6005a6.htm?s_cid=tw_mmwr90

National Vaccine Plan

The U.S. Department of Health & Human Services has unveiled a new National Vaccine Plan to enhance coordination of all aspects of federal vaccine and immunization activities. Its goal is to ensure that all Americans can access the preventive benefits of vaccines. http://www.hhs.gov/news/press/2011pres/02/20110216b.html

Tdap Vaccination Strategies

Representatives from the Association for Professionals in Infection Control and Epidemiology, US Centers for Disease Control and Prevention, the National Foundation for Infectious Diseases, and the Society for Healthcare Epidemiology of America co-authored a report titled Tdap Vaccination Strategies for Adolescents and Adults, Including Health Care Personnel, which is available at http://www.jointcommission.org/tdap/

The report is intended to help health care organizations of all types (hospitals, long term care facilities, ambulatory settings, home health organizations, etc.) improve Tdap vaccination rates.

The report notes that some important changes to the previously published ACIP recommendations were approved at the October 2010 ACIP meeting:

1. For adults ages 65 years and older, a single dose of Tdap vaccine may be given in place of a tetanus and diphtheria toxoids (Td) vaccine in persons who have not received Tdap.
2. Adults ages 65 years and older who have or anticipate having close contact with an infant age less than 12 months should receive a single dose of Tdap to protect against pertussis and reduce the likelihood of transmission of pertussis to infants age less than 12 months.
3. Tdap can be administered regardless of the interval since the last tetanus- or diphtheria-containing vaccine.
4. Children ages 7 through 10 years who are not fully immunized against pertussis and for whom no contraindication to pertussis vaccines exists should receive a single dose of Tdap to provide protection against pertussis. If additional doses of tetanus and diphtheria toxoid–containing vaccines are needed, then children ages 7 through 10 years should be vaccinated according to catch-up guidance.

PCR Diagnosing of Pertussis – Best Practices

US CDC has issued a Health Alert on the best practices for health care professionals related to the use of polymerase chain reaction (PCR) for diagnosing pertussis in light of the continuing resurgence of pertussis and the likelihood that health care professionals will see more patients with suspected pertussis.

• For guidance in distinguishing signs and symptoms of pertussis from those of other conditions, see http://www.cdc.gov/pertussis/clinical/features.html
• For more information on diagnostic testing, see http://www.cdc.gov/pertussis/clinical/diagnostic-testing/diagnosis-confirmation.html
• For information on specimen collection, see http://www.cdc.gov/pertussis/clinical/diagnostic-testing/specimen-collection.html
• For the entire guidance on PCR best practices in diagnosing pertussis, see http://www.cdc.gov/pertussis/clinical/diagnostic-testing/diagnosis-pcr-bestpractices.html

Influenza Update

Flu is widespread in Maine. In the week ending Feb. 12, there were seven new outbreaks – one in a long term care facility and six in K-12 schools. It is not too late to be vaccinated against the flu this season. To obtain flu vaccine, contact your health care provider, or look up clinics at www.flu.gov or www.211maine.org

Weekly updates on flu activity are available

• For Maine: http://www.maine.gov/dhhs/boh/influenza_surveillance_weekly_updates.shtml
• For the US: http://www.cdc.gov/flu/weekly/summary.htm
• For the world: http://www.cdc.gov/flu/international/activity.htm

Influenza Update

December 6-10 is National Influenza Vaccination Week. For more information, see this Maine CDC press release: http://www.maine.gov/tools/whatsnew/index.php?topic=DHS+Press+Releases&id=162508&v=article

There was no significant flu activity reported in Maine for the week ending Dec. 4. Weekly updates on flu activity in Maine are available at http://www.maine.gov/dhhs/boh/influenza_surveillance_weekly_updates.shtml

Weekly updates for the US are available at http://www.cdc.gov/flu/weekly/summary.htm and international updates are available at http://www.cdc.gov/flu/international/activity.htm.

Getting a flu vaccine is a safe way to prevent serious illness

For millions of people each year, the flu can bring a runny nose, cough, muscle aches, sore throat, fever, chills, and miserable days spent in bed instead of at work or school. However, you may not realize that it’s estimated that more than 200,000 people end up in the hospital from flu complications each year. And while unpredictable, the flu can be deadly. Between 1976 and 2007, US CDC estimates that annual flu-associated deaths in the United States have ranged from between about 3,000 people to about 49,000 people.

But there’s a safe alternative to getting the flu—getting the flu vaccine. The vaccine is a safe way to protect yourself from the flu and its potentially serious complications.

This season, health experts across the country are recommending that everyone 6 months and older get a flu vaccine. This “universal” flu vaccine recommendation was adopted by the CDC's Advisory Committee for Immunization Practices (ACIP), an independent group of physicians and health advocates that sets recommendations for all adult and childhood immunizations in the United States.

Over the years, the number of people recommended for flu vaccination has grown as experts learned more about who was at highest risk for flu complications or who was bearing the greatest burden of illness and possibly playing a role in spreading flu in the community. With the official universal vaccination recommendation, ACIP and the medical community are acknowledging the risk that everyone faces from the flu.

This year’s flu vaccines are being made using the same production and safety methods that have been standard for decades, during which hundreds of millions of flu vaccines have been given safely. The most common side effects from flu shots have been soreness, redness, or tenderness where the shot was given; fever; and aches. Some people who have gotten the nasal-spray flu vaccine, in use over the past seven years, have had runny nose, cough, or nasal congestion. Neither the flu shot nor the nasal-spray vaccine can give you the flu.

Every year, US CDC works closely with the Food and Drug Administration (FDA), health care providers, state and local health departments, and other partners to ensure the highest safety standards for all flu vaccines. CDC and FDA both share responsibility for monitoring the safety of vaccines and ensuring systems are in place to promptly detect unexpected health problems following vaccination.

For more information, visit www.maineflu.gov or www.flu.gov

Influenza Update

Surveillance

There was no flu activity reported in Maine for the week ending Nov. 20. Weekly updates on flu activity in Maine are available at http://www.maine.gov/dhhs/boh/influenza_surveillance_weekly_updates.shtml

Weekly updates for the US are available at http://www.cdc.gov/flu/weekly/summary.htm and international updates are available at http://www.cdc.gov/flu/international/activity.htm.

Update on state-supplied vaccine distribution

Most influenza vaccine arrives in Maine through private sector channels, but Maine CDC will be distributing a total of about 290,000 doses of flu vaccine this year; 92% of doses have already been shipped out to providers in the state. Almost 350 schools have received a total of more than 80,000 doses of state-supplied vaccine for school-based clinics.

Maine Influenza Update 10/14/10

Flu information for the general public

The first and most important step in protecting against the flu is to get a flu vaccination each season. US CDC recommends that everyone 6 months of age and older be vaccinated against the flu this year. Vaccine is already available in many places – you can check listings by zip code at www.flu.gov – and it will provide protection through the entire flu season.

The 2010-2011 flu vaccine will protect against:

· an influenza type A H3N2 virus,

· an influenza type B virus, and

· the 2009 H1N1 virus that caused so much illness last season.

You need to get the 2010-11 seasonal flu vaccine even if you got the 2009 H1N1 flu vaccine last season.

While there is a universal vaccination recommendation this season, it continues to be especially important that people at increased risk of serious flu complications get vaccinated against the flu. This includes:

· older people,

· young children,

· people with chronic lung disease (such as asthma and COPD), diabetes (type 1 and 2), heart disease, neurologic conditions, and certain other long-term health conditions,

· pregnant women, as well as

· American Indians and Alaska Natives, and

· people who are morbidly obese (defined as Body Mass Index (BMI) of 40 or more)

Over the years, hundreds of millions of people in the U.S. have safely received seasonal flu vaccines. Last flu season, about 80 million people in the U.S. also received the vaccine made to protect against the 2009 H1N1 virus, and the vaccine’s safety was similar to that of seasonal flu vaccines. Over the last 50 years, flu vaccines have been shown to be safe. Every year, CDC works closely with FDA, health care providers, state and local health departments, and other partners to ensure the highest safety standards for flu vaccines. CDC also works closely with FDA to ensure systems are in place to promptly detect unexpected health problems following vaccination.

Update on state-supplied vaccine distribution

Most influenza vaccine arrives in Maine through private sector channels, but some federal and state funds allow Maine CDC to purchase flu vaccine for some populations in Maine such as pregnant women, those in nursing homes, K-12 school children and their teachers and other staff, all other children, homeless people,, and people served by municipal and tribal health departments. Maine CDC will be distributing a total this year of about 290,000 doses of influenza vaccine, with over half of it having already arrived.

Doses Approved for Shipment as of Oct. 4:

Population	Doses
Children ages 6 months to 18 years	131,680*
Adults	34,560
Nursing homes and long-term care facilities	11,650
Total	177,890

* This includes doses shipped to both schools and private health care providers.

Number of schools that have received flu vaccine so far: 156

Number of doses distributed to schools so far: 49,090

All health care providers who have fulfilled the requirements in their provider agreements have received some vaccine toward their orders. If you are a provider who has not yet received vaccine, ensure that you have submitted all the appropriate paperwork and temperature logs.

Billing for state-supplied flu vaccine administration

Providers who receive state-supplied vaccine may not bill insurance for the cost of the vaccine itself. However, it is reasonable and allowable to bill insurance or charge for an administration fee for the administering the state-supplied vaccine in some circumstances, provided that:

1. MaineCare eligible children are not charged an out of pocket administration fee;
2. Administration fees do not exceed the regional Medicare maximum ($14.37/vaccine administration); and
3. No one is denied vaccine because of their inability to pay an administration fee.

Maine CDC and the Office of MaineCare Services have worked together to enable roster billing for administration fees provided to MaineCare-eligible individuals. The ability to roster bill through ImmPact2 will be available October 18. For more information: http://www.maine.gov/dhhs/boh/maineflu/h1n1/educators-RosterBillingUpdateMeCare.pdf

Due to the large number of private insurers, Maine CDC has not been able to arrange for roster billing arrangements with private insurers. For more information on how to bill private insurers for flu vaccine administration, contact the insurer directly.

School-based Flu Vaccine Clinics

The governor has issued an executive order to provide certain liability protections to volunteer health care workers who register with Maine Emergency Management Agency and participate in school-based flu vaccine clinics. To register, visit https://www.maineresponds.org/.

Maine CDC has posted materials – including registration forms, consent forms, sample protocols, and a copy of the governor’s executive order – at: http://www.maine.gov/dhhs/boh/maineflu/h1n1/educators.shtml#schoolclinics.

Flu Information for Health Care Workers (HCW)

Flu can spread rapidly in health care settings. Vaccination is the first and most important step all Health Care Workers (HCW) can take to protect against the flu. HCW include all people whose occupational activities involve contact with patients or contaminated material in health care settings, including home health care or clinical laboratory settings. This includes those who do not provide direct patient care, but have patient contact as well as those working in clinical settings within non-health care institutions, such as school nurses or those staffing clinics in correctional facilities. For more information on who is considered a Health Care Worker and why HCW should get vaccinated against the flu, see our new Health Care Workers and Flu web site at http://www.maine.gov/dhhs/boh/maineflu/hc-workers.shtml

US CDC, Maine CDC, and other professional groups recommend that all Health Care Workers get annual influenza vaccine. However, fewer than half of HCW nationwide get the flu vaccine. With the emergence of the pandemic H1N1 flu in 2009, Maine CDC required health care facilities to report the rate of their workers vaccinated against H1N1. For these rates and other information, please see our Current Messages to Health Care Providers at http://www.maine.gov/dhhs/boh/maineflu/h1n1/health-care-providers.shtml

Maine CDC has also issued a health alert (http://www.maine.gov/tools/whatsnew/index.php?topic=DHHS-HAN&id=143003&v=alert) for health care providers to provide information and guidance for the 2010-2011 flu season.