Issue
Number 491
November 15, 2004
CONTENTS OF THIS ISSUE
- New: CDC issues a patient-screening questionnaire to determine who is
eligible for nasal-spray influenza vaccine
- New: CDC and states to distribute 10.3 million doses of influenza
vaccine nationwide
- Medicare plans to raise physician payment for administering eligible
adult vaccinations from $8 to $18 in 2005
- New: MedImmune announces changes in the storage requirements for
FluMist influenza vaccine
- CDC issues report on vaccination coverage among U.S. children entering
school in 2003-04
- New VIS translations: VIS for LAIV now available in seven additional
languages
- Update: CDC continues to update its website with information regarding
the influenza vaccine shortage
- New: IAC adds a section of Spanish-language resources to its website
for the public
- DHHS announces contract to secure future egg supply for influenza
vaccine production
- Reminder: December 1 is the date for CDLHN's free satellite broadcast
on vaccine storage and handling
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ABBREVIATIONS: AAFP, American Academy of Family Physicians; AAP, American
Academy of Pediatrics; ACIP, Advisory Committee on Immunization Practices;
CDC, Centers for Disease Control and Prevention; FDA, Food and Drug
Administration; IAC, Immunization Action Coalition; MMWR, Morbidity and
Mortality Weekly Report; NIP, National Immunization Program; VIS, Vaccine
Information Statement; VPD, vaccine-preventable disease; WHO, World Health
Organization.
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November 15, 2004
NEW: CDC ISSUES A PATIENT-SCREENING QUESTIONNAIRE TO DETERMINE WHO IS
ELIGIBLE FOR NASAL-SPRAY INFLUENZA VACCINE
On November 12, CDC issued a patient self-screening questionnaire, "Patient
Screening Form for Clinics Providing FluMist (Nasal Spray) During the
2004-05 Flu Season." According to an accompanying document, "the FluMist
patient screening form is intended to enable self-screening by patients
visiting healthcare providers to receive an influenza vaccination. It should
be especially useful in influenza clinics. The form is based on the most
current ACIP recommendations for this influenza season and will help
providers to more easily screen potential vaccinees. In influenza clinics,
the form may help reduce long lines by enabling the early identification of
those who should NOT be vaccinated during this influenza season. These
persons could take themselves out of line or seek clarification or answers
from clinic staff before leaving the clinic area."
To access a ready-to-print (PDF) version, go to:
http://www.cdc.gov/flu/professionals/flugallery/pdf/flumistscreeningform.pdf
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November 15, 2004
NEW: CDC AND STATES TO DISTRIBUTE 10.3 MILLION DOSES OF INFLUENZA VACCINE
NATIONWIDE
On November 9, CDC issued a press release outlining a plan it and the states
have developed to distribute 10.3 million doses of influenza vaccine
nationwide. The press release also announces the start of an information
hotline for the public and health professionals. Focusing on the topic of
influenza and influenza vaccine, the hotline will be staffed 24 hours a day,
7 days a week. Portions of the press release are reprinted below.
***********************
November 9, 2004
For immediate release
CDC AND STATES ANNOUNCE PLAN TO DISTRIBUTE 10.3 MILLION FLU SHOTS
NATIONWIDE; PUBLIC HEALTH OFFICIALS CALL ALLOCATION FAIR AND AIMED AT MOST
VULNERABLE AMERICANS
Working closely with public health officials nationwide, the Centers for
Disease Control and Prevention (CDC) today announced plans to distribute the
remaining 10.3 million doses of Aventis Pasteur influenza vaccine to state
health departments, which will then help ensure the doses reach those people
at highest risk for complications from influenza. The vaccine will be
distributed over several weeks through December and into January.
"The work by our colleagues in state and local health departments across the
country that has gone into developing this plan has been absolutely
extraordinary," said CDC Director Dr. Julie Gerberding. "We're doing
everything possible to ensure that vaccine is distributed in a fair way and
that it goes to those who need it most."
Under the plan outlined today, states and territories will be receiving 100
percent of any orders they had originally placed under federal, state, and
multi-state contracts. Overall, this accounts for 3.1 million doses of
vaccine. The distribution plan for the [remaining] 7.2 million doses takes
into account three things: (1) the number of high-priority individuals in
the state, (2) the number of doses the state has already received, and (3)
the state's unmet needs. In the coming weeks, another 1.2 million doses of
pediatric [vaccine] will be allocated to states using the same approach.
"The allocation plan announced today, designed to get vaccine to those
individuals in greatest need of protection, demonstrates once again the
critical role the federal, state, and local governmental public health
system, working with the nation's healthcare providers, can play in
protecting the public," said Richard A. Raymond, MD, president of the
Association of State and Territorial Health Officials (ASTHO) and chief
medical officer, Nebraska Health and Human Services System. "While all of
the nation's vaccine needs will not be met, this system is fair and will
assure that remaining doses of vaccine get to those most in need."
"We support the influenza vaccine allocation method outlined today. It is
the best available solution for getting the remaining vaccine to the persons
who need it most," said Patrick M. Libbey, executive director, National
Association of County and City Health Officials (NACCHO). "The nation's
local public health departments will continue to assist their communities
and their state health departments in every way possible to protect the
public's health during this period of flu vaccine shortage."
Vaccine manufacturer Aventis Pasteur had already shipped 33 million of its
expected total 58 million vaccine doses prior to Chiron Corporation's Oct. 5
announcement. The remaining 25 million doses have been allocated at a rate
of about 3 million doses per week--or about 14 million doses--since Oct. 11,
under a joint distribution plan developed by CDC and Aventis. The vaccine
has gone to state public health departments, the Department of Veterans
Affairs, long-term care facilities/acute care hospitals, Vaccines for
Children program providers, private physicians who care for young children,
HMOs, and private providers serving high-priority groups. The plan announced
Tuesday will allocate the remaining 7.2 million influenza vaccine doses. . .
.
To provide more information to healthcare professionals and the public about
influenza and influenza vaccine, CDC has launched (800) CDC-INFO, a new 24/7
central telephone hotline available in English and Spanish. This number will
enable people to obtain information from CDC. The number for the hearing
impaired is (800) 243-7889 (TTY/TDD).
"We are excited to be able to provide a new information hotline that will
help people, including healthcare providers, to get answers about the
influenza vaccine and at a later time, a wide range of health and
disease-related questions," said Dr. Gerberding. "We encourage people to
call this number for information about the flu and this year's flu season or
to report when they cannot find vaccine in their communities."
Any information CDC receives about problems in finding influenza vaccine
will be shared with state health officials to help them direct the available
vaccine to people and places where it's needed most.
Callers to the hotline can choose to hear voice messages on a variety of
flu-related topics. Every caller has the option to transfer to a live person
who can provide more information.
Healthcare providers can also call the number to report cases of influenza
or flu-like illness in their community.
For more information about the flu, visit the CDC website:
http://www.cdc.gov/flu or call
(800) 232-4636 [(800) CDC-INFO].
***********************
To access the complete press release, go to:
http://www.cdc.gov/od/oc/media/pressrel/r041109.htm
To access a related tele-briefing transcript, go to:
http://www.cdc.gov/od/oc/media/transcripts/t041109.htm
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November 15, 2004
MEDICARE PLANS TO RAISE PHYSICIAN PAYMENT FOR ADMINISTERING ELIGIBLE ADULT
VACCINATIONS FROM $8 TO $18 IN 2005
On November 3, the Centers for Medicare & Medicaid Services (CMS) issued a
press release announcing new preventive benefits and physician payment
increases in Medicare's final rule for physician payment for 2005. The final
rule proposes significant increases in payments for administering
vaccinations and other injections. Portions of the press release are
reprinted below.
*******************
November 3, 2004
For immediate release
MEDICARE ANNOUNCES NEW PREVENTIVE BENEFITS AND PHYSICIAN PAYMENT INCREASES
IN FINAL PHYSICIAN PAYMENT RULE FOR 2005
The Centers for Medicare & Medicaid Services (CMS) today issued Medicare's
final rule for physician payment for 2005, with new benefits and higher
payments for preventive services including a "Welcome to Medicare Physical"
and increased payment rates to physicians. The expanded benefits and
increased payments result from the Medicare Modernization Act of 2003 (MMA)
and are included in the 2005 Physician Fee Schedule rule, which will become
effective January 1. . . .
The final rule also dramatically increases payments for vaccinations and
other types of injections, reflecting Medicare's rapid action on
recommendations from the American Medical Association's Drug Administration
Workgroup to assure appropriate payment for all drug administration
services. For example, payments for administering the influenza vaccine will
rise from $8 to $18. Physicians can also be paid for injections and
vaccinations, even when performed on the same day as other Medicare-covered
services. Medicare currently does not allow payment for injections provided
on the same day as other Medicare services. . . .
The final rule adopts 18 new codes to be used for billing for administering
drugs, developed by the American Medical Association's (AMA) CPT Editorial
Board. Because new permanent codes will not be included in the CPT until
2006, CMS has developed these temporary codes to allow physicians to be paid
for these services beginning January 1, 2005. The rule also accepts the
relative values (which are used to determine payment rates) for these codes
that were recommended by the AMA's Relative Value Update Committee (RUC). .
. .
*******************
To access the complete press release, go to:
http://www.cms.hhs.gov/media/press/release.asp?Counter=1248
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November 15, 2004
NEW: MEDIMMUNE ANNOUNCES CHANGES IN THE STORAGE REQUIREMENTS FOR FLUMIST
INFLUENZA VACCINE
Recently, MedImmune, Inc. announced changes in the storage requirements for
FluMist live attenuated influenza vaccine (LAIV). The storage changes have
FDA approval. The announcement, addressed to healthcare professionals, is
reprinted below in its entirety.
**********************
IMPORTANT STORAGE INFORMATION FOR FLUMIST
Dear Healthcare Professional:
In an effort to enable wider and prompt distribution of FluMist, influenza
virus vaccine live, intranasal, and to expand the number of vaccine
providers, MedImmune, Inc. has taken steps to make it easier for physicians
and pharmacists to store the product. Based on new data showing that FluMist
remains stable for at least 4 months in conventional frost-free freezers
without the use of a freezer insert (known as the FluMist FreezeBox), the
FDA has approved a supplement to our license for a modification of the
storage requirements FOR DOSES OF FLUMIST SHIPPED BETWEEN NOVEMBER 2, 2004
AND FEBRUARY 8, 2005. These changes in storage requirements are not
applicable to FluMist doses currently stored in the FluMist FreezeBox.
Effective immediately, FluMist received after November 2, 2004, may be
stored in its packaging without the use of a FluMist FreezeBox until
February 8, 2005. Of note:
- FluMist doses shipped after November 2,
2004, can be stored in a conventional frost-free refrigerator/freezer
combination unit (i.e., a refrigerator with a separate, isolated freezer
section) without a FluMist FreezeBox. In such units, the temperature
setting for the freezer compartment should ideally be set at a low
(colder) level, while the temperature setting for the refrigerator
compartment should ideally be set at the midpoint. Refrigerator/freezer
units with a single control should use the normal setting.
- FluMist CANNOT be stored in
dormitory-style refrigerator/freezer units (i.e., a refrigerator not
having a separate isolated freezer section).
- Physicians and pharmacists who wish to
continue using the FluMist FreezeBox or a manual defrost freezer may
certainly do so; in which case the imprinted expiration date on the
sprayer remains in effect.
- All unused doses of FluMist shipped
between November 2, 2004, and February 8, 2005, and stored in a frost-free
freezer without a FluMist FreezeBox must be either returned or discarded
effective February 8, 2005, regardless of the expiration date imprinted on
the sprayer.
- In mid-January 2005, MedImmune will send a
reminder letter on this policy to all healthcare professionals receiving
FluMist doses after November 2, 2004.
Please note that this change in the storage
requirements for FluMist applies only to doses of THIS SEASON'S VACCINE
SHIPPED BETWEEN NOVEMBER 2, 2004 AND FEBRUARY 8, 2005. MedImmune will
provide additional data to the FDA in order to determine storage
requirements for FluMist for the 2005-2006 influenza season. If you already
have a FluMist FreezeBox, a representative will be in contact at the end of
the influenza season to provide direction on how to store or return your
FluMist FreezeBox. Please do not discard your FluMist FreezeBox until
notified.
Should you have any questions regarding this information or would like to
order FluMist, please contact us at (877) 358-6478 [(877) FLUMIST] or visit
www.flumist.com
Sincerely,
Peter Patriarca, MD
Vice President, Regulatory Affairs
MedImmune, Inc.
**********************
To access the information directly from the FluMist website, go to:
http://www.flumist.com/professional/ordering/new.asp
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November 15, 2004
CDC ISSUES REPORT ON VACCINATION COVERAGE AMONG U.S. CHILDREN ENTERING
SCHOOL IN 2003-04
CDC published "Vaccination Coverage Among Children Entering School--United
States, 2003-04 School Year" in the November 12 issue of MMWR. Portions of
the article and Editorial Note are reprinted below.
***********************
[From the article]
One of the national health objectives for 2010 is to sustain >=95%
vaccination coverage among children in kindergarten through first grade
(objective 14-23). To determine the percentage of vaccination coverage among
children entering kindergarten, data on vaccination coverage were analyzed
from reports submitted to the National Immunization Program by states, the
District of Columbia (DC), and eight current or former U.S. territories for
the 2003-04 school year. This report summarizes the results of that
analysis, which determined that coverage for all vaccines except hepatitis B
(HepB) and varicella was reported at >90% in 45 areas. However, the vaccines
required in each reporting area and the methods for surveying
kindergarten-aged children vary substantially; in seven states, <20% of
eligible children were surveyed. The wide variations in survey populations
underscore the need for CDC to continue working with immunization programs
in states, DC, and current or former territories to improve survey methods
and automate reporting of data. . . .
[From the Editorial Note]
State laws requiring proof of vaccination before entering school have been
referred to as a "safety net" for the U.S. vaccination program because they
ensure that no child is missed. This safety net relies on the efforts of
school nurses, teachers, and others to identify children who are not UTD [up
to date]. Findings of uniformly high nationwide coverage during the 2002-03
and 2003-04 school years underscore the success of school entry requirements
in boosting vaccine coverage. Childhood vaccination coverage is also
measured nationally among children aged 19-35 months. Higher percentages of
children are UTD at kindergarten entry than at younger ages, suggesting that
school entry laws are a key to ensuring high coverage. . . .
***********************
To access a web-text (HTML) version of the complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5344a4.htm
To access a ready-to-copy (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5344.pdf
To receive a FREE electronic subscription to MMWR (which includes new ACIP
statements), go to:
http://www.cdc.gov/mmwr/mmwrsubscribe.html
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November 15, 2004
NEW VIS TRANSLATIONS: VIS FOR LAIV NOW AVAILABLE IN SEVEN ADDITIONAL
LANGUAGES Dated 5/24/04, the current
version of the VIS for live attenuated intranasal influenza vaccine (LAIV)
is now available on the IAC website in seven additional languages:
Cambodian, Chinese, Hmong, Japanese, Korean, Tagalog, and Vietnamese. IAC
gratefully acknowledges the California Department of Health Services for
the translations.
To obtain a ready-to-copy (PDF) version of the VIS for LAIV in CAMBODIAN,
go to:
http://www.immunize.org/vis/caLAIV04.pdf
To obtain it in CHINESE, go to:
http://www.immunize.org/vis/chLAIV04.pdf
To obtain it in HMONG, go to:
http://www.immunize.org/vis/hmLAIV04.pdf
To obtain it in JAPANESE, go to:
http://www.immunize.org/vis/jpLAIV04.pdf
To obtain it in KOREAN, go to:
http://www.immunize.org/vis/koLAIV04.pdf
To obtain it in TAGALOG, go to:
http://www.immunize.org/vis/taLAIV04.pdf
To obtain it in VIETNAMESE, go to:
http://www.immunize.org/vis/vnLAIV04.pdf
To obtain it in ENGLISH, go to:
http://www.immunize.org/vis/liveflu.pdf
For information about the use of VISs, and for VISs in a total of 32
languages, visit IAC's VIS web section at
http://www.immunize.org/vis
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November 15, 2004
UPDATE: CDC CONTINUES TO UPDATE ITS WEBSITE WITH INFORMATION
REGARDING THE INFLUENZA VACCINE SHORTAGE
CDC recently updated its website with several documents related
to the influenza vaccine shortage. Following are links to the
new information.
- One item of particular importance is a change made to the
Q&A web page "Questions & Answers: Flu Vaccination in the
2004-05 Season." The answer to the question "Can healthcare
workers get LAIV?" previously contained incorrect information:
It had said that healthy, nonpregnant healthcare workers who are
less than 49 years of age can receive LAIV. The information has
been corrected to say that healthy, nonpregnant healthcare
workers who are less than 50 years of age can receive LAIV.
To access the corrected information, go to:
http://www.cdc.gov/flu/about/qa/0405vaccination.htm
- The two-page document "Fact Sheet--Key Facts About the Flu:
How to Prevent the Flu and What to Do If You Get Sick" gives
patients a succinct overview of the disease, antiviral
medications, preventive health habits, and warning signs of
serious influenza complications. It is available in Spanish,
Vietnamese, Chinese, and Tagalog, as well as in English.
To access a ready-to-print (PDF) version in ENGLISH, go to:
http://www.cdc.gov/flu/pdf/keyfacts.pdf
To access a web-text (HTML) version in ENGLISH, go to:
http://www.cdc.gov/flu/keyfacts.htm
To access a ready-to-print (PDF) version in SPANISH, go to:
http://www.cdc.gov/flu/espanol/pdf/keyfacts.pdf
To access a web-text (HTML) version in SPANISH, go to:
http://www.cdc.gov/flu/espanol/keyfacts.htm
To access a ready-to-print (PDF) version in VIETNAMESE, go to:
http://www.cdc.gov/flu/vie/pdf/keyfacts-vietnamese.pdf
To access a ready-to-print (PDF) version in CHINESE, go to:
http://www.cdc.gov/flu/cht/pdf/keyfacts-chinese.pdf
To access a ready-to-print (PDF) version in TAGALOG, go to:
http://www.cdc.gov/flu/tgl/pdf/keyfacts-tagalog.pdf
- The web page "Questions & Answers: 2004-05 Vaccine Supply"
was updated on November 5. To access the updated information, go
to: http://www.cdc.gov/flu/about/qa/0405vaccinesupply.htm
- The web page "Questions & Answers: Testing" was updated
November 4. To access the updated information, go to:
http://www.cdc.gov/flu/about/qa/testing.htm
- The seven-page document "CDC Guidelines for Large-Scale
Influenza Vaccination Clinic Planning, 2004-05" presents
considerations on the following topics: leadership, human
resources, clinic location, clinic layout and specifications,
crowd management, security, and advertising.
To access a ready-to-print (PDF) version, go to:
http://www.cdc.gov/flu/professionals/vaccination/pdf/vaxclinicplanning0405.pdf
- The patient self-screening questionnaire "Patient Screening
Form: Who Should and Who Should Not Get a Flu Shot?" is now
available in Russian.
To access a ready-to-print (PDF) version, go to:
http://www.cdc.gov/flu/professionals/flugallery/pdf/vaccinescreeningform-rus.pdf
- The three-page "Fact Sheet: HIV/AIDS and the Flu" clarifies
information about giving influenza vaccine and antiviral
medications to people with HIV/AIDS.
To access a ready-to-print (PDF) version, go to:
http://www.cdc.gov/flu/protect/pdf/hiv-flu.pdf
To access a web-text (HTML) version, go to:
http://www.cdc.gov/flu/protect/hiv-flu.htm
CDC is continually adding information to its Influenza web
section (including Q&A pieces for patients and professionals);
visit it often by going to: http://www.cdc.gov/flu
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November 15, 2004
NEW: IAC ADDS A SECTION OF SPANISH-LANGUAGE RESOURCES TO ITS
WEBSITE FOR THE PUBLIC
The Immunization Action Coalition recently added a page of
Spanish-language resources to its website for the public,
www.vaccineinformation.org The home page now features a link to
"Información en Español," which brings interested visitors to a
section of immunization materials in Spanish.
The "Inmunización" page includes immunization schedules for
adults, adolescents, and children; 15 Vaccine Information
Statements; print materials from IAC and other organizations;
videos from CDC and the Vaccine Education Center; photos;
Spanish-language websites related to immunization, viral
hepatitis, and general health; and toll-free telephone numbers.
The Spanish-language resource page can be accessed directly by
going to http://www.vaccineinformation.org/spanish.asp Of
course, we encourage you to refer all your patients and parents
with immunization questions to the website's home page:
http://www.vaccineinformation.org
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November 15, 2004
DHHS ANNOUNCES CONTRACT TO SECURE FUTURE EGG SUPPLY FOR
INFLUENZA VACCINE PRODUCTION
On November 9, the Department of Health and Human Services
(DHHS) issued a press release announcing it has awarded a
contract to ensure the egg supply needed to manufacture
influenza vaccine in the event of a pandemic influenza outbreak
or future vaccine shortage. Portions of the press release are
reprinted below.
********************
November 9, 2004
For immediate release
SECRETARY THOMPSON ANNOUNCES CONTRACT TO SECURE FUTURE EGG
SUPPLY FOR FLU VACCINES
HHS Secretary Tommy G. Thompson announced today the awarding of
a contract to Sanofi Aventis Inc., part of the Sanofi Aventis
Group, to ensure there are enough eggs on hand to manufacture
flu vaccines in the event of a pandemic flu outbreak or future
vaccine shortages.
This contract will ensure eggs are available to permit vaccine
production at any time during the year, which will prevent gaps
in flu vaccine supply due to inflexible, tightly planned
manufacturing schedules, inadequate surge capacity, and
dependency on foreign manufacturers. It also will provide for
the stockpiling of other needed vaccine manufacturing supplies
for ready availability.
"The existing flu vaccine manufacturing system is not
adequate to meet the nation's needs in the event of a flu
pandemic or a shortage," Secretary Thompson said. "This is an
important step toward protecting Americans should a flu pandemic
break out. . . ."
This contract follows Secretary Thompson's announcement in
August of the National Pandemic Influenza Preparedness and
Response Plan, which outlines a coordinated national strategy to
prepare for and respond to an influenza pandemic. The draft plan
may be found online at http://www.hhs.gov/nvpo/pandemicplan and
is a result of years of work by the department.
The contract to Aventis Pasteur is nearly $10 million for the
base contract to develop and implement the egg supply plan for
transition to a year-round egg supply, to stockpile other
vaccine manufacturing supplies, and to obtain initial
investigational lots of pandemic influenza vaccine. Maintenance
of the egg supply plan, which will provide an increased surge
capacity for vaccine manufacturing, and more investigational
lots of pilot pandemic influenza vaccines through 2008 may
increase the overall contract value to $41 million. . . .
********************
To access the complete press release, go to:
http://www.dhhs.gov/news/press/2004pres/20041109a.html
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November 15, 2004
REMINDER: DECEMBER 1 IS THE DATE FOR CDLHN'S FREE SATELLITE
BROADCAST ON VACCINE STORAGE AND HANDLING
Quality Assurance in Vaccine Storage and Handling, a live
satellite broadcast, will take place on December 1 from 10AM to
11:30AM PT. Seating is limited for this free event, and
registration at a viewing site is required. CDLHN does not
handle registration. For information about registering with a
facilitator at a viewing site in your location, go to:
http://cdlhn.com/default.htm
The overarching goal of the broadcast is to help clinics and
practices avoid handling and storage errors that can result in
thousands of dollars in wasted vaccines. The broadcast will
include a live Q&A segment and will present real-life scenarios
that clinics and practices face every day. Topics that will be
covered include vaccine storage equipment, temperature logging,
and protecting vaccines in the event of storage problems or an
emergency.
The intended audience includes physicians, nurses, physician
assistants, and other personnel in hospital and outpatient
settings such as nursing homes, chronic-care facilities, and
assisted-living residences. It also includes personnel who
provide home healthcare.
The California Distance Learning Health Network (CDLHN) and the
California Department of Health Services, in partnership with
CDC, are the broadcast producers.
For additional information, contact Kate Spilis at
(619) 594-5912 (phone), (619) 594-7427 (fax),
info@cdlhn.com
(email), or http://cdlhn.com/default.htm
(Web). |
