1. Implementing Lessons Learned from the 2004 – 05 Flu Season
Donna Lazorik, RN, MS
Massachusetts Department of Public Health

2. Seasonal
Influenza
Preparedness
Pandemic
Influenza
Preparedness

3. MDPH State-Supplied Flu Vaccine
50% of flu vaccine administered in MA
Prioritized to:
Children 6 – 23 m/o and older HR children
All LTC residents
HR people seen at public sites
Some private providers get some state-supplied vaccine

4. State-Supplied Flu Vaccine 2004-05
462,000 Chiron doses (NOT available)
167,900 SP doses
25% received Sept 8 (to pediatric sites)
25% received Sept 30 (held awaiting national guidelines)
167,900 (26%) Aventis
41,970 received to pedi sites, CHC
41,970 received being held
462,000 (73%) Chiron will NOT come
Total 630,000

5. MDPH Legal Order (10/13/04) Health Care Providers required to:
Limit flu vaccine to HR groups
Report to MDPH on vaccine inventory
Penalties associated with non-compliance (“fine not less than $50 and not more than $200 or imprisonment for not more than 6 months, or both”)

6. Additional Activities
Hotline
Alerts via the HHAN
Conference calls with local HDs and hospitals
Campaign to promote other control measures

7. MDPH Legal Order 10/27: Further restrict vaccine (> 75 y/o)
Received 1.3 M doses
700,000 state-supplied; 600,000 privately purchased
95% of state-supplied vax by Nov 9
12/1: Expand TIV eligibility; lift LAIV restrictions
12/21: Legal orders rescinded

8. Inactivated Flu Vaccine In MA
49,000 doses (7%) of state-supplied vaccine unused
vs. 0.6% in
167,900 (26%) Aventis
41,970 received to pedi sites, CHC
41,970 received being held
462,000 (73%) Chiron will NOT come
Total 630,000

9. 2004 Flu Season Review Internal after-action meetings
2 facilitated focus groups
Adult Immunization Coalition
Workshop at Adult Immunization Conference
Flu season look-back with Rand
BRFSS data

10. Lessons Learned
Providers and consumers made sure that HR people received vaccine
63% of > 65 y/o vs. 66% in
48% of children 6 – 23 m/o
9% of non-HR adults vs. 18% in
Need to promote LAIV
Providers need information on a regular basis
Whether there is anything new or not

11. Lessons Learned
Providers need to know about policy changes before the media
Public needs to know they will be told when vaccine is available – waiting lists, call-backs
Need for plan flexible enough to ensure that no vaccine goes unused

12. Lessons Learned – Public Health Order
Cons
Order limited vaccine for too long
Physician autonomy
News stories leading with ”Doctors will go to jail…”
Pros
Clarified for providers and the public who was eligible for vaccine
Some providers felt supported by the order
Rationing Flu Vaccine (Lee TH. N Engl J Med 351;23)

13. Actions Taken in 2005–06/ Pandemic Plan
Coordination
Contingency plans for various vaccine scenarios
Weekly MDPH flu team meetings
Epi, Vaccine Unit, Health Ed, Commissioner’s Office
Review vaccination distribution
Monitor calls, questions to determine content of MDPH Flu Advisories

14. Actions Taken in 2005–06/ Pandemic Plan
Communication
MDPH Flu Advisories to providers and stakeholders
Status of vaccine distribution, recommendations and guidelines, disease surveillance
q 1 – 2 weeks, Aug – Jan
, partners, web, HHAN

15. Actions Taken in 2005–06/ Pandemic Plan
Communication
Enhanced and promoted flu clinic website
Contracted for hotline services
Expanded promotion of non-vaccine control measures

16. Lemons to Lemonade Better coordination Enhanced communication
Revised pandemic plan
Seasonal
Influenza
Preparedness
Pandemic
Influenza
Preparedness