1. H1N1 Vaccine Management Basics

2. Allocations Inventory Ordering Doses Administered H1N1 Guidance Distribution Enrollment

3. Support for H1N1 Vaccine Management Guidelines Reporting Quality Assurance Support Tools Allocations Ordering and Distribution

4. H1N1 Vaccine Guidelines Washington State H1N1 Vaccine Management Guidelines Washington State H1N1 Vaccine Management Guidelines H1N1 Vaccine Ordering and Distribution Basics H1N1 Vaccine Ordering and Distribution Basics

5. H1N1 Vaccine Guidelines Available This Guidance is in draft form. As information about H1N1 vaccine management evolves the Guidelines will evolve. Though in draft format, they will be useful for planning.

6. H1N1 Vaccine Management Guidelines

7. H1N1 Vaccine Allocation Strategy Population Based Allocation CountyShipment 1 TotalH1N1 Vaccine Adams120 Asotin210 Benton - Franklin920 Chelan - Douglas380 Clallam190 Clark440 Allocation Strategy Benton-Franklin H1N1 Vaccine Order TrackingShipment 1 H1N1 Vaccine Total Shipment Allocation920 Balance (MUST BE ≥ 0)730 PINProvider NameApproved 152002Richland Family Medicine50 152004Chou, H.D.40 H52001Ham Pharmacy LLC50 H52002Wright OB/GYN Practice20

8. H1N1 Vaccine Distribution Georgia McKesson Specialty TennesseeOhioCalifornia

9. Washington Experience with McKesson 2 ½ years distribution of childhood vaccines 2 ½ years distribution of childhood vaccines 8 million doses distributed 8 million doses distributed <.01% error rate with shipments <.01% error rate with shipments All shipments monitored for cold-chain All shipments monitored for cold-chain Vaccine packed for 48 hour guarantee Vaccine packed for 48 hour guarantee Tracking numbers with every shipment Tracking numbers with every shipment

10. H1N1 Vaccine Distribution Private Providers McKesson Specialty LHJ P.O.D. or Depot Combination Private Providers

11. LHJ Depot or Pod Distribution H1N1 Providers Local Health Jurisdiction (LHJ) WA State Department of Health CDCDistributor McKesson Specialty Provider Submits vaccine order or Requests Allocation from LHJ DOH Approves Processes Pod Orders CDC Receives Order and sends to Distributor LHJ Places bulk Pod order with DOH Provider Clinic Inventory LHJ Clinic Inventory Depot / Pod Inventory Distributor Fills LHJ Pod Orders Same day order processing. Shipment data sent to LHJs at minimum 1x per week. Information Exchange: Vaccine Product Flow: Vaccine Inventory: 1-2 day order submission timeline. Electronic shipping file, with ground carrier tracking numbers sent to DOH when shipment leaves warehouse – typically 3 – 5 business days after receipt. LHJ must send DOH data on vaccine redistribution to each provider H1N1 Vaccine Ordering and Distribution

12. Direct Distribution H1N1 Providers Local Health Jurisdiction (LHJ) WA State Department of Health CDCDistributor McKesson Specialty Provider Submits vaccine order or Requests Allocation from LHJ DOH Approves Processes All Orders CDC sends orders to Distributor LHJ Approves Provider Orders and Submits to DOH Provider Clinic Inventory Information Exchange: Vaccine Product Flow: Vaccine Inventory: LHJ Clinic Inventory Distributor Fills Provider Order Direct Ships to Provider Electronic shipping file, with ground carrier tracking numbers sent to DOH when shipment leaves warehouse – typically 3 – 5 business days after receipt. Same day order processing. Shipment data sent to LHJs at minimum 1x per week. 1-2 day order submission timeline. Existing providers – LHJ processes orders via VOMS New providers – LHJ processes orders via paper form H1N1 Vaccine Ordering and Distribution

13. H1N1 Vaccine Ordering

14. H1N1 Enrollment Enrollment is a 2 step process: Enrollment is a 2 step process: Pre-registration Pre-registration H1N1 Provider Agreement H1N1 Provider Agreement LHJ manages: LHJ manages: vaccine ordering vaccine ordering reporting requirements reporting requirements Quality assurance Quality assurance

15. H1N1 Provider Pre-registration On-line pre-registration application On-line pre-registration application Activated 8/21/09 Activated 8/21/09 Web-site: Web-site: Spreadsheet with pre-registration requests Spreadsheet with pre-registration requests Captured by DOH Captured by DOH Sent to LHJs daily during height of pre- registration Sent to LHJs daily during height of pre- registration Initially: All childhood vaccine participants enrolled (1194) Initially: All childhood vaccine participants enrolled (1194)

16. H1N1 Provider Agreements Still waiting finalization by CDC Still waiting finalization by CDC Once available: Once available: DOH fax out directly to providers DOH fax out directly to providers Requesting fax return Requesting fax return Providers with agreements matched with list of pre-registered Providers with agreements matched with list of pre-registered LHJs will receive list of providers with both (pre-registration and provider agreement) LHJs will receive list of providers with both (pre-registration and provider agreement)

17. At the time of each order: At the time of each order: Simple refrigerator count Simple refrigerator count Captured on order form or in CHILD Profile Vaccine Ordering and Management System Captured on order form or in CHILD Profile Vaccine Ordering and Management System At a minimum weekly report of provider vaccine usage (inventory section only) At a minimum weekly report of provider vaccine usage (inventory section only) Paper form Paper form Possibilities for electronic reporting Possibilities for electronic reporting Inventory Management for H1N1 Vaccine

18. Monthly H1N1 Vaccine Usage Report Monthly H1N1 Vaccine Usage Report Inventory Management for H1N1 Vaccine

19. CDC requires weekly reporting of each dose administered CDC requires weekly reporting of each dose administered By age range By age range 6-23 months 6-23 months 24-59 months 24-59 months 5-18 years 5-18 years 19-24 years 19-24 years 25-49 years 25-49 years 50-64 years 50-64 years > Or = 65 years > Or = 65 years Dose Number Dose Number 1 st or 2 nd dose administered 1 st or 2 nd dose administered Inventory Management for H1N1 Vaccine Aggregate Doses Administered Reporting Requirements

20. Range of Options: Range of Options: CHILD Profile CHILD Profile Regular CHILD Profile Immunization registry use Regular CHILD Profile Immunization registry use Mass Immunization Module Mass Immunization Module Mass Immunization Stand Alone Mass Immunization Stand Alone On-line via DOH web-link On-line via DOH web-link Paper-based Paper-based LHJs may use multiple avenues for reporting doses administered LHJs may use multiple avenues for reporting doses administered Methods should be selected that fit with LHJs/Provider business practices Methods should be selected that fit with LHJs/Provider business practices Inventory Management for H1N1 Vaccine Aggregate Doses Administered Reporting

21. Demonstration showing how Mass Immunization can be used to track by priority tier if desired by LHJ Demonstration showing how Mass Immunization can be used to track by priority tier if desired by LHJ Inventory Management for H1N1 Vaccine Use of Mass Immunization

22. Paper Report Form: Aggregate doses administered Aggregate doses administered By age By age By priority group By priority group No patient specific data available No patient specific data available Submitted to DOH for aggregating Submitted to DOH for aggregating LHJ level data reports made available LHJ level data reports made available By age, priority group By age, priority group For the jurisdiction For the jurisdiction Inventory Management for H1N1 Vaccine Aggregate Doses Administered Reporting

23. Inventory Management for H1N1 Vaccine Doses Administered Reporting