OVERVIEW OF THE NATIONAL INFLUENZA

VACCINE SUMMIT

OVERVIEW OF THE NATIONAL INFLUENZA

VACCINE SUMMITDennis J. O’Mara

Associate Director for Adult ImmunizationImmunization Services DivisionNational Immunization Program

Centers for Disease Control and PreventionDepartment of Health and Human Services

NVAC, Washington, D.C.June 3, 2003

2003

Summit conceived in response to delays in influenza vaccine production and distribution in 2000

Co-sponsored by AMA and CDC1st two Summits:

March and August 20013rd Summit in May 20024th Summit in May 2003

History of the National Influenza Vaccine Summit

History of the National Influenza Vaccine Summit

The Summit is . . .The Summit is . . .

An annual meetingA conceptAn informal, action-

oriented organizationA resource

Composition of the Summit (1)

Composition of the Summit (1)

Vaccine ManufacturersVaccine DistributorsFederal AgenciesProfessional Medical

OrganizationsPublic Health HospitalsPharmacists

Composition of the Summit (2)

Composition of the Summit (2)

Community Immunization ProvidersOccupational Health Providers BusinessPrivate Insurance and Managed

CareLong-term Care Quality Improvement OrganizationsConsumers

The 2003 Summit: Attendees

About 100 individuals attended54 organizations represented12/14 categories well-

represented2 categories (consumer groups

and business) need more representation

The 2003 Summit: Agenda

Plenary updatesFuture directions in vaccine

productionInfluenza pandemic planningBreakout sessions by working

group

Previously-ExistingSummit Working Groups

Previously-ExistingSummit Working Groups

CommunicationsCommunity-based Vaccination

ProvidersOccupational Vaccination

ProvidersPayment IssuesVaccine Distribution

NewSummit Working Groups

NewSummit Working Groups

Consumers’ IssuesVaccine ReallocationPhysicians’ IssuesLong-Term Care

Addressing the 50 Summit

Recommendations: Process

Addressing the 50 Summit

Recommendations: ProcessOne lead group/organization

per recommendationOther groups/organizations

in support as neededCollaboration as appropriatePeriodic updates on progress

collected and posted on AMA’s Summit website

Examples of Progress To Date

on 2002 RecommendationsMedicare vaccine administration

rates increased by an average of 94%

National Influenza Vaccination Catch-up Fortnight

Elimination of Medicare CPT Code for whole-cell influenza vaccine

Updated draft influenza vaccine storage and handling guidelines

Examples of Future Plans from Summit Working

Groups (1)Coordinated promotion/information

campaigns for providers and consumers

Coordinated campaign to promote extending the influenza vaccine campaign

List of provider vaccine ordering strategies

Examples of Future Plans from Summit Working

Groups (2)Vaccine reallocation model practices

databaseProvider organization messages to

members re: purchasing vaccine this year

Vaccine distribution system matrix

The Dual Challenge We FaceThe Dual Challenge We Face

To increase demand for and uptake of vaccine to approach true need

To increase vaccine supply to approximate the (growing?) demand

To increase demand for and uptake of vaccine to approach true need

To increase vaccine supply to approximate the (growing?) demand

Influenza VaccineRisk and Target Groups,

U.S., 2002

Influenza VaccineRisk and Target Groups,

U.S., 2002

GroupEstimated Population

(MILLIONS)

Increased risk* 83 (+2)

Target** 102

Others aged 2-49 years

101

All persons aged >5 mos.

286 * Includes children aged 6-23 months as of 7/1/02; 2 million children turn 6 months during

Oct.-March

** Includes health care personnel, household contacts of persons at increased risk (persons with medical indications, aged 65 or older, or aged <2 years), and other persons aged 50-64 years

PRELIMINARY ESTIMATES (1997-2001 National Health Interview Survey, 2000-2002 Census estimates)

Groups at Increased Riskfrom Influenza, U.S., 2002Groups at Increased Riskfrom Influenza, U.S., 2002

GroupEst.

Population(MILLIONS)

Aged >64 years 36Chronic illness Aged 50-64 years (30%) Aged 19-49 years (14%) Aged 6 mo.-18 years (11%)

39½ 13 18 8

Pregnant women 2Other children 6-23 months 5½Total at increased risk* 83 (+2)* Includes children aged 6-23 months as of 7/1/02; 2 million children turn 6 months during

Oct.-March

PRELIMINARY ESTIMATES (1997-2001 National Health Interview Survey, 2000-2002 Census estimates)

Influenza Vaccine Target Groups*, U.S.,

2002

Influenza Vaccine Target Groups*, U.S.,

2002Group

Est. Population

(MILLIONS)

Health care personnel <65 7

Household contacts** Aged 50-64 years (33%) Aged 19-49 years (35%) Aged 2-18 years (45%)

75½10 3828

Other persons aged 50-64 19½Total, other target groups 102

* Includes household members, but not out-of-home caretakers, of children aged <2 years

** Based on Monte Carlo imputation of increased risk status using 2000 NHIS; does not include household contacts of children born during influenza season

PRELIMINARY ESTIMATES (1997-2001 National Health Interview Survey, 2000-2002 Census estimates)

Influenza Vaccine DosesProduced for the U.S. Market,

1999-2002*

Influenza Vaccine DosesProduced for the U.S. Market,

1999-2002*

Year Number Doses Produced

1999 77.2 Million

2000 77.9 Million

2001 87.7 Million

2002 95.0 Million* Data provided by manufacturers producing

influenza vaccine for the U.S. market.

Increase VaccineDemand/UptakeIncrease VaccineDemand/Uptake

Increase Capacity of the Delivery System- Get more providers vaccinating- Get providers vaccinating more- Determine vaccination

opportunities based on community and provider norms

Community/Provider Influenza Vaccination

Norms

Community/Provider Influenza Vaccination

NormsWhat are the current

community coverage levels?Who vaccinates?Where/when do they vaccinate?What is the vaccination-

seeking behavior of the population?

and…

Community Influenza Vaccination Norms

Community Influenza Vaccination Norms

What is the general health care seeking behavior of the population?

What is the population’s perception of health care and providers?

What is the correct balance of vaccine delivery between:- Fixed health facilities- Non-traditional sites

Increase Vaccine SupplyIncrease Vaccine Supply

Maximize existing production capacity

Bring new manufacturers to the market

Employ new or improved vaccine production technology

A Vision of theFuture of the National

Influenza Vaccine Summit

A Vision of theFuture of the National

Influenza Vaccine SummitRemains a permanent but informal

organization at the national levelWorks year-round on the issuesFlexible — can respond to

contingenciesCould expand attention to broader

array of adult vaccination issues

Dennis J. O’MaraAssoc. Director Adult

Immunization

ISD / NIP / CDC1600 Clifton Road NE · MS E-52

Atlanta, GA 30333

Telephone: 404-639-8820Fax: 404-639-8615

E-mail: djo1@cdc.gov

AMA Summit Web Site: http://www.ama-assn.org/ama/pub/article/1826-6268.html