Pandemic Influenza Vaccine Distribution

Selected Updates

Pandemic Influenza Vaccine: Doses Administered and Safety Training Conference

Toscha Stanley, MHSAImmunization Services Division

Centers for Disease Control and Prevention (CDC)

August 21, 2008

Vaccination periods

• Five vaccination periods (take into account both timing and supply)– Preparation period – Pre-pandemic influenza vaccination period– Manufacturing period– Early pandemic influenza vaccination period– Later pandemic influenza vaccination period

Vaccine distribution

• Initial demand expected to exceed supply– When (demand >>> supply): allocation “push” model– When (demand > supply): may transition to “pull” model

• Vaccine distribution will be monitored via CDC’s FluFinder

• States will be able to access FluFinder data for their individual state through the CDC secure data network

Direct distribution

• Manufacturer ships vaccine to states using its established distribution channels (commercial shipper or 3rd party distributor)

• May involve single or multiple manufacturers depending on the current state of domestic manufacturing capacity

Ship-to site 1(50%)

POD POD POD

Ship-to site 2(25%)

POD POD POD

Ship-to site 3(25%)

POD POD POD

State A (4% of U.S. supply)

Ship-to site 1(60%)

POD POD POD

Ship-to site 2(30%)

POD POD POD

Ship-to site 3(10%)

POD POD POD

State B (2% of U.S. supply)

Vaccine manufacturer B

3rd party distributor

Vaccine manufacturer A

Direct distribution: Pre-pandemic influenza vaccine distribution with multiple manufacturers jointly supplying states

CDC and HHS

Needle/syringe manufacturer

Ship-to site 1(50%)

POD POD POD

Ship-to site 2(25%)

POD POD POD

Ship-to site 3(25%)

POD POD POD

State A (4% of U.S. supply)

Ship-to site 1(60%)

POD POD POD

Ship-to site 2(30%)

POD POD POD

Ship-to site 3(10%)

POD POD POD

State B (2% of U.S. supply)

Vaccine manufacturer A

Direct distribution: Pandemic influenza vaccine distribution with a single manufacturer

CDC and HHS

Needle/syringe manufacturer

Operations at the state level

• State-designated ship-to sites must be capable of:– Receiving

– Storing

– Securing

– Repackaging

– Allocating to PODs

– Follow-on distribution to PODs

• Allocation, distribution, and administration within a state will be a state and local function

Ship-to sites

• Total # of Pre-pandemic vax ship-to sites = 623• Total # of Pandemic vax ship-to sites = 976

1 site 2-10 sites >10 sites

Pre-Pandemic 43 9 10Pandemic 38 8 16

• Federal ship-to sites

Single central

ship-to site

POD 1

POD 2

POD 3

State X: Single central ship-to site with direct shipment to PODs

Vaccine, adjuvant, needles and syringes

POD 4

POD 5

Single Central

ship-to site

POD 1

POD 2

POD 3Vaccine

manufacturer or distributor

POD 4

POD 5

Regional sub-ship-to

site #1

Regional Sub-ship-to

site #2

State Z: Single ship-to site with regional sub-ship-to sites within the state

Ship-to site#1

POD 1

POD 2

POD 3

POD 4

POD 5

Ship-to site#2

Ship-to site#3

State Y: Multiple ship-to sites with direct shipment to PODs

Vaccine, adjuvant, needles and syringes

The findings and conclusions in this presentation have not been formally disseminated by CDC and should not be construed to represent any agency determination or policy.

Extra Slides

Ship-to site 1(50%)

POD POD POD

Ship-to site 2(25%)

POD POD POD

Ship-to site 3(25%)

POD POD POD

State A (4% of U.S. supply)

Ship-to site 1(60%)

POD POD POD

Ship-to site 2(30%)

POD POD POD

Ship-to site 3(10%)

POD POD POD

State B (2% of U.S. supply)

Vaccine manufacturer B

Centralized distribution: Multiple manufacturers and multiple products

Vaccine manufacturer A

Central distributor

CDC and HHS

Needle/syringe manufacturer

Centralized Distribution Option