Program implementation
description
Transcript of Program implementation
Program implementation
Pascale Wortley, MD, MPH
January 22, 2010
Program Managers Meeting
H1N1 Response: overall structure
Incident Manager
State Coordination Task Force
Community Mitigation
Task Force
Medical Countermeasures
Task Force
Vaccine Task Force
Epi/surveillanceTask Force
Deputy Incident Manager
Chief of Staff
Chief Health Officer
H1N1 Vaccine Task Force
Task Force DirectorJay Butler
Vaccine Task Force Deputy
Tom Shimabukuro
Vaccine Coverage &
Monitoring teamJim Singleton
Gary Euler
Vaccine Data Management
TeamDavid Walker
Doses Administered Team
Jeanne Tropper Warren Williams
Vaccine Effectiveness
TeamDavid Shay
VaccineSafety Team
Claudia VellozziFrank DeStefano
Vaccine Communication& Education Team
Kris Sheedy
Vaccine Distribution
TeamJeanne Santoli
Vaccine Implementation
TeamPascale Wortley
Vaccine Task Force Operations
AnalystEric Marble
Vaccine EOC DeskDuane KilgusVicki Evans
H1N1 Vaccine
Steering Committee
Task ForceChief of Staff
Dave Brownell
Task ForceSenior Deputy for Science
Cynthia Whitney
Status Update• Doses ordered to date (Sept 31-January 15): 120 million doses
• VFC program annual ordering: 80 million doses
• Almost 120,000 provider agreements signed
• Almost 70,000 unique ship-to sites
Cumulative Number of Provider Agreements, H1N1 Vaccine Program, Sept 2009-Jan 2010
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20000
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Pre-launch
Cumulative Number of Ship-to Sites, H1N1 Vaccine Program, Oct 2009-Jan 2010
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Vaccination Distibution, United States, 2009-2010
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4-Oct 11-Oct 18-Oct 25-Oct 1-Nov 8-Nov 15-Nov
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Pro-Rata Allocations (Received at McKesson)
Ordered by States
Shipped from McKesson to States
As of 15 Jan 2009Pro-Rata Allocation: 139,334,000Advance Allocation: 5,691,500Retail Allocation: 5,521,800
CA Depot: AZ, CA, CO, HI, NV, OR, UT, WA, Pacific Territories
Number of Doses Shipped From Each Depot (7-Day Moving Averages)
OH Depot: IN, MI, MN, NE, NJ, NY, NYC, OH, PA, Philly, WI
GA Depot: AL, CT, DE, FL, GA, KY, ME, MD, MA, NH, NC, RI, SC, TN, VA
Number of Doses Shipped From Each Depot (7-Day Moving Averages)
TN Depot: AK, AR, DC, ID, IL, Chicago, IA, KS, LA, MS, MO, MT, NM, ND, OK, PR, SD, TX, VT, VI, WV, WY, Federal Employees
Note: Among the general population, 43% of those who intend to get vaccinated for H1N1 have already done so.
Projected H1N1 Influenza Vaccination Coverage Based on Reported IntentNHFS, Interviews Conducted September 28 - January 2, 2010
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Vaccinated Will Definitely Get Will Probably Get
Initial Target Children Adults 19-24y Adults 50-64y Adults 65+yTotal Population Adults 25-49y
Reported intention to be vaccinated
Target Group Sample Size Weighted
Coverage95% CI
Population Size estimate (millions)
Pregnant women <30 **NA NA 1.0
Adults living with or caring for infants <6m
(not HCP)69 *19.8% UNK 16.0
Health Care Personnel (HCP) 157 *43.3% 29.9, 56.7 28.4
Persons 6m-24y 1,716 25.9% 20.6, 31.2 101.0
Children 6m-4y 500 *33.0% 21.6, 44.4 19.1
Children 5-18y with medical conditions 109 *53.7% 29.3, 78.1 7.7
Adults 25-64y with medical conditions 192 24.7% 15.8, 33.6 29.4
Total initial target groups 2,101 27.9% 23.5, 32.3 160.2
Limited vaccine subset 807 37.5% 30.1, 44.9 61.5
Total population 3,023 20.3% 17.2, 23.4 299.3
H1N1 Influenza Vaccination Coverage by ACIP Target Groups, NHFS Dec 27, 2009-Jan 02,
2010
*Estimate may not be reliable, (CI half-width/estimate)≥0.6 or (CI half-width)≥10.**Estimates with an unweighted denominator of <30 observations are not reported and are coded as NA.
H1N1 Influenza Vaccination Coverage - childrenSource: National H1N1 Flu survey
• Month of Dec 2009 - picture of mid Dec
Age
• 6-23 months 33.4±6.4
• 2-4 years 30.0±5.5
• 5-18 years 24.2±3.2
– 5-9 years 32.6±5.8
– 10-12 years 21.8±5.6
– 13-18 years 18.7±4.6
Proportion of People Receiving H1N1 Vaccine, by Initial Target Group Status, NHFS Dec 27-Jan 2
Initial Target Group, 73%
Not Initial Target, Aged 25-64y, 22%
Not Initial Target, Aged
65+y, 5%
Note: The proportion of people in non-initial target groups receiving H1N1 vaccine has increased as states have
relaxed prioritization.
Note: In some weeks, black non-Hispanics appear to have somewhat lower coverage rates than other
groups.
H1N1 Vaccination Coverage by Race/EthnicityNHFS, Interviews Conducted September 28 - January 2, 2010
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Initial Target Limited Vaccine Subset Total Population
HispanicHispanicHispanic Other non-HispanicOther non-HispanicOther non-Hispanic White, non-HispanicWhite, non-Hispanic Black, non-HispanicBlack, non-HispanicBlack, non-Hispanic
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Cumulative H1N1 influenza vaccination coverageamong children aged 6 months-17 years, by state
based on combined estimates from the December 2009 BRFSS and NHFS interviews
Significantly >30%: Indiana, Massachusetts, Connecticut, South Dakota, Maine, Rhode Island.Significantly >20%: Washington, New York, Ohio, Virginia, Nebraska, Kansas, Iowa, Delaware, Hawaii, New Hampshire, Pennsylvania, Minnesota, Illinois, West Virginia, South Carolina, Vermont, Arkansas.Significantly <20%: Texas.
Combined national estimate=27.6%
Cumulative H1N1 influenza vaccination coverageamong persons 6 months and older, by state
based on combined estimates from the December 2009 BRFSS and NHFS interviews
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National estimate: 13.6% (12.5-13.7)
Range: 6.2-23.1%
Note: In December, more people reported receiving H1N1 vaccine in non-medical locations, particularly schools and worksites, than in October and
November.Totals do not equal 100% due to “don’t know”
Place of VaccinationNHFS, Interviews Conducted December 2009
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Medical LocationSeasonal 66%, H1N1 60%
Non-Medical LocationSeasonal 31%, H1N1 39%
H1N1
Seasonal
Weekly uptake of seasonal and H1N1 influenza vaccines through January 02, 2010, SDI
Note: An uptick in billing for seasonal and H1N1 influenza vaccinations in physician offices occurred after the Thanksgiving
holiday week, but decreased again during the Christmas holidays.
H1N1 Influenza Vaccine Uptake in Physician Offices, through January 2, 2010, SDI
Note: Observed dips in billing for H1N1 vaccinations represent Thanksgiving and Christmas holiday weeks.
Situational Awareness Project (Univ of Michigan)
Next steps• Completing the campaign, determining how to scale
back efforts
• Evaluation: what are the most important things to learn
» for seasonal vaccination
» for future responses