immunization program 2009 h1n1 adventure
DESCRIPTION
Immunization Program 2009 H1N1 Adventure. Governor’s Child Health Advisory Committee Immunization Workgroup Topeka, KS February 19, 2010. Sue Bowden, RN, BS Immunization Program Manager Kansas Department of Health & Environment. - PowerPoint PPT PresentationTRANSCRIPT
To protect the health and environment of all Kansans by promoting responsible choices.
Immunization ProgramImmunization Program2009 H1N1 Adventure2009 H1N1 Adventure
Governor’s Child Health Advisory CommitteeImmunization Workgroup
Topeka, KS
February 19, 2010
Sue Bowden, RN, BSImmunization Program Manager
Kansas Department of Health & Environment
To protect the health and environment of all Kansans by promoting responsible choices.
April 24, 2009April 24, 2009
Received Health Alert Network notice regarding 1st H1N1 case in Kansas.
To protect the health and environment of all Kansans by promoting responsible choices.
May 2009May 2009
Began discussions with registry staff and KDHE IT staff about documentation of patient level data for mass vaccination clinics.
To protect the health and environment of all Kansans by promoting responsible choices.
June 2009June 2009 Received first communication from CDC regarding
estimated allocation of H1N1 vaccine under different planning scenarios.
Scenarios ranged from an initial vaccine shipment to Kansas of 360,000 to 1.5 million doses with 90,000-300,000 doses per week after that.
Program staff discussed plans for surge capacity for vaccine ordering, distribution and inventory management.
Conference call with GIV regarding 3rd party distribution, in addition to investigation of local resources for receipt and distribution of vaccine by KDHE staff.
ARRA grant application
To protect the health and environment of all Kansans by promoting responsible choices.
July 2009July 2009
Developed plans for enhancement of the immunization module for the preparedness KS-CRA information system.
First vaccine is projected to be available by late fall
Annual CDC Grant application preparation
To protect the health and environment of all Kansans by promoting responsible choices.
August 2009August 2009 Met with KSWebIZ vendor to define
modifications to KS-CRA system for H1N1 vaccine inventory management and doses administered reporting.
Received first hint that vaccine may be made available as early as mid September.
Participated in weekly conference calls with LHDs and their partners.
Vaccine availability projections change. 8/05 120M doses (1M doses for KS) 8/14 45M doses (408,000 doses for KS)
To protect the health and environment of all Kansans by promoting responsible choices.
August August continuedcontinued
Developed process for granting user access to immunization module of KS-CRA system.
Developed online system for H1N1vaccine provider pre-registration.
Encouraged early vaccination with seasonal flu vaccine
Drafted H1N1 Provider Enrollment Form Communicated Target Groups for vaccination McKesson was named as centralized vaccine
distributor so local distribution of Kansas vaccine allocation would not be necessary.
To protect the health and environment of all Kansans by promoting responsible choices.
September 2009September 2009 Kansas one of 22 states with an established
process for pre-registering private sector providers for H1N1 vaccine administration.
Approximately 920+ providers had pre-registered on the KDHE website by the first week of September.
Conducted webinars with LHDs to clarify provider enrollment process.
Local Health Departments began vetting and approving private H1N1 providers within their county
Finalized the H1N1 Vaccine Distribution Plan with local, state and federal input.
To protect the health and environment of all Kansans by promoting responsible choices.
http://www.kdheks.gov/H1N1/download/KS_H1N1_Vaccine_Distribution_Plan.pdf
Kansas H1N1 Vaccine Kansas H1N1 Vaccine PlanPlan
To protect the health and environment of all Kansans by promoting responsible choices.
The immunization team spent many hours working through each step of the process to
Enroll providers Submit and approve orders by the LHD Place orders with CDC by KIP Enter vaccine shipments into KS-CRA inventory Accomplish weekly on-hand inventory amount
reports by providers
To protect the health and environment of all Kansans by promoting responsible choices.
Process Flow – Vaccine Process Flow – Vaccine DistributionDistribution
To protect the health and environment of all Kansans by promoting responsible choices.
Private ProviderLHD
Allocation per county is established based on
available vaccine
Provider submits order to H1N1
Vaccine Orders email address
Order reviewed and filled as appropriate – Entered order into
VACMAN
Vaccine entered into KSCRA and
transferred to provider.
LHDIMM Staff
Private Provider
CDC
Vaccine Distribution FlowChart
LHD receives vaccine transfer in
KSCRA when vaccine shipment
received.
Scenario: LHDs have already approved which private providers can
receive vaccine. LHDs faciliatate provider completion of enrollment
form and submit to KDHE
KDHE Planning
Provider submits order to LHD
CDC receives, processes, and McKesson fills.
McKesson emails KDHE of shipment.
LHD documents patient level doses
administered in KSCRA.
Run end of week reports
KDHE approves order w/ LHD input when
necessary
Order reviewed and entered into VACMAN
as appropriate
CDC receives, processes, McKesson
fills. CDC emails KDHE of shipment.
Vaccine entered into KS CRA and transferred to
provider. KDHE receives vaccine in CRA on behalf of provider.
Private Providers (that do not enter
patient level)
KSWebIZ Private Provider (that choose to enter patient
level history in IIS)
Provider receives vaccine inventory and administers to
patients
Provider adds history into legacy KSWebIZ and runs new report that counts number of H1N1 historical vaccines*. Must select provider
clinic when entering as historical.
Provider logs into KSCRA and enters end of week counts in
KSCRA Inv Report**.
*New report in legacy WebIZ that counts H1N1 vaccines added as history.**New interactive KSCRA Inv Report screen that will allow private providers to enter number of vaccines administered, wasted, transferred, or ending count.
Provider logs into KSCRA and enters end
of week summary counts in KSCRA Inv
Report**.
Provider receives vaccine inventory and administers to patients
Provider documents doses administered in
local system.
Run end of week reports
LHD reviews previous weeks
report before approving new
orders??
KDHE reviews previous
weeks report and updates
county allocations – sends new
reports to LHD on Fridays.
Email sent to provider when order is on its
way.
Actions in CRA
Last Updated: 9/10/2009
Email sent to provider when order is on its
way.
CPHP sends weekly statewide counts to CDC
CPHP
Email will be sent to confirm receipt of order
To protect the health and environment of all Kansans by promoting responsible choices.
September September ContinuedContinued
Developed tools for daily and weekly allocation of vaccine to counties.
Developed vaccine storage and handling protocols; identified resources for reputable vaccine storage equipment; drafted standing orders for H1N1 vaccine administration and patient documentation and consent form.
Initial KS-CRA customization for vaccine inventory management and patient level documentation completed. (6 weeks from 1st JAD session!)
Began process to create KS-CRA accounts and grant users access to the system.
Conducted KS-CRA training for local health departments
To protect the health and environment of all Kansans by promoting responsible choices.
September September ContinuedContinued Sept 18
Vaccine availability projections continue to change. Initial KS allocation of vaccine expected to be 27K doses instead of larger amounts previously communicated.
Kansas one of 11 states with signed H1N1 provider agreements in place
Sept 30 Received first allocation of H1N1 vaccine from CDC 16,300 doses of LAIV
The challenge changed from coping with a large amount of vaccine to coping with a small amount of vaccine that
could not be given to all of the highest risk individuals.
To protect the health and environment of all Kansans by promoting responsible choices.
October 2, 2009October 2, 2009 First vaccine allocation amounts were
communicated to each county Processed all vaccine orders submitted by
LHDs that day (1,400)
H1N1 Vaccine Distribution Began!
To protect the health and environment of all Kansans by promoting responsible choices.
October 2009October 2009 1552 providers had pre-registered and 498
had been approved by LHDs by the first week of October.
Continued to communicate provider enrollment, vaccine ordering and documentation process during the KDHE weekly conference call with LHDs and their partners.
Developed web-based training for administration of both injectable and nasal vaccines
To protect the health and environment of all Kansans by promoting responsible choices.
Vaccine Distribution & Vaccine Distribution & Administration ChallengeAdministration Challenge
Vaccine came from five manufacturers and was licensed for different age groups
To protect the health and environment of all Kansans by promoting responsible choices.
October October ContinuedContinued Distributed an average of 41,000 doses of vaccine per
week for a total of 164,000 doses during the month of October. 68,000 doses reported as administered.
Four functions required significant staff time Provider enrollment Vaccine orders Inventory management of doses shipped Doses administered reporting
KS-CRA/KSWebIZ data quality Immunization team met weekly to review processes and
reassign resources. Immunization program staff averaged over 200 H1N1
calls per day Essential VFC program operations were maintained Remaining LHDs were brought on to KSWebIZ through
bidirectional interface
To protect the health and environment of all Kansans by promoting responsible choices.
Provider Enrollment Provider Enrollment ComparisonComparison
Number of providers
245
373
1114
0
200
400
600
800
1000
1200
1400
KSWebIZ VFC H1N1
Type of Provider
Nu
mb
er o
f P
rovi
der
s
To protect the health and environment of all Kansans by promoting responsible choices.
H1N1 Doses H1N1 Doses Allocated/Shipped/AdministeredAllocated/Shipped/Administered
Data as of February 18, 2010 Doses distributed = 76% of doses allocated to KS.
Doses Available vs. Doses Administered Comparison
0
200,000
400,000
600,000
800,000
1,000,000
1,200,000
1,400,000
10/210/9
10/1610/23
10/3011/6
11/1311/20
11/2712/4
12/1112/18
12/251/1
1/81/15
1/221/29
2/52/12
Reporting Week
Nu
mb
er
of
Do
se
s
KS Allocation
Ordered
Doses Administered
To protect the health and environment of all Kansans by promoting responsible choices.
H1N1 Doses H1N1 Doses AdministeredAdministeredDoses Administered
0 2336,657
25,384
35,585 38,31744,098
53,001
34,231
55,881
68,074
81,163
29,526
18,94425,167
37,690
26,82619,750
13,2109,212
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
Reporting Week
Num
ber o
f Dos
es A
dmin
iste
red
•626,000 H1N1 doses reported as administered•70% of doses distributed•53% of doses allocated to Kansas
To protect the health and environment of all Kansans by promoting responsible choices.
November 2009November 2009
Distributed an average of 83,000 doses of vaccine per week for a total of 332,000 doses during the month. 170,000 doses reported as administered in November
To protect the health and environment of all Kansans by promoting responsible choices.
December 2009December 2009
Distributed an average of 77,000 doses of vaccine per week for a total of 309,000 doses during the month. 255,000 doses reported as administered in December
To protect the health and environment of all Kansans by promoting responsible choices.
January 2010January 2010
Distributed an average of 17,000 doses of vaccine per week for a total of 85,000 doses during the month. 110,000 doses reported as administered in January
To protect the health and environment of all Kansans by promoting responsible choices.
FebruaryFebruary
Distributed 3,300 doses thus far this month. 23,000 doses reported as administered
To protect the health and environment of all Kansans by promoting responsible choices.
KIP distributed a total of KIP distributed a total of 893,000893,000 doses of H1N1 vaccine doses of H1N1 vaccine
in the four months since the in the four months since the first week of October first week of October
During CY 2009 KIP distributed 643,000 doses of all VFC vaccines
To protect the health and environment of all Kansans by promoting responsible choices.
Questions?Questions?