Influenza Vaccine: Supply and Distribution

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Influenza VaccineSupply and Distribution
Presented to Evolving Issues in the Prevention
and Treatment of Influenza Media Forum Presented
by Christine M. Layton, PhD, MPH
701 13th St., NW, Suite 750 Washington, DC
20005Phone [phone] layton_at_rti.org
www.rti.org RTI International is a trade name of
Research Triangle Institute.
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Key Points to be Addressed

• Influenza vaccine supply and distribution is tied
  closely to demand
• The system by which influenza vaccine is supplied
  and distributed is
• a. Highly complex
• b. Predominantly a private-sector enterprise
• Means to resolve challenges to influenza vaccine
  supply rely on the efforts of multiple
  stakeholders

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Demand and Supply
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Influenza Vaccine Doses Produced and Distributed
for the U.S. Market 1999-2004
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Vaccine Supply and Demand are Not in Synch
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Who Orders What From Whom?
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Influenza Vaccine Purchasers Wholesalers

• Wholesalers may be medical-surgical wholesalers
  or pharmaceutical wholesalers
• Wholesalers often specialize with a particular
  type of customer (e.g., cardiologists, large
  hospitals, etc.)
• The actual number of all wholesalers who offer
  influenza vaccine is unknown
• Wholesalers may sell to other wholesalers,
  so-called redistributors

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Influenza Vaccine Purchasers Immunization
Providers

• Private health care providers
• Private physicians
• Clinics
• Community immunizers
• Visiting Nurse Associations (VNAs)
• Mass immunizers
• State Federal Government
• VFC
• DoD/VA
• Multi-state contracts (e.g., MMCAP)

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US Influenza Vaccine Distribution Pathways
DoD U.S. Department of Defense ERs emergency
rooms LHDs local health departments MMCAP
Minnesota Multi-State Contracting Alliance for
Pharmacy VA U.S. Department of Veterans
Affairs VNAs Visiting Nurse Associations
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Stakeholders Involved in Increasing Demand

• Government (federal, state and local)
• Academia
• Health care providers
• Community immunizers
• Advocacy organizations
• Health insurance companies
• Vaccine industry (manufacturers, distributors)
• Wholesalers
• Professional societies
• Consumers

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Increasing Demand for Influenza Vaccine Increases
Supply of Influenza Vaccine

• Manufacturers produce as much vaccine as they
  anticipate they can sell
• As past challenges to vaccine supply and
  distribution are addressed, all stakeholders need
  to work to promote increased uptake of vaccine
• Pursue an array of interventions, e.g.
• Increase use by health care workers
• Expand ACIP recommendations
• Broaden immunization season

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The Real Threat

• Mamas little vector
• Childrenespecially young childrenare notorious
  for spreading influenza virus