Provide Orientation to Vaccine Management powerpoint

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Washington State Third Party Vaccine
DistributionA Providers Orientation

Washington State Department of HealthImmunization
Program CHILD Profile
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Washingtons Immunization Delivery System
Protecting Children and Communities
Savings to Health Care System of about 30
Informing parents providers
Universal Access to Vaccines
The right shot at right time
Working together to protect the people of
Washington from vaccine preventable diseases.
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Key Things to Remember

• PLAN Ahead
• Many things are NOT changing
• Know what your vaccine need is
• Monitor your inventory closely
• Have adequate storage capacity
• Make sure staff are knowledgeable about storage
  and handling
• Keep your contact and receiving information
  current
• Take good care of your vaccine, so you can
  protect the children and families in your
  practice
• CHILD Profile
• Stay in touch with your local health department

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Third Party Vaccine Distribution The National
Perspective

• CDC Initiative to Improve Vaccine Management and
  Accountability
• Decreasing the number of vaccine inventories
  nationally to 3 central locations
• Decreasing the number of times vaccine is
  transported from manufacturer to administration
• Increase focus on quality assurance activities
• Centralizing Distribution
• Vaccine will be shipped directly to providers
  from a distributor
• CDC will contract with 2 3 vendors
• Maintain 2 3 inventories nationally
• Washington will start in October 2006
• National implementation will begin shortly
  thereafter
• National implementation complete 2008

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Expected Benefits to CDC

• Simplifies national fund and inventory management
  
• Increases flexibility and inventory visibility
• Easy movement of vaccine to areas of need
• Increased equity in distribution during shortages
• Increased visibility for Congressional oversight
• Decreased vaccine losses nationally
• Decreasing the number of stops in the cold chain
• Savings
• National inventory reduction saves 150 million
• Annual national savings of 25 47 million
• Lower system-wide costs enable funding of other
  immunization priorities

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Current Washington State Vaccine Distribution
Model
CDC Receives Order and sends PO to Manufacturer
Manufacturers Replenish DOH Inventory
DOH Places bulk order through CDC
LHJ Places bulk order with DOH
DOH Fills LHJ Order
Provider Submits vaccine order to LHJ
LHJ Verifies and fills Provider order
State Depot Inventory
LHJ Depot Inventory
Provider Clinic Inventory
LHJ Clinic Inventory
Information Exchange Vaccine Product
Flow Vaccine Inventory
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Washington State Third Party Distribution Model
(VMBIP)
Submit vaccine order
Verify and Submit Provider order
Receive into NIPVAC, send PO
Distributor Fills Provider Order
DOH submits provider order through CDC
LHJs Maintain Clinic Inventory
Provider Maintains Clinic Inventory
Information Exchange Vaccine Product
Flow Vaccine Inventory
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Benefits to Providers

• Maintains the provider / local health
  relationship
• vaccine and immunization information,
• quality assurance,
• training and support
• Direct delivery of vaccine to provider offices
• Improves the consistency and reliability of the
  vaccine supply
• Gives CDC flexibility to support equitable access
  across the nation

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Principles of Provider Participation

• Providers contact LHJs for participation
• VFC Provider Agreements in place
• Providers abide by provider agreement
• Providers are prepared for direct delivery
• DOH determines brand availability
• LHJs approve and submit orders to DOH

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Provider Vaccine Ordering

• Initially, no change in ordering
• Providers submit orders to local health
  jurisdictions (LHJ) Via
• Fax
• Phone,
• Regular mail
• In the near future providers may order vaccine
  through the CHILD Profile Immunization Registry

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Provider Order Development

• Determining order size
• Doses administered reports
• Prior year use data
• Note circumstances affecting order
• Maintain proper inventory levels
• Determine current inventory
• Know monthly usage need
• Determine reserve need (15 days suggested)
• Submit inventory on hand with each order

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Calculating the Provider Order
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Provider order planning LHJ Role

• LHJs establish order scheduling and frequency
• LHJ can help assess storage capacity
• Establish a regular ordering pattern
• Provider orders placed on DOH standard form
  (hard-copy or electronic)
• Provider order schedules (examples)
• 2x per month
• 1x per month
• quarterly

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Principles of Provider Receiving

• Vaccines delivered directly to providers
• Trained staff available to receive vaccine
• A primary and back-up person trained for storage
  and handling
• Post signage where deliveries are left
• Vaccine should not be left unattended (signature
  required)
• Contact information for storage and handling
  staff posted in reception area
• Vaccines stored immediately upon receipt
• Establish a designated receiving area and inform
  your delivery drivers
• Talk to your delivery people and make sure they
  understand how important it is that the vaccine
  not be left unattended

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Do Not Leave Vaccine Unattended Store
Immediately
Signature Required for Perishable Deliveries!
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Guidelines for Receiving

• Check vaccine received against the invoice
• Lot numbers match
• Correct number of doses and antigens
• Expiration dates match and are at least 6 months
  out
• Check packages for damage, leakage, or evidence
  that cold chain was not maintained
• Contact your LHJ if there are any discrepancies
  or questions

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Tools to assist with receiving
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LHJ Approval of Orders

• LHJs will approve all provider orders
• Orders will be reviewed for
• Shipping addresses and delivery information
• Appropriate order size, timing, and antigens
• Compliance with accountability reporting
• Inclusion of inventory on hand information
• Approve or hold the order for review
• LHJs will establish how often providers will
  order

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Provider Ordering Frequency
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Ordering Frozen Vaccines

• LHJs certify providers for frozen vaccines
• Assess storage
• Complete and sign certification form
• Frozen vaccines ordered on same form and time as
  other orders
• Frozen vaccines will be shipped directly from the
  manufacturer

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Timeline for delivery to providers

• 1014 days once order placed with LHJ
• May be as soon as 3 5 days
• Once pattern is established, mark calendars for
  likely delivery dates
• Shipment data from DOH to LHJs
• Contact LHJ if shipments are not received within
  14 days
• Emergency Deliveries will be coordinated by LHJs
  and DOH
• Can arrive within 24 hours of placement
• Emergency orders should be the exception
• LHJs will follow-up with all emergency orders

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Vaccine Transfers

• LHJs will coordinate all vaccine transfers
• Transfers may be used for
• Managing shortage situations
• Redistribution of flu vaccine
• Moving short dated vaccine before it expires
• Meeting short term, limited dose needs for
  providers
• Vaccine transferred between clinics or between
  LHJs and clinics replenished through regular
  ordering process
• LHJs will follow-up when necessary

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Protecting it Protects Them

• The vaccine in your refrigerator or freezer is
  your most valuable asset in protecting
  Washington children from vaccine preventable
  diseases. Non-viable vaccine will not protect a
  child from a vaccine preventable disease.
• Critical tools for ensuring protection against
  VPDs
• Proper vaccine storage and handling equipment
• Well trained staff with designated back-up
• Emegency procedures in place
• Good temperature monitoring protocols
• Protect this valuable asset!

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Quality Assurance

• LHJs provide consultation and technical
  assistance to providers
• Correct storage and handling problems
• Assure accountability reporting compliance
• Assure best practices in storage and handling
• Determine strategies to promote best practices
• Phone, written or in person follow-up
• Holding provider orders until accountability
  issues have been resolved
• Remedial or corrective action as appropriate
• DOH is available for consultation

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Vaccine Returns

• LHJ must be notified of all vaccine returns
• LHJs notified immediately about all storage and
  handling incidents
• Vaccine return reports submitted LHJ
• LHJs send copies of reports to DOH
• Vaccine return report includes
• vaccine type, lot number, expiration date, and
  number of doses for all returned vaccines.
• Reason for the vaccine loss and corrective action
  taken
• LHJs will tell providers how to return vaccine

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Accountability Reporting

• Vaccine Usage form submitted to LHJs by the 5th
  of each month.
• Doses administered by age for each antigen
• Temperature monitoring
• Submit temperature logs to LHJs by the 15th of
  the month
• Record both refrigerator and freezer temperatures
• Record temperatures twice daily

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Invest in Vaccine Storage and Handling its well
worth it!

• 1,149.99
• 51 doses of Hib
• 17 doses of Prevnar

1,149.99 Kenmore Elite 18.8 cu. ft Freezer
Refrigerator
249.00 11 doses of Hib 4 doses of Prevnar
249.00 Dickson VFC70 Recording Thermometer
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