Workgroup Three
(The Orange Group)
• Vaccine Supply
• Vaccine Distribution
• Vaccine Financing
– Key issues
• Barriers
• Needs
• Solutions
Vaccine Supply & Distribution:
Barriers
• Unpredictable production
• Multiple products and formulations
• Importance of timing of vaccine availability
• Inherent challenge in balancing supply
and demand/utilization
Vaccine Supply & Distribution:
Barriers
• Information
– Not very coordinated right now
• Who gets what and when?
• Unclear how influenza distribution in the public
sector will work this year – first year using the
centralized system
– How does influenza vaccine travel through the
distribution network?
• Byzantine path from manufacturer to
implementation points
Vaccine Supply & Distribution:
Needs
• Improved uptake and demand
– Minimize waste of vaccine
• Change in providers’ mindsets
– Why do all doses have to arrive in September and
October?
– Opposition to non-traditional sites
• Inconsistent with push to extend the vaccination season and
knock down access barriers
• Change in public’s mindsets
– Need to be vaccinated annually and vaccinated
throughout the season, irrespective of risk profile
Vaccine Supply & Distribution:
Solutions
• Communications
– Multiple levels
• Better communications between and amongst stakeholders
about vaccine yield and production
– Need information for contingency plans
– Improves consistency and combats rumors and misperceptions
– Make sure that all the information trickles down to the levels of
implementation
• Better communications to providers and the public
– Helps combat complacency
– What are the message maps that work that drive demand?
Identifying those will be helpful
Vaccine Supply & Distribution:
Solutions
• Improve Flu Finder
• Local access to SNS data
– Granularity of the data
• Improved operational support to implement the
expanded recommendation
• Partnerships
• Identifying and disseminating best practice
models
– Model private provider practices
– Models of what works in communities
Vaccine Supply & Distribution:
Lingering Questions/Issues
• Does public health want to take on the role
of community coordinator?
• Who will take charge of identifying,
documenting, evaluating, warehousing,
and disseminating best practices?
Vaccine Financing: Barriers
– Accountability for vaccine is important
challenge
• Lots of suggestions about points of access but
more involved than just getting vaccine doses to
those places
– Full access to vaccines is expensive
– Gaps exist for underinsured children
• These situations put health departments in
“ethically tense” situations
Vaccine Financing: Needs
• Financing of expanded recommendations
– Adequate, timely federal and state
discretionary funds
– Managed care / private insurance funds
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Adequate administration fee
State appropriated funds
Local funding support
Federal Section 317 program funds
Vaccine Financing: Solutions
• Work with state Medicaid agencies to
increase the administration fee toward the
allowable amount
• Continue the dialogue on vaccine
financing
– NVAC
– AAP
– Flu Summit
Vaccine Financing: Solutions
• Make influenza vaccination a “standard of
care” issue
• Mobilization of state and local resources
– Focus on resources vs deficits
• The discussion should not be about how
much money is being spent on
implementing influenza recommendations,
it should be on how it is being spent
Final Thoughts
• Many have repeatedly stated in different ways
that “implementation will be local”
• If we really want to meet the challenges of
implementing the expanded
recommendations, then let’s recognize the
value of a robust public health infrastructure
and support it accordingly
• The rubber meets the road at the local level,
and there is not a lot of tread on the tires
Final Thoughts
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There’s a whole new world of stakeholders out there
Renewed vigor with Federal/State health officials
Renewed vigor with non-traditional partners
Renewed vigor with medical care
providers/institutions
Renewed vigor with social service agencies –
reaching the hard-to-reach
(Re)new relationship with business community
Renewed vigor with schools
(Re)new vigor with faith communities
Renewed emphasis on communications
Overarching
• Barriers
– 20th century systems, thinking, and practices
attempting to implement 21st century
recommendations
• Needs
– Thorough review of current systems and practices –
desperate need of updating
• Solutions
– Transformation of public health and health care
systems (no tinkering around)