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Introduction. Department of Defense Influenza Vaccination Program Briefing 2009-10. Director’s Welcome. INFLUENZA. 2009-10. UNCLASSIFIED. 1. ACIP Recommendations 2. Vaccines 3. Screening and Documentation 4. Administration 5. Adverse Events. Outline.

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Introduction l.jpg

Introduction

Department of Defense

Influenza Vaccination Program Briefing

2009-10

Director’s Welcome

INFLUENZA

2009-10

UNCLASSIFIED


Outline l.jpg

1. ACIP Recommendations

2. Vaccines

3. Screening and Documentation

4. Administration

5. Adverse Events

Outline

PURPOSE: To discuss details of the 2009-10 DoD Influenza

Vaccination Program.


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Influenza Season 2009-10

“Annual influenza vaccination is the most effective method

for preventing influenza virus infection and its complications”

“Influenza viruses can cause disease among persons in any age group, but rates of infection are highest among children. Rates of serious illness and death are highest among persons aged >65 years, children aged <2 years, and persons of any age who have medical conditions that place them at increased risk for complications from influenza.

An annual average of approximately 36,000 deaths during 1990–1999 and 226,000 hospitalizations during 1979–2001 have been associated with influenza epidemics.”

ACIP Recommendations for Prevention and Control of Seasonal Influenza with Vaccines MMWR, July 2009

The 2009-10 trivalent influenza vaccine strains are

  • A/Brisbane/59/2007 (H1N1)-like virus

  • A/Brisbane/10/2007 (H3N2)-like virus

  • B/Brisbane/60/2008-like antigens

Only the influenza B component represents a change from the 2008-09 vaccine


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All children 6 mo – 18 yrs

All adults ≥50 yrs of age

Adults or children who have

Chronic pulmonary, cardiovascular, renal, hepatic, hematological or metabolic disorders

Immuno-suppressed

Any conditions that compromise respiratory functions

Residents of chronic care facilities

Women who are or may become pregnant during the influenza season

Healthcare personnel

Household contacts and caregivers of children aged < 5 yrs

Household contacts and caregivers of people with medical conditions

2009-10 ACIP Influenza Guidelines

Advisory Committee on Immunization Practices released the recommendations for Prevention and Control of Influenza

2009-10 Season


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DoD contracted with three manufacturers

Injectable

Sanofi-Pasteur - Fluzone

CSL Biotherapies - Afluria

Intranasal

MedImmune - Flumist

Vaccine Manufacturers

3.69 Million doses of influenza vaccine contracted for DoD

  • 1.83 Million - U.S. Army

  • 866K - U.S. Air Force

  • 953K - U.S. Navy

  • 64K - U.S. Coast Guard


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Vaccine Comparison Table

READ PACKAGE INSERTS


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Prioritization

No vaccine shortage is anticipated this year

  • Should an unexpected vaccine shortage occur, directions will be provided by ASD (HA) and will be consistent with recommendations published in subsequent issues of the Morbidity and Mortality Weekly Report.

  • In accordance with (IAW) HA Policy 08-005, “Policy for Mandatory Seasonal Influenza Immunization for Civilian Health Care Personnel Who Provide Direct Patient Care in Department of Defense Military Treatment Facilities”, military treatment facilities are directed to require all civilian health care personnel (HCP) who provide direct patient care in DoD MTFs be immunized against seasonal influenza infection each year as a condition of employment, unless there is a documented medical or religious reason not to be immunized.

Every effort should be made to swiftly complete seasonal influenza vaccinations and begin preparing for the impending Novel A(H1N1) Influenza Vaccine Immunization Program (NIVIP). A vaccine that can potentially prevent infection by the H1N1 virus is currently being developed and further guidance will be published detailing its use in DoD.


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Injectable vaccines (Fluzone) (Afluria)

- 45% AUG - 45% AUG

- 25% SEP - 25% SEP

- 20% OCT - 20% OCT

- 10% NOV - 10% NOV

Intranasal (Flumist)

- 35% AUG

- 25% SEP

- 30% OCT

- 10% NOV

Expected Shipment Dates


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Fluzone

Shipped and stored at 2-8ْC

Shelf life 12 months

Afluria

Shipped and stored at 2-8ْC

Shelf life 12 months

Flumist

Shipped from manufacturer frozen and stored locally in refrigerator at 2-8ْC

18 week shelf life

Storage and Handling Requirements


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Read package inserts for contraindications, precautions and warnings

Pay particular attention to

Approved age ranges of product

Individual allergies (eggs, thimerosal, vaccine components, latex)

Individual medical conditions (pregnancy, history of Guillain-Barre Syndrome, asthma, immune-compromised)

Choose the best product for your patient

Screening


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Electronic and paper documentation should include warnings

Patient name, rank and SSN

Date of vaccination

Vaccine name/code

Manufacturer

Lot #

Volume

Administration route and anatomic site

Name, rank and SSN of prescriber

Vaccinator name

Date patient given Vaccine Information Statement

(VIS) and VIS version date

Proper Documentation


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Service members should receive influenza vaccination by 1 December 2009

Services will monitor influenza immunization compliance through their respective Immunization Tracking Systems beginning in October 2009

On 1 December 2009, DoD will include influenza compliance in FMR calculations for all components

MILVAX will report influenza vaccination compliance during the OTSG Operations Update

Compliance will be categorized as

Green (≥ 90% vaccinated)

Amber (80-90% vaccinated)

Red (<80% vaccinated)

Immunization Tracking and Reporting


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Administration December 2009



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Most common adverse reactions with influenza vaccinations December 2009

Injectable: soreness, tenderness, pain and swelling at the injection site. Malaise, headache and myalgia

Intranasal: runny nose or nasal congestion in all ages, fever >100ºF in children 2-6 yrs of age and sore throat in adults

Vaccine Adverse Event Reporting System (VAERS)

www.vaers.hhs.gov

Contact VAERS 1-800-822-7967

Vaccine Healthcare Centers (VHC) Network

1-866-210-6469 (24 hrs)

www.vhcinfo.org

Adverse Event after Vaccination


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Key Points December 2009

  • Use Intranasal vaccine for healthy 2-49 year olds without contraindications

  • Administer injectable vaccine for those in whom the intranasal vaccine is contraindicated or where the intranasal vaccine is unavailable due to logistical constraints

  • Remain cautious – read all packaging

  • Initiate vaccination campaigns once adequate vaccine has arrived to avoid unnecessary waste of vaccine

  • Unless significant local shortages occur, no eligible beneficiary should be denied vaccination when requested

  • Screen for other vaccine needs, such as pneumococcal or Tdap vaccine at time of influenza vaccine screening

  • Use seasonal influenza immunization program to test installation-based processes that might be used in a Pandemic


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For more information about DoD Influenza Vaccination Program, or if you have any vaccine related questions please contact the MILVAX Agency.

www.vaccines.mil/flu

vaccines@amedd.army.mil

(877) GET-VACC

Contact Us

(877-438-8222)


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www.vaccines.mil Program, or if you have any vaccine related questions please contact the MILVAX Agency.

www.vaccines.mil