Program for Reallocation of Influenza Vaccine

Since Chiron Corporation’s October announcement, that the company could not provide vaccine for distribution in the United States for the 2004-2005 influenza season, CDC has worked closely with vaccine manufacturer Aventis Pasteur and State Health Officials to distribute available vaccine to the most vulnerable individuals and those who care for them.

CDC appreciates the tremendous efforts from states and urban areas to distribute and administer influenza vaccine to those most in need. CDC discourages use of vaccine for individuals not considered high-priority until we have met the demand for the priority population in every state. CDC will reallocate vaccine from states or urban areas that report having more than enough vaccine to serve their targeted populations to the remaining states or urban areas. High priority populations identified by the Advisory Committee for Immunization Practices (ACIP) for vaccination with inactivated influenza vaccine are identified at http://www.cdc.gov/flu/protect/whoshouldget.htm

By early October, Aventis Pasteur had already shipped 33 million of its expected total 58 million vaccine doses. Together, CDC and Aventis Pasteur decided to fill orders placed with Aventis Pasteur and Chiron distributors that were easily identifiable as intended for providers serving substantial numbers of high risk patients.

These orders included:

· State and Local Public Health Departments via federal, state, or multistate contracts

· Vaccines for Children’s Program orders

· Aventis Pasteur’s preservative-free influenza vaccine orders

· Federal Veteran’s Administration and Indian Health Service orders

· Long-term care facility and acute care hospital orders placed with Aventis Pasteur

· Pediatric provider orders placed directly with Aventis Pasteur

· Visiting Nurse Associations of America orders

· Department of Defense orders

As these orders were being processed and shipped, ongoing discussions about vaccine allocation with State and Local Public Health Officials resulted in a consensus that those best suited to guide allocation of remaining vaccine were State and Local Public Health Officials working collaboratively within each state. CDC and State and Local Public Health Officials developed a needs-based formula to apportion the remaining vaccine across states so that they could direct vaccine to providers and facilities serving high risk patients within their jurisdiction. This formula included estimates of the size of the target populations and the number of doses that had been shipped to the Aventis Pasteur customers in each state and was based on the best available information at the time. This information was incomplete, however, and may have overestimated the needs in some states and underestimated the needs in others. CDC continues to receive reports from some states that they have significant unmet needs to provide influenza vaccine for their priority populations as identified by the ACIP. However, other states have reported that they have or will have received supplies exceeding demand for their priority populations.

In response to these reports from the states, the Association of State and Territorial Health Officials (ASTHO) and CDC conducted a survey to assess the current national status of Aventis Pasteur influenza vaccine distribution on a state-by-state basis. The preliminary results of the survey indicate that need for vaccine continues to exceed the available supply. A few states reported an adequate supply of vaccine or a small amount of vaccine in excess of their needs. CDC will work collaboratively with these states to reapportion the excess amount to the other states.

The goal of the reapportionment is to reach as many individuals in the target populations as possible. Based on the results of the ASTHO/CDC survey, CDC will work closely with states to reapportion vaccine. In addition, CDC will contact states that report excess vaccine in the state to facilitate the transfer of vaccine to states with insufficient vaccine to meet priority groups. Because a substantial number of states reported being uncertain about the sufficiency of their apportionment, ASTHO/CDC will conduct a follow up survey in the near future to obtain additional detail to help with the reallocation of available vaccine.

##This Message was distributed to State and Local Health Officers, Public Information Officers, Epidemiologists, Lab Directors, WMD and HAN Coordinators as well as Public Health Associations and Clinician organizations##

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