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Allocation and Distribution Q&A

November 3, 2009, 4:00 PM ET

Introduction

The purpose of this document is to provide information on plans for allocation and distribution of 2009 H1N1 vaccine. This document has been updated with additional information about the distribution process.

Background

2009 H1N1 vaccine distribution is a health department managed process similar to the process for the Vaccines for Children (VFC) Program. The distribution process for 2009 H1N1 vaccine builds on the existing mechanism for shipping vaccine to VFC providers. Vaccine orders are submitted by Project Area health departments on behalf of vaccine providers. These orders are transmitted to CDC and are processed and forwarded to CDC’s contractor for centralized distribution. The contractor, in turn, ships vaccine directly to the end user. The centralized distribution contract for the VFC program has been supplemented to provide for 2009 H1N1 vaccine distribution and distribution of ancillary supply kits.

Questions and Answers

Vaccine allocation

1. How do project areas know how much vaccine is available for them to order?
CDC sends project areas a 2009 H1N1 allocation report each morning as it does for seasonal influenza vaccine. The report indicates how much of each formulation of 2009 H1N1 vaccine is available for them to order.

2. What is the number of doses "allocated" for ordering?
The number of doses "allocated" for ordering is the amount that is at the distribution depots and ready for states to order. The quantity of vaccine allocated is based on the project area's population size. As an example, if 6 million doses total (3 million doses of nasal spray vaccine AND 3 million doses of injectable vaccine) are ready for ordering nationally (as of today) and a state has 10% of the US population, then their allocation for today is 600,000 doses total (300,000 doses of the nasal spray vaccine and 300,000 doses of injectable vaccine).

3. How will vaccine be allocated among project areas (the CDC Public Health Emergency Preparedness grantees)??
Vaccine is allocated to each project area in proportion to its population (pro rata).

4. Will there be a separate allocation for active duty DOD?
Yes, there will be a separate allocation for active duty DoD. It is not included in the project area allocations.

5. Will there be a separate allocation for DoD dependants, retirees and civilian employees?
There is no separate allocation for these groups. Military facilities may be willing to vaccinate these groups, but there will need to be allocated vaccine for these populations by the project areas.

6. Will there be a separate vaccine allocation for IHS-served populations and other tribal communities?
There will be no separate allocation. States and local areas needs to ensure that IHS-served population and other tribal communities are included in their state vaccination plans.

7. Can Project Areas request less than their full allocation?
Yes, Project Areas will not be required to accept vaccine they cannot store or administer.

8. If a Project Area requests less than their full allocation, will they have given up rights to the balance of their allocation?
Project Areas will not forfeit the remainder of their allotment if not all is ordered at one time.

9. Can Project Areas share or exchange allocations of specific products with other Project Areas?
As with seasonal influenza vaccine, CDC will facilitate such exchanges.

Vaccine distribution

10. How is vaccine shipped to project areas?
CDC’s contractor for centralized distribution ships vaccine to hospitals, clinics, doctor’s offices, health departments, and other providers of vaccines that have been designated as vaccine-receiving sites by the Project Area (the project areas include all 50 states, the District of Columbia, 8 US Territories and freely associated states, and 3 large metropolitan health departments).

11. What kind of providers can be designated as vaccine recipients?
Providers that have the capability to receive, store and administer vaccine, including but not limited to provider offices, occupational health clinics, hospitals, local health departments, community vaccinators and pharmacies.

12. How many sites can a jurisdiction designate to receive vaccine?
There is a maximum of 150,000 sites to which vaccine can be shipped via centralized distribution. Project areas have received information about their allocation of sites.

13. Can project areas make changes to the sites to which vaccine will be shipped?
Project areas can add their distribution sites over time, but cannot exceed their overall allocation. They cannot replace a site that has already received vaccine with a new site.

14. How is information about vaccine-receiving sites transmitted?
Programs transmit orders to CDC as they do with VACMAN currently, and these orders, in turn, are sent to CDC’s contractor for centralized distribution.

15. Will VACMAN be able to handle the increased volume required for 2009 H1N1 vaccine distribution?
CDC is working to ensure that the anticipated large volume of 2009 H1N1 vaccine orders flowing through CDC systems (VACMAN, NIPVAC, EDI, SDN, etc.) are ready to support your 2009 H1N1 vaccine order volumes.

16. How will the transition to Vaccine Tracking System (VTrckS) impact the 2009 H1N1influenza program?
The top priority during the 2009 H1N1 influenza pandemic will be to maintain the flow of data and vaccines. CDC assessed the impact of the 2009 H1N1 response on Vaccine Management Business Improvement Project (VMBIP) activities including the VTrckS deployment dates using recent survey results and feedback from grantees. Based on this information, CDC has decided to postpone full VTrckS deployment (as discussed in a National Center for Immunization and Respiratory Diseases (NCIRD) grantee message). CDC is currently in the process of planning VTrckS next steps, including planning a revised rollout timeline and strategy and more information will be provided when it becomes available.

17. How do project areas know how much vaccine is available for them to order?
CDC sends project areas a daily 2009 H1N1 allocation report each morning as it does for seasonal influenza vaccine. The report indicates how much of each formulation of 2009 H1N1 vaccine is available for them to order.

18. What should project areas expect with respect to frequency of vaccine shipments?
Vaccine will be shipped as it becomes available, taking into account state allocations and orders. The process is modeled after that utilized by immunization programs to order seasonal influenza vaccine off the federal contract.. Details about CDC's ordering/allocation process for seasonal influenza are described in the all-grantee message sent to immunization program grantees on 8/11/2009 (Grantee message for allocation).

19. What is the shipping timeline?
Details of the shipping timeline are described in the H1N1 Vaccine Ordering Guide Version 1.2 which has been shared with planners.

20. What ancillary supplies will be provided by the federal government?
Syringes and needles, alcohol swabs and sharps containers.

21. How are orders of ancillary supplies transmitted?
Ancillary supply kits and sharps containers are included in VACMAN as products, similar to individual vaccines. Project Areas place orders for these products and transmit these orders just as vaccine orders are transmitted.

22. Can vaccine be sent to one address and ancillary supply kits to another address?
Because of logistical considerations, vaccine and ancillary supply kit orders cannot be shipped to different addresses.

23. What is the minimum dose order for shipments of 2009 H1N1 vaccine
For each vaccine formulation (identified by its National Drug Code) the minimum dose order is 100 doses and all orders must be placed in increments of 100 doses. Each ancillary supply kit contains supplies to support 100 doses of vaccine, with different kits available for prefilled syringe products and for multi-dose vial products.

24. What is the size of storage volume for each product type?
This information is included in the H1N1 Vaccine Ordering Guide Version 1.2 which has been shared with planners.

25. Can Project Areas determine where specific presentations of vaccine (multi-dose vials, single dose syringes, and nasal sprayers) are directed?
Project Areas select the specific presentation of vaccine when ordering for providers in the VACMAN system.