H1N1 Vaccine Clinic Plan
Anschutz Medical Campus
Oct. 16, 2009
Point Person: Teran Williams, Occupational Health
Ordering of the vaccine: UC Denver requested 10,664 vaccines from the CDC, ordering with the following numbers for high priority groups:
• Pregnant Women: 53
• Household contacts/caregivers of children younger than 6 months: 500
• Health care and emergency medical services personnel: 3046
• Children from 6 months through 18 years: 0
• Young adults 19 through 24 years: 919
• Persons aged 25 through 64 with high risk of medical complications: 1340
As a part of this agreement, we agreed to the following (taken directly from the provider agreement):
1. Administer the 2009 Influenza A (H1N1) monovalent vaccine according to the recommendations of CDC’s Advisory Committee on Immunization Practices as adopted by the Centers for Disease Control and Prevention.
2. Store and handle the vaccine in accordance with the package insert provided with the vaccine including in compliance with cold chain requirements.
3. Provide a current Vaccine Information Statement to each individual before vaccination, and answer questions about the benefits and risks of vaccination, including different indications for live versus inactivated vaccines.
4. Record in the patient’s medical record or in an office log the date of administration, the site of administration, the vaccine type and lot number, and the name of the immunization provider for each individual vaccinated. The record must be kept for a minimum of three years following vaccination.
5. Report moderate and severe adverse events following vaccination to the Vaccine Adverse Event Reporting System (1-800-822-7967, http://vaers.hhs.gov/contact.htm).
In addition, the provider:
6. Cannot charge patients, health insurance plans, or other third party payers for the vaccine, the syringes or the needles as these are provided at no cost to the provider. The provider/facility is also prohibited from selling H1N1 vaccine, syringes or needles.
7. May charge a fee for the administration of the vaccine to the patient, their health insurance plan, or other third party payer. The administration fee cannot exceed the regional Medicare vaccine administration fee. If the administration fee is billed to Medicaid, the amount billed cannot exceed the state Medicaid administration fee.
8. May either administer the 2009 Influenza A (H1N1) monovalent vaccine for free to individuals who cannot afford the administration fee, or refer these individuals to a public health department clinic or affiliated public health provider for vaccination.
9. Must report the number of doses of 2009 Influenza A (H1N1) monovalent vaccine administered to individuals as requested by the state or local public health department.
10. Must report to the state health department the number of doses of vaccine that were not able to be used because the vaccine expiration date was exceeded or the vaccine was wasted for other reasons. These doses must be disposed of in accordance with state regulations for biological waste.
11. Are strongly encouraged to provide an immunization record card to the vaccine recipient or parent/guardian to provide a record of vaccination, to serve as an information source if a Vaccine Adverse Event Reporting System report is needed, and to serve as a reminder of the need for a second dose of vaccine (if necessary). Immunization cards will be included in each shipment of vaccine.
INITIAL DOSES
The following procedures will be implemented:
1. TARGET GROUPS: For this round of distribution, we will target health care providers. This includes faculty, staff or students who are directly engaged in patient care. Additional vaccine will be available for the rest of the AMC community at a later date (see below).
2. VOUCHER SYSTEM: To distribute the vaccine, we will use a voucher system. Vouchers for the “live” or “inactivated” vaccines will be distributed in advance of the vaccine administration. Those with vouchers will redeem them for the vaccine. An ID will be required for both receipt of the voucher and the administration of the vaccine.
3. Attached to the voucher is information regarding both types of vaccines (see attached). This information is also posted on our “flu alert” website.
Voucher distribution—place and times to be set
Vaccine administration - Once we receive the vaccines we will e-mail all voucher recipients and announce the date and times of the clinics.
Location of vaccine administration: South Lounge Ed I. This location has been secured through the month of October and can be reserved later if needed. A card reader has been wired and placed in the lounge. Tables, chairs and other necessary equipment have been delivered. A back up location is the Occupational Health Clinic, but this is only a one room clinic and not ideal for the initial delivery. We believe that this clinic could be used after the majority of doses have been given.
Storage: Storage of the vaccine will be in the Occupational Health Clinic, room 201. The refrigerator has arrived and is working properly. We will be able to store 10,000 doses. Teran Williams will be the person accepting delivery. The Clinic is secured and access to the clinic is granted through a card reader.
Staffing: Faculty in the School of Nursing and School of Pharmacy are participating in an “on call” schedule. These people have been notified that they could be contacted and asked to distribute vaccines. These on call faculty are scheduled through October 31, 2009. Both schools have secured students who will deliver vaccines in 3-hour blocks. These students will receive credit for their time and will have a faculty member present as a preceptor. Both schools believe they can get between 6 – 10 students per 3-hour time block. With seasonal flu clinics being cancelled around the Denver Metro area, it should not be a problem securing these students. We will also have staff available to help with check in, crowd control, and check out. Finally, on the initial days of the clinic delivering the vaccine, we will have a UC Denver police officer present to ensure safety and security of vaccine and equipment.
Times clinic will operate: 7 am – 6 pm, Monday – Friday or until the doses are gone. We anticipate a high demand for the initial doses, so it is unclear how many days in a row we will be operating. Based on our trial run with the flu clinic, we estimate we can do 150 doses in one hour, with 4 students administering and 2 faculty preceptors.
Record Keeping: We will utilize the card readers to help keep track of those faculty, staff and students who receive vaccines. Those receiving a vaccine will receive a card as proof that they received it. We will keep the paper screening form (as required by the CDC, see attached) and mirror this information into an excel database. Teran Williams will keep all records for the required period of time.
Forms: will be provided by CDC
Advertising: We are ready to go at a moments notice with advertising for the clinic. We will use school and college distribution email lists, list-serves and flyers to provide a consistent, coordinated message through the schools and colleges.
Procedures for the Clinic: Those who arrive to receive the vaccine will go through the outlined steps (below). We have prepared large posters with each station, so that it is clear where the folks need to go. Further, we are developing a FAQ page for all those delivering vaccines or working the check in stations for ease in answering questions (see attached).
• Station 1: Check in. Badges will be swiped at this point. Consent forms filled out
• Station 2: Waiting line
• Station 3: Administering the vaccine: The person (including the preceptor) administering the vaccine screens the form for high risk and will record all necessary information about the doses.
• Station 4: Check out: Form with dose information is handed in here and a “proof of immunization” card will be given.
ADDITIONAL DOSES
The above protocols and procedures will be used for additional clinics, once we receive additional doses. Given that we do not know when we will get the vaccine and how many doses we will get, we are committed to remaining flexible with this plan, including whether or not we will need to utilize a voucher system for additional doses.