October 2001 • Volume 7 • Number 10
Vaccine at issue as FPs brace for flu season
BY TONI LAPP
"Order early and often" might have been the mantra of some health care professionals when they ordered the flu vaccine this season, says the CDC.
The CDC is concerned that some medical professionals might have placed double orders for fear there would be shortages again this flu season. The CDC is now asking providers to reassess their vaccine needs and alert their vaccine suppliers if their orders overstated their needs.
And those providing services in work sites are being asked to notify their vaccine suppliers and request that their shipments be deferred until November. That way, ample vaccine will be available for persons at high risk of complications from the virus.
Those who placed double orders of the vaccine just to ensure they'd have some may want to familiarize themselves with the return policy of the manufacturers. The two U.S. manufacturers, Wyeth Lederle and Aventis Pasteur, will not accept returns.
Both manufacturers call customers before shipping to confirm the order, said company spokespersons. Customers can revise their orders at that time.
Because delays are expected in the shipment of flu vaccine, the CDC is asking that physicians give their high-risk patients priority when administering the vaccine.ETA FOR SHIPMENTS
Wyeth Lederle had not started shipping as of mid-September but expected to begin filling orders by early October, said spokeswoman Natalie deVane. Aventis Pasteur had started shipping and was on track to complete its goal of sending customers at least 25 percent of their orders by the end of September, said spokesman Len Lavenda.
The reason for sending partial shipments is to allow all vaccine providers to offer their high-risk patients the vaccine early in the season.
The message being repeated by the AAFP and other health organizations is this: If your healthy patients want to beat the rush to get their flu vaccine this fall, tell them to wait until December, when the vaccine supply will be plentiful. However, if your patients are at increased risk of influenza complications or are health care workers, go ahead and vaccinate in October and November.
The CDC projects that about 56 percent of the total vaccine supply will be distributed by the end of October, about 31 percent will be delivered in November and the final 13 percent in early December.
Information on influenza vaccine lots that are released by FDA and available for distribution by manufacturers can be found at http://www.fda.gov/cber/flu/flu.htm.
The AAFP has released a prioritization schedule for the vaccine; it can be found online at http://www.aafp.org/policy/camp/27.html.
State health department contingency plans are being added to the CDC influenza Web site at http://www.cdc.gov/nip/flu/.
CONCERNS VOICED OVER SUPPLY, COST
Clearly, family physicians are concerned about their ability to provide the vaccine: At press time, the AAFP Congress of Delegates was set to consider seven resolutions about vaccine supply or cost during the delegates' meeting Oct. 1 - 3 in Atlanta.
The cost of the vaccine went up from 22 percent to 67 percent compared with last year. Some reasons: One manufacturer withdrew from the flu vaccine market, the remaining manufacturers made improvements to their production facilities, and the cost of shipment increased because of the move to split orders. Reimbursement has been another concern. The Centers for Medicare and Medicaid Services reimburses 95 percent of the average wholesale price and then adds an additional amount for administration costs. Currently, the CMS reimbursement is $4.26 for the vaccine and an additional $4.59 for administration costs. The reimbursement for the vaccine is expected to go up to $6.29 on Oct. 1, said Kent Moore, manager of health care financing and delivery systems for AAFP.
For those physicians thinking ahead to the 2002 - 2003 flu season, the mantra could be "order early, but not often." This year, one manufacturer took orders only through May 15. Since then, customers have been advised to order through a distributor, which may cost more.
FP Report is published by the AAFP News Department.
Copyright © 2001 by American Academy of Family Physicians.
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