Influenza Vaccine Update

AAFP Board Approves Comprehensive Task Force Recommendations

By Cindy Borgmeyer
4/19/2006

At its March meeting, the AAFP Board of Directors approved recommendations submitted by the Academy's Influenza Vaccine Task Force, a group formed last November to investigate and seek potential solutions to problems members had obtaining influenza vaccine for the 2005-06 flu season. Chief among those recommendations: Work with vaccine manufacturers and distributors "to ensure family physicians receive the influenza vaccine necessary to meet their patients' needs in a timely manner."

Task force members already have made progress on that front, according to AAFP President-Elect and task force chair Rick Kellerman, M.D., of Wichita, Kan. The task force met with several flu vaccine manufacturers and distributors in December to discuss members' concerns.

"I think we've already made some in-roads with the vaccine manufacturers, multiplicity of distributors and CDC by raising the issue and illustrating for them the conviction of AAFP members that family physicians and other groups that focus on high-risk patients must be given preference in receiving the vaccine." said Kellerman.

The task force report suggests several ways flu vaccine manufacturers and distributors could help accomplish that goal, such as

increasing the percentage of vaccine they set aside for physicians;
prebooking physicians' vaccine orders before opening prebooking to the general marketplace;
guaranteeing timely shipment of vaccine in return for order prepayment;
completely filling and shipping small vaccine orders;
prioritizing vaccine distribution to physician offices and clinics, as well as to hospitals, nursing homes and other facilities that serve high-priority patients;
educating industry on how vaccine distribution problems affect physicians who care for high-priority patients; and
developing policies for handling financial risks of vaccine ordered late in the season, such as buy-back programs.

In addition, the recommendations urge the Academy to work with third-party payers to implement annual flu coverage and payment policies largely consistent with those of Medicare, including covering both the cost of the vaccine and its administration with no patient cost-sharing, as well as covering an evaluation and management service during the same visit. The report notes, however, that it does not recommend following Medicare's reimbursement rate of 95 percent of the average wholesale price for vaccine.

Other recommendations promulgated by the task force ask the Academy to

create and disseminate an influenza vaccine toolkit for use in members' practices;
advocate that the CDC recommend administering annual influenza vaccine in the patient's medical home;
work with the CDC, media, AAFP members and other stakeholders to communicate that flu immunizations may be performed as late as February each season;
collaborate with the CDC and other physician organizations to develop appropriate public messages in times of vaccine shortage or maldistribution;
examine the possibility of instituting federal buy-back programs for physicians' unused vaccine; and
investigate the feasibility of developing an AAFP group purchasing organization.

Members can keep an eye on the AAFP's Influenza Vaccine Information page, which is updated on a continuing basis, for information about influenza vaccine-related resources and tools.

Given the complexity of the distribution process, seasonality of the vaccination period and biologic nature of the vaccine, said Kellerman, "there is no 'easy' solution to members' continuing difficulties obtaining vaccine.

"Still, I think the task force brought some clarity and direction to the AAFP efforts and influenced the CDC, manufacturers, distributors and others to take a hard look at the problem," he added.

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