Flu

MMS Flu Advisory: H1N1 Increasing in Massachusetts

Posted in Flu, Flu Advisory, H1N1 on November 3rd, 2009 by MMS – Comments Off on MMS Flu Advisory: H1N1 Increasing in Massachusetts
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H1N1 in Massachusetts
There has been a continuous increase in influenza-like illness (ILI) in Massachusetts over the last few weeks.
The Massachusetts Department of Public Health (MDPH) continues to receive reports of ILI clusters in schools and the State Laboratory is receiving an increased number of specimens for H1N1 testing. Follow-up of individual cases by MDPH epidemiologists and local health departments continues to focus on severely ill and hospitalized cases.
From October 4 – 29, 1004 cases of H1N1 have been confirmed by the state laboratory, including 14 hospitalizations and one death due to laboratory-confirmed 2009 H1N1 influenza were reported in Massachusetts.

The Emergency Use Authorization of Peramivir for Treatment of 2009 Influenza A (H1N1)
On November 2, The New England Journal of Medicine released a Perspectives article on The Emergency Use Authorization of Peramivir for Treatment of 2009 Influenza A (H1N1).
H1N1 Vaccine in Massachusetts

MDPH reports that, by the end of this week, more than 660,000 doses of H1N1 vaccine will have been distributed to providers in Massachusetts, enough to vaccinate 10% of the state’s population. Massachusetts expects to receive a total of 3.5 million H1N1 vaccine doses this flu season.

These initial limited supplies have been prioritized for distribution to the health care providers who serve the populations at the highest risk of H1N1 flu – pregnant women, children, and caregivers of infants less than 6 months old. It has also been prioritized for health care workers with direct patient contact in light of their vital role in keeping the health care system working. MDPH believes this targeted distribution approach, using health care providers who serve these high risk groups every day, is the most effective way to ensure the vaccine gets to those who need it most as quickly as possible.
As vaccine supplies arrive in larger quantities, more and more providers will receive vaccine for their patients. Vaccine will then be targeted to young adults up to 24 years old and people 25-64 with chronic health problems. Eventually, flu clinics for the general public will begin. However, they won’t be scheduled until there are large enough quantities of vaccine available to support them. Based on current projections from the Centers for Disease Control, these flu clinics will not likely be feasible until December. When they have been scheduled, they will be listed on http://flu.masspro.org, searchable by town or zip code. No H1N1 clinics are listed at this time.

MDPH Vaccine Distribution Processes

In response to requests for details on how vaccine arrives in the state, the role of MDPH in that process, and how providers receive word on upcoming vaccine availability, MDPH has provided the following information:

There are 9 different vaccine formulations approved for various age groups. Vaccine comes as thimerisol-free prefilled syringes, multidose vials with thimerisol, and live, attenuated virus nasal spray (Flumist). So, the doses of vaccine are not interchangeable. Each formulation can only be used for the groups for which it was made and approved.
When a provider first registers with MDPH to receive H1N1 vaccine, they include key details about their practice, including:

• Type of practice and target patient population served
• Capacity to vaccinate (how many people could they vaccinate in a month with sufficient  vaccine supplies)
• Whether they are willing to receive live attenuated vaccine formulations (e.g., Flumist vaccine)
• How much vaccine and which formulations they would like to order
Several times each week, MDPH receives notice about how much newly available vaccine, in which formulations, it can expect to receive. It uses the information in the vaccine registration system to figure out where that vaccine should be shipped. For instance, pregnant women can’t take Flumist, so if the only vaccine available is Flumist, it will not be sent to OB/GYNs. It can however, be administered to healthy children, and would therefore be sent to pediatricians.
MDPH does not play any role in physically receiving and redistributing H1N1 vaccines, which are shipped directly to providers in the community. However MDPH does match up available formulations to appropriate providers as vaccine comes off the production line.
More than 4,000 health care providers in Massachusetts have signed up with MDPH to receive H1N1 vaccine this year. (The actual number of vaccination sites is higher, because some of the larger providers will further distribute their allocations of vaccine to their affiliated provider locations.) Virtually all of the providers that serve the priority groups have received some amount of vaccine and will receive more in the coming weeks. However, very few have received all of the vaccine that they wanted because we just have not gotten enough vaccine yet.
Unfortunately, the vaccine supply is unpredictable during these early days of distribution and at this time, the state does not have enough vaccine for everyone in the highest priority groups. Massachusetts has 3.4 million residents that fall into one of the target groups for H1N1 vaccine.

MMS Flu Advisory: H1N1 Vaccine Allocation in Massachusetts

Posted in Flu, Flu Advisory, H1N1 on October 23rd, 2009 by MMS – Comments Off on MMS Flu Advisory: H1N1 Vaccine Allocation in Massachusetts
H1N1 Vaccine Allocation in Massachusetts
flu badgeTo date, the Massachusetts Department of Public Health (MDPH) has received approximately 270,000 doses of H1N1 vaccine in all formulations, or between 5% and 10% of the total H1N1 doses it expects to receive this season.
MDPH has prioritized allocation of H1N1 vaccine to ob-gyn, pediatric, family and multi-specialty practices in order to reach the priority populations of pregnant women, health care workers and youth (including high risk youth). In addition, all registered hospitals and community health centers have been prioritized to receive vaccine. This week, the MDPH H1N1 Vaccine Program began allocating limited quantities of vaccine to Local Boards of Health.

Provider Reporting of Doses Administered
Providers receiving H1N1 are required to report use to the MDPH. MDPH’s system for reporting of doses administered went live on Friday, October 9. On Tuesday, October 20, MDPH reported to the CDC a total of 51,879 doses administered in Massachusetts from October 11-17.

Registration for H1N1 Vaccine
Providers who would like to receive and administer H1N1 vaccine may still register with MDPH. As of 10/21/09, 2,416 sites registered as primary sites to receive H1N1 vaccine. These primary sites registered an additional 1,807 secondary sites for a total of 4,223 sites across the Commonwealth. If you have questions about registering or reporting, please contact the MDPH H1N1 Vaccine Program Help Desk:
o Help Desk phone number: 888-578-5585
o Help Desk email address: MDPHH1N1Registration@state.ma.us
For additional information, including clinical and patient resources, visit www.mass.gov/flu.

MMS Flu Advisory: Seasonal Flu Vaccine Supply

Posted in Flu, Flu Advisory on October 20th, 2009 by MMS Communications – Comments Off on MMS Flu Advisory: Seasonal Flu Vaccine Supply
MDPH Announces Seasonal Influenza Vaccine Shipment Delaysflu badge
Massachusetts Department of Public Health (MDPH) today informed its providers that the remainder of its seasonal flu vaccine supply is expected to arrive over the course of the next 4-6 weeks with the balance of MDPH vaccine not arriving until the end of November. MDPH had previously projected all seasonal vaccine would be available by early November. To date, MDPH has received and distributed 631,530 doses of state-supplied seasonal flu vaccine, which is 71% of its total order of 885,000 doses.

MDPH states that the supply situation is similar for private-purchased seasonal flu vaccine. As of October 2, 2009, approximately 61%, or 77 million doses, of the expected doses for this season had been distributed nationally.

For questions regarding seasonal flu vaccine availability, please contact the MDPH Vaccine Management Unit at 617-983-6828.


MDPH Recommendations for Physicians
MDPH recommends that pediatric and other providers continue to vaccinate their patients with seasonal influenza vaccine during routine visits and in scheduled clinics as supply allows based on their available vaccine supply and formulation types.


 
Flu Clinics at Local Health Departments and Schools
MDPH is recommending that local health departments and schools delay large public clinics and school-based seasonal flu clinics until additional information about vaccine supply is available, unless they have an adequate amount of vaccine on hand to meet the expected demand.

 
Flu Clinic Locator
Physicians who do not have vaccine can refer patients seeking seasonal or H1N1 flu vaccination to http://flu.masspro.org for a searchable database of locations offering flu vaccination in their area. Currently there are no public H1N1 vaccination clinics currently scheduled in the state.

MMS Flu Advisory: Mass. Announces First Autumn Death from H1N1

Posted in Flu, Flu Advisory, H1N1 on October 2nd, 2009 by MMS – Comments Off on MMS Flu Advisory: Mass. Announces First Autumn Death from H1N1

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The victim was a 55-year-old woman from Middlesex County with "multiple underlying health conditions."

Department of Public Health Commissioner John Auerbach's statement said, in part, “While most cases of H1N1 in
Massachusetts and across the nation have been relatively mild, this
news demonstrates once again how serious flu can be.”

Read the complete DPH announcement.

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MMS Flu Advisory: September 30 Statewide H1N1 Webcast

Posted in Flu, Flu Advisory, H1N1 on September 29th, 2009 by MMS – Comments Off on MMS Flu Advisory: September 30 Statewide H1N1 Webcast

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The state Department of Public Health will host a webcast of its Statewide H1N1 Conference.

The webcast will be archived on the webcast web site for one year. The program will include an H1N1 situation update and outlook for the months ahead, and discussion of activities related to H1N1, clinical management, surge capacity, vaccination, DPH communications activities, school and university issues.

To view the webcast, visit: http://video.webcasts.com/events/pret001/32329/

If you have trouble with the link, please copy and paste it into your web browser.

Source: Massachusetts Department of Public Health (September 29, 2009).

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MMS Flu Advisory: New CPT Codes for H1N1 Immunizations

Posted in Flu, Flu Advisory, H1N1, Swine Flu on September 28th, 2009 by MMS – Comments Off on MMS Flu Advisory: New CPT Codes for H1N1 Immunizations

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The AMA today announced two new CPT codes for the upcoming H1N1 immunizations. Coding from the AMA:

Use code 90470 to report H1N1 immunization administration and counseling. Code
90663 was revised by the CPT Editorial Panel to refer specifically to
the H1N1 vaccine product. Both, revised code 90663 and Category I CPT
Code 90470 are effective immediately.

For quick reference, the two codes are below:

90470-H1N1 immunization administration (intramuscular, intranasal), including counseling when performed

90663-Influenza virus vaccine, pandemic formulation, H1N1

For more information:

http://www.ama-assn.org/ama/pub/news/news/cpt-codes-h1n1-immunizations.shtml

MMS Flu Advisory: FDA Approves H1N1 Vaccine; Some Seasonal Flu Vaccine Shipments Delayed

Posted in Flu, Flu Advisory, H1N1, Swine Flu on September 17th, 2009 by MMS – Comments Off on MMS Flu Advisory: FDA Approves H1N1 Vaccine; Some Seasonal Flu Vaccine Shipments Delayed

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The U.S. Food and Drug Administration has approved four vaccines against the 2009 H1N1 influenza virus. The vaccines will be distributed nationally after the initial lots become available, which is expected within the next four weeks. The state will be responsible for distributing vaccine to health care and public health providers. Massachusetts health care practices wishing to receive vaccine must complete an online registration by October 9. Click here to read the FDA press release.

Seasonal Flu Vaccine Delayed
Due to prioritization of H1N1 vaccine and other challenges, remaining shipments of seasonal flu vaccine may be delayed. The state Department of Public Health (MDPH) has received over 40% of its seasonal flu vaccine supply to date. Remaining doses are expected to become available over the next 4-6 weeks. The majority of doses are still expected by the end of October and all doses expected by early November. Additionally, doses of both state-supplied and privately purchased pediatric formulation vaccines (0.25ml pre-filled syringes for <4 years of age) have also been delayed. Currently, less than 30% of the state’s total supply is available now; the majority of doses are expected to be delivered by the end of October. 

Almost all of the influenza viruses currently circulating are H1N1.

MDPH Recommendations
MDPH recommends that all health care providers continue to vaccinate patients with seasonal influenza vaccine during routine visits and in scheduled clinics as supply allows.

Pediatric Providers
MDPH recommends that pediatric providers:

  • Continue to vaccinate patients based on their available vaccine supply and formulation types.
  • For infants who cannot now be vaccinated due to lack of current supplies, schedule vaccination appointments in late October, when MDPH expects supplies of both state-supplied and privately-purchased pediatric formulation seasonal flu vaccine to be sufficient.
  • Plan for simultaneous administration of both seasonal and H1N1 flu vaccine starting in mid-late October. H1N1 flu vaccine will become available starting in early October. Young children are one of the highest risk groups for H1N1 influenza. Pediatric providers will be allocated some of the initial doses of H1N1 vaccine that become available in Massachusetts. Note: Doses of the intranasal H1N1 LAIV and seasonal LAIV must be separated by 4 weeks, but  you can administer H1N1 and seasonal vaccines simultaneously if one or both vaccines are the injectable vaccine.

School and Public Clinics
MDPH is recommending that large public clinics and school based flu clinics be delayed until mid October (and possibly into early November) unless there is sufficient vaccine on hand to meet the expected demand.  By mid-October, we anticipate vaccine supplies will be sufficient to mount large clinics efforts. 

MDPH is advising schools and public health departments to anticipate holding clinics for H1N1 flu vaccine starting in early November as well, and to consider offering both seasonal and H1N1 flu vaccine at these clinics.

Sources: U.S. Food and Drug Administration (September 15, 2009) and Massachusetts Department of Public Health (September 17, 2009).

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H1N1 Vaccine Reimbursement Policies in Massachusetts

Posted in Flu, H1N1, Swine Flu on September 11th, 2009 by MMS – Comments Off on H1N1 Vaccine Reimbursement Policies in Massachusetts

The MMS has canvassed the payers operating in Massachusetts to determine their reimbursement policies for administration of the H1N1 vaccine.

Aetna, Cigna, Fallon, Health New England, Harvard Pilgrim, Medicare, and Network Health have provided their reimbursement policies. We're waiting to hear from Blue Cross, MassHealth, Tufts and Neighborhood Health Plan.

The emerging trend is that payers will reimburse for the administration, but not for the vaccine or supplies, since those are being supplied free of charge by the federal government.

For an overview and the policies and related billing codes, click here.

Reminder: Practice sites wishing to administer the H1N1 vaccine must register with the state by October 9. Click here to visit the state registration site.

MMS Flu Advisory: DPH Opens Online Provider Registration for H1N1 Vaccine

Posted in Flu, Flu Advisory, H1N1, Swine Flu on September 8th, 2009 by MMS – Comments Off on MMS Flu Advisory: DPH Opens Online Provider Registration for H1N1 Vaccine

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The state Department of Public Health (DPH) has launched its online registration for H1N1 vaccine. This fall, the federal government will provide states with H1N1 vaccine and supplies (needles, syringes, sharps containers, alcohol swabs, H1N1 immunization cards) at no cost. DPH is responsible for directing the vaccine and supplies in Massachusetts. Providers (including private providers, hospitals, local health departments, regional public health coalitions, visiting nurses associations, clinics, pharmacists and commercial community vaccinators) wishing to receive and administer H1N1 vaccine must register with the DPH. The deadline for registering is October 9, 2009. Click here to be directed to more information and the online registration, or visit http://www.mass.gov/dph/h1n1registration.

Statewide H1N1 Conference

On September 30, DPH will host the Massachusetts Statewide Conference on H1N1 Influenza Response for public health, health care, school and community leaders at the DCU Center in Worcester. For information and to register, click here. The conference will present the latest situation update regarding the flu in Massachusetts, and elsewhere and what the outlook is for the coming months. And will provide the latest information on guidance and planning for flu vaccination, both seasonal and H1N1.
 

Seasonal Influenza Vaccine Still Available for Purchase

For information about vaccine distributors with seasonal influenza vaccine available for purchase, go to the National Influenza Vaccine Summit website at: http://www.preventinfluenza.org/ivats/ivats_09_10.xls

Source: Massachusetts Department of Public Health (September 8, 2009).

MMS Flu Advisory: State Passes Emergency Regulations for Flu Vaccination

Posted in Flu, Flu Advisory, H1N1, Swine Flu on August 14th, 2009 by MMS – Comments Off on MMS Flu Advisory: State Passes Emergency Regulations for Flu Vaccination

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On Wednesday, the state Public Health Council adopted emergency regulations to increase vaccination among health care workers and the public against seasonal and pandemic influenza.

The regulations promulgated by the MA Department of Public Health (DPH) require hospitals and clinics in the state to offer vaccinations to their employees, patient care volunteers and medical staff against seasonal and novel H1N1 as soon as the vaccines are available.

Additional regulations also allow the Commissioner of Public Health to license and certify additional categories of health care workers, such as dentists and paramedics, to administer vaccinations against pandemic or novel influenza pursuant to a prescriber’s order if the Commissioner issues a determination that additional health care professionals are needed for timely vaccination of the population.

DPH to allocate H1N1 vaccine

The federal government has contracted to develop enough novel H1N1 vaccine for widespread use in the fall of 2009. DPH will be responsible for the allocation of vaccine once it arrives—as early as late September—and anticipates getting it to providers within two weeks. DPH’s plan for allocation is in development.

DPH recommends vaccinating against seasonal flu early

DPH stated that 90% of the national vaccine supply for seasonal flu is anticipated to be available in August, and is recommending providers vaccinate patients against seasonal flu as soon as they receive it.

View the emergency regulations for hospital and clinic vaccination of health care workers, and for administration of vaccine.

Source: Massachusetts Department of Public Health (August 12 and 13, 2009), Massachusetts Executive Office of Health and Human Services (August 13, 2009).

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