Immunization Program

To: SSV Provider
From: Mark Francesconi, Immunization Vaccine Manager
Date: Tuesday, May 17, 2007
Subject: Vaccine Distribution

MMR/V – ProQuad:

• A few months ago Merck Pharmaceuticals, manufacturer of ProQuad, announced that they anticipated a supply shortage of their MMR/V product for the 4th quarter of 2007. On May 11, 2007 they updated their estimate of shortage to be in effect July 2007 (see enclosed MMWR copy). Due to this development the SSV Program has decided to implement a restriction on MMR/V orders. Effective June 1, 2007 all orders for MMR/V will be filled with equal quantities of Varicella and MMR products. The State will no longer be requesting the MMR/V product until Merck has established an adequate supply for distribution. I have been informed that this will not be a short-term shortage; this shortage will be in effect well into 2008.

Pneumovax:

• In consideration of customer preference for smaller packages of Pneumovax 23, Merck has transitioned to a smaller dose presentation.  Effectively immediately, NDC 0006-4739-50, Pneumovax 23, 10 pack 5-dose vial is no longer available for ordering.  The new smaller dose presentation, NDC 0006-4739-00, Pneumovax 23, 1 pack 5-dose vial is available now for ordering.

Distribution:

• It has come to my attention that there have been some delays regarding delivery of vaccines. Enclosed is a chart explaining the ordering process and the distribution timeline from McKesson. A best case scenario demonstrates that an order should take no longer than 4 business days, however a worst case scenario shows us that delivery could take up to 13 business days. It is our recommendation that you take a look at your Par Stock levels and adjust them accordingly. We also would suggest that the best days to submit your orders to the SSV Program are Thursday, Friday or Monday, in order to receive your vaccines by the following Friday. These days seem to offer the highest probability of a best case outcome.

Returns:

• All expired vaccines (except for 2006-2007 Influenza) should be returned to McKesson using the shipping containers that your vaccine orders are delivered in. These containers are pre-addressed with a return label to McKesson. By changing the fold on the top of the containers you should see the return label. McKesson also asks that even if you do not have any expired vaccine to return that you please send the empty container back to them for future use. In order to send back expired vaccine please remember that you must first submit a copy of the “Returned/Expired/Spoiled Vaccine Form” to the SSV Program for return authorization. McKesson will not accept any returns without prior State approval. You are also required to include a copy of the Approved return form in the container with the returned vaccines.

New Temperature Recording Devices:

• The Immunization Program is in the process of purchasing some new temperature recording devices (see enclosed product brochure) and we are looking for volunteers to pilot these units at SSV provider’s offices. The new units have a USB adapter in order to upload the temperature information to a computer for analysis as well allow the provider’s office to submit their temperature information to the SSV Program electronically (email) each month with the vaccine order. These devices will be made available on a first come / first served basis. If you are interested in piloting one or more of these devices please send an email request to Mark.Francesconi@health.ri.gov. Please include the practice name, SSV Pin, and quantity of units requested in your email.

Adult Influenza Vaccine:

• If your practice is a family practice and you anticipate that you will be ordering Adult Influenza Vaccine for the 2007-2008 seasons through the SSV Program you should have recently received an “Office Managers Letter” (dated 4/30/07). If you did not receive this letter please contact Ann Gimprich at 222-7876 or Ann.Gimprich@health.ri.gov in order to be added to the mailing list.

Additional Vaccine-Related Information:

MMWR Weekly-Notice to Readers: Update on Supply of Vaccines Containing Varicella-Zoster Virus.

Rhode Island Distribution Timeliness Concerns Vaccine Management Business Improvement Project

MICROLite: The Plug and Record Mini Data Logger