October 31, 2005
To: VFC Providers
From: Becky Bessette, Immunization Program Manager
Mark V. Francesconi, Vaccine Manager
Re: Influenza Vaccine Survey: 2005 – 2006 Flu Season (Update 2005-4)
Earlier this year, we asked each practice to submit to the Department of Health an estimate of how much influenza vaccine they would need for the 2005-2006 flu season. We are now hearing from many practices that they over or underestimated their needs. In response to this, we would like you to tell us how much more flu vaccine you think your practice will need for the remainder of this flu season.
The Department of Health expects to receive the remainder of its flu vaccine order for the 2005-2006 flu season by mid-November. We need to know how much flu vaccine to distribute to each of the hospital pharmacy locations. Please fill out the information below to help us make sure that the vaccine is at the proper location for you to pick up when it arrives.
If you have any questions, please contact Mark at 222-5988 or markf@doh.state.ri.us.
Please fill out this survey and fax it back to 222-1442 by November 4 th. Failure to reply will be recorded as “No More Vaccine Needed.”
Name of Practice:
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Tel. Number: |
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Contact Person:
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Date: |
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Practice Address:
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Pick Up Site: (circle one) |
DOH Fatima Kent Landmark Memorial Miriam Newport So. County St. Joseph’s Women & Infants Westerly Pilot Site |
Age Group |
Product |
Package |
Number of Doses Requested |
6-35 Months |
Sanofi
Fluzone-PF® (preservative free) |
0.25mL
Pre-filled syringe |
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3-18 Years |
Sanofi Fluzone®* |
0.50mL
10-Dose vials |
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5-18 Years |
MedImmune FluMist®**
(live intranasal) |
0.50mL
Pre-filled single-use sprayers |
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*May also be used for children 6-35 months at 0.25mL dose
** For healthy children |
