The CDC has stated that Indian health sites are considered a high
priority vaccine providers, and Aventis orders will be shipped in their
entirety.

**Question:  If an IHS, Tribal and Urban program ordered vaccine from
Chiron or for some other reason has not received part or all of their
flu vaccine order, who should they notify?**

 

**Answer:**  Sites with vaccine issues should contact their Area
Immunization Coordinator, **they are the primary point of contact for
all vaccine issues.**  This includes issues related to shortages and
extra vaccine.  The Coordinators are:

[Area]{.underline}                 [Contact]{.underline}     
                              [Phone]{.underline}              
          [E-mail]{.underline}

Aberdeen         Robin Charging-Hawk         605-226-7473            
Robin.Charginhawk2@ihs.gov  

Alaska             Dr. Ros Singleton             907-729-3418
            ris2@cdc.gov

Albuquerque   Theresa Tsosie-Robledo         505-248-4035            
<ttsosie@abq.ihs.gov>

Bemidji          Mary Fairbanks                     218-444-0488
            Mary.Fairbanks@ihs.gov

Billings         Rita Harding                          406-247-7122
            Rita.Harding@ihs.gov

California      Susan Ducore                        916-930-3981
            Susan.Ducore@ihs.gov

Nashville       Jim Marshall                         615 467-1500 
            jmarshall@usetinc.org

Navajo          Dr. Diana Hu                         928-283-2680
            diana.hu@tcimc.ihs.gov

Oklahoma     Becky Loving                        405-951-3832
            Rebecca.Loving@ihs.gov

Phoenix        Dr. Roy Teramoto                  602-364-5175
            Roy.Teramoto@ihs.gov

Portland         Joshua Jones                         503
416-3272              Jjones@npaihb.org

Tucson         Sybil Cochran                        520-383-7242
            Sybil.Cochran@ihs.gov

 

**Question:  I heard on the news that CDC is redistributing flu vaccine
from Aventis, what does this mean for IHS and Tribal sites?**

**Answer:**  The Centers for Disease Control and Prevention (CDC) and
Aventis Pasteur announced the first phase of the plan to allocate
influenza vaccine in response to the recently announced loss of half of
the nation\'s expected flu vaccine supply for the 2004-2005 season. The
plan, calls for CDC to work closely with Aventis to distribute in phases
22.4 million doses of unshipped vaccine to identified areas of need
throughout the country. Beginning immediately, about 14.2 million doses
of vaccine will be allocated over the next 6-8 weeks through Aventis
Pasteur contracts directly to high-priority vaccine providers, including
hospitals, long-term care facilities, nursing homes, and private
providers who care for young children.  CDC will continue to work with
Aventis Pasteur and state and local health departments to identify
people, by region, on the vaccination priority list. The approximately
8.2 million doses remaining after the first phase is completed will be
shipped to other high-need areas.

Sites that ordered through the National Supply Service Center (Ada, OK),
the Gallup Supply Service Center or the Phoenix Area Office has received
or should soon receive their entire order.  Other sites that ordered
directly from Aventis or a wholesaler and have not yet received their
full order, need to contact their Area Immunization Coordinator so IHS
can notify CDC that these are Indian health sites.  CDC has categorized
IHS and Tribal facilities to be high-priority vaccine providers, and has
asked that all flu vaccine for these facilities ordered through Aventis
be shipped as soon as possible.

Sites that did not order from Aventis need to provide the requested
information about vaccine needs.  Once the need for vaccine has been
determined, IHS and CDC staff will work to redistribute or acquire
additional vaccine.  If you have not yet reported vaccine needs to your
Area Vaccination Coordinator, please do so **no later than Friday,
October 15th**.  Sites that do not notify the Area Immunization
Coordinator, so that the CDC can be notified to protect your order from
redistribution, will likely not receive any undelivered flu vaccine
order.  Your Area Immunization Coordinator will need the following
information:

Site Name:

Address:

Who the site ordered from:

Approximate size of high risk population:

Flu vaccine coverage last year percent:

How much vaccine was ordered:

How much has already been delivered:

Account number:

Person who ordered the vaccine:

Phone Number:  

Date Ordered:

** **

**Question:  With flu vaccine in short supply nationally, who should
receive flu vaccine this year?**

 

**Answer:**  The Centers for Disease Control and Prevention have issued
guidance that influenza vaccination only be offered to highest priority
patients and employees.  These include:

\- all children 6-23 months

\- children 6 months to 18 years of age on chronic aspirin therapy,

\- patients aged 65 and older

\- patients aged 2-64 with underlying chronic medical conditions

\- all women who will be pregnant during the influenza season

\- residents of nursing homes and long-term care facilities

\- health care workers with direct patient care and

\- out-of-home caregivers and household contacts **of children aged**
**\<6 months**.

 

**Question:  Can employees, including non-beneficiary employees,**
**receive flu vaccine since the CDC recommends that high risk
individuals including Health Care Workers involved in direct patient
care receive flu vaccine?**

 

**Answer:**  Yes. As discussed in the Indian Health Manual Part 1,
Chapter 12 - IHS Employee Immunization Program - employees including
salaried personnel, consultants, contractors, temporary employees and
volunteer workers who work within an Indian health facility may be
provided influenza vaccine, at no charge. 

 

**Question:  Can flu vaccine ordered at federal pricing be used for
non-beneficiaries (other than employees) including caregivers for
beneficiaries?**

** **

**Answer:**  Yes.  According to 25 U.S.C. 1680 (c)(2), the IHS has
authority to provide services which will prevent the spread of a public
health hazard. The IHS has discretion to define a public health hazard
under the 1680(c) authority.   Non-Indian family members of an Indian
house hold may be provided care under 25 U.S.C. 1680(c)(2) or
1680(c)(4).  Either of these provisions authorizes the Service to give
flu shots in order to prevent the spread of the flu which could be
dangerous to vulnerable persons in the community.  Current
recommendations are that only caregivers and household contacts for
children under 6 months of age receive the flu vaccine.

**Question:  My site has more vaccine than the anticipated need for
highest priority patients and employees.  What should I do with the
extra vaccine? **

**Answer:  ** If you believe you have extra doses of flu vaccine, you
should contact your Area Immunization Coordinator.  Coordinators are
keeping track of which sites have extra vaccine and which IHS and Tribal
sites are short on vaccine.  Most areas are expecting to redistribute in
their Area first and then to other IHS Areas.  If you get calls from IHS
or Tribal sites asking for vaccine, please have them call their Area
Immunization Coordinator.

 

**Question:  For sites that do not have enough flu vaccine, can Flumist
still be ordered?**

**Answer:**  Yes.  Sites need to work through their State.

** **

**Question:  We have heard reports of price-gouging for flu vaccine.
 What is the current federal and non-federal price for flu vaccine.**

**Answer:**  The current price for flu vaccine (if available) is \$85
(open Market) and \$63.31 (National Contract) per vial (10 doses) for
Adult flu vaccine.  If you suspect price gouging, please report it to
Jim Harrison at <JHarrison@cdc.gov>

**Question:  Where can I look for IHS updates on the flu vaccine
shortage?  **

**Answer:**  Regular updates will be posted starting on October 15^th^
at [www.pharmacyissues.ihs.gov](http://www.pharmacyissues.ihs.gov/)
click on "**Acquisition of Medications**" then go to "**Drug
Shortages**".

**Question:  How often do Area Immunization Coordinators meet?**

**Answer: ** Area Immunization Coordinators have twice weekly conference
calls and regularly talk with the IHS Epidemiology Department in
Albuquerque.  Coordinators met today, October 14^th^ and the next
meeting is scheduled for Tuesday, October 19^th^.

 

CAPT Robert E. Pittman

Principal Pharmacy Consultant

Indian Health Service