**PARTICIPANTS**

Maribeth Bartz (TX), Don Blose and Paula Boatner (OK),Kathy Fredrickson
(AZ), Houston Hurlock (CO), Marianne Koshak, delegate for Joni
Reynolds(CO), Mary Beth Kurilo (OR), Elaine Lowery (CO), Lisa Moffatt
(OR), Sherry Riddick (WA), Gary Rinaldi (NY), Charlotte Sims-Higgins
(MO), Angela Sorrells-Washington (NJ), Amy Metroka (NYC), Jan
Hicks-Thomson (WA), Bob Swanson (MI), Barbara Laymon (CTR),Claire Hannan
(AIM), Jack Nemecek (CDC), Doug Corell (CDC), Janet Kelly (CDC), Jeanne
Santoli (CDC), Melissa Ely Moore (CDC), Sally Somerfeldt (CDC)

**ANNOUNCEMENTS**

-   The VTrckS project schedule was approved and base-lined at the
    Steering Team meeting on July 24, 2008.

-   Invitation to present and have a panel discussion at the Program
    Managers meeting in New Orleans, LA. November 17-20, 2008.

-   Logistics for the September 9-10 meeting in Atlanta -- forms
    required for travel need to be filled out and returned by Friday,
    August 1, 2008.

**DISCUSSION POINTS**

**Approval of July 15, 2008 Minutes**

Angela Sorrells-Washington motioned to approve the minutes, and it was
seconded by Jan Hicks-Thomson. Approved by all.

**Discussion -- NDC vs. Brand**

Committee members acknowledged receipt of a second document containing a
set of questions and answers on presentation level: NDC vs. Brand. A
question was asked if it was a CDC expectation to move collection of
vaccine presentation to the provider level and what would be the impacts
of managing inventory for those grantees using an immunization
information system (IIS). Melissa Ely Moore said that CDC would not want
this data at the provider level, but does want it at the grantee level.
Jeannie Santoli agreed and said historically, CDC did not manage
inventory like they do now. One important lesson learned was that if CDC
is going to have specific presentations available for grantees and
providers to order, CDC needs to have that data at the NDC level. CDC
wants to know what they can do to help grantees get at this level of
data. Jeannie said the thing to remember is that VOFA is a living
document and changes as needed. Melissa agreed and said that CDC would
not want grantees to change VOFA weekly

or monthly unless they had to and quarterly should be fine. Committee
members and CDC agreed that VOFA would be the grantees best estimate and
that grantees would not be strictly held to these VOFA estimates.

A question was raised on whether the benefit of CDC having this data
outweighs the amount of work that grantees will have to do. Sally
Somerfeldt said additional benefits from collecting data at the NDC
level include managing need along seasonality. Seasonality is difficult
to forecast on a national level because laws and trends are different
from state to state. Sally said that CDC uses the last few weeks/months
orders to project purchases because there is not a full year data with
all grantees on centralized distribution. Keeping a larger inventory is
not cost effective; keeping a five week inventory means CDC has a one
week working inventory which could be quickly depleted if there were
large unexpected provider orders or if provider presentation demands
change dramatically. As an example, the distributor could have 5 weeks
of DTaP, but not at the presentation level being ordered by grantees and
providers, which can create backorders.

There was further discussion on whether the information CDC will get
from this data will help as much as CDC expects because there are so
many changes and influences present at the grantee and provider level.
One member stated that another point for CDC to consider was that while
grantees transitioned to centralized distribution, they drew down their
current inventory and this will have an impact on forecasting from a
grantee perspective as well as at a national level. In addition, one
member reminded everyone that as grantees transitioned onto centralized
distribution there were many environmental dynamics that influenced the
way grantees and providers ordered. One suggestion was for CDC to look
at the last two previous years of grantees' provider order history to
see if it can be useful to CDC when projecting purchases.

CDC stated that NDC level data is needed and wants to create tools which
will make collection as easy as possible for the grantees. One idea is
to pre-populate the spend plan workbook for grantees with historical
data. The grantees would review it and let CDC know if it seems
reasonable. Committee members noted that not all grantees use the spend
plan workbook, but utilize self-developed tools. One member said that
having a pre-populated spend plan workbook would make this request more
palatable and manageable for grantees.

Committee members asked if there could be some compromise between the
amount of work that grantees would need to do to gather this data and
the CDC's needs. One suggestion was for CDC to review vaccine orders
from grantees that had been on centralized distribution for the longest
period of time to help determine seasonality in the new distribution
environment. By looking at those patterns, it may be possible to
determine the percentage of increase in ordering for various product
types during peak times such as back to school. CDC might be able to

determine a pattern of seasonality using that data, and develop a
percentage based methodology for increasing replenishment of all
products to ensure inventory is available during peak times. With many
grantees well into their second year of third party distribution, it
seems plausible to learn something about ordering patterns based on
these data. These patterns will stabilize over time. CDC responded that
this is risky because the result of purchasing the extrapolated Product
X may be misrepresented due to the pharmaceutical company of Product X
having a big push in those grantees' geographical jurisdiction. As with
any kind of random sample selected, Product X could be the product that
grantees order, when in fact, the majority of the grantees' providers
use Product Z.

Another suggestion was to ask for this level of data on only certain
vaccines that were most difficult to manage. Jeanne said that CDC has
conducted these types of activities in the past and the feedback from
grantees was that they felt their interests were not properly accounted
for and did not like the methodology or the results. One Committee
member asked about the potential impact this requirement might have on
IIS. Another committee member reminded everyone that NDC is a current
requirement for vaccine ordering and those IIS interfacing with VACMAN
do so through an import file.

Janet Kelly called for a motion. Jan Hicks-Thomson motioned that the GAC
survey grantees, using a prototype of a pre-populated spend plan
workbook along with the Q&A document to determine barriers grantees
might encounter with a CDC requirement for vaccine ordering at the NDC
presentation level. Elaine Lowery seconded. Motion carried.

**Discussion -- Process for communicating to all grantees**

There was a brief discussion on the process for how the Committee should
communicate to grantees. Options included posting the minutes on the
VTrckS page of the VMBIP website and developing a summary of the
minutes. Jeanne Santoli proposed that the minutes be made available to
all grantees. Angela Sorrells-Washington motioned to post the minutes on
the VMBIP website. Sherry Riddick seconded. Approved by all.

**Next Call -- August 12, 2008, 2:30pm -- 3:30pm EST**

This document can be found on the CDC website at:

<http://www.cdc.gov/vaccines/programs/vmbip/downloads/vtrcks-min/gac-min-07-29-08-508.doc>