Immunization Program and Links

Atlantic Health Partners Announces Lower Tdap Vaccine Price!

As you know, Atlantic Health Partners, the nation’s leading vaccine buying group, offers our members the lowest prices for Sanofi and Merck vaccines.  We wanted to share with you that Atlantic has obtained an even lower Tdap vaccine price for Sanofi’s Adacel.  This is especially timely given the recent ACIP expanded indications for Tdap vaccine along with the pertussis outbreak in several states. 

Atlantic works with Sanofi Pasteur and Merck to provide our members with the lowest prices on their vaccines, including Sanofi’s Fluzone.  Sanofi is still accepting pre-book orders, and you will get Atlantic’s contract pricing for their Fluzone and High Dose Fluzone (which is reimbursed by Medicare).

Additional benefits offered by Atlantic:

  • Lowest pricing and terms for Fluzone and Flumist
  • Medical supply discount program
  • Office and business supply discounts
  • Discounted patient recall program

Jeff Winokur and Cindy Berenson are the primary contact persons at Atlantic, and we encourage you to contact them at 800-741-2044 or at info@atlantichealthpartners.com  for more information and details about how your practice can benefit from participation. 


Update on future availability of Tripedia and TriHIBit

In 2011, Sanofi Pasteur will discontinue the supply of Tripedia® (Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed) and TriHIBit® (Haemophilus b Conjugate Vaccine [Tetanus Toxoid Conjugate]-ActHIB® reconstituted with Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed-Tripedia) in an effort to support their other DTaPa and Hibb products. Supplies are expected to last through Q2 2011 however, this is subject to change based on fluctuations in demand. Sanofi is sending Dear Doctor letters to communicate this information directly to providers (see attachment for draft of the Dear Provider letter).

Sanofi Pasteur continues to offer a full line of DTaP and Hib products, including Pentacel® (Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed, Inactivated Poliovirus and Haemophilus b Conjugate [Tetanus Toxoid Conjugate] Vaccine), DAPTACEL® (Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed), and ActHIB® (Haemophilus b Conjugate Vaccine [Tetanus Toxoid Conjugate]).


Click here for more information (pdf)


Pre-book your Influenza Vaccine for 2011-2012
Please note that pre-booking of Vaccines for Children (VFC) influenza vaccine for the 2011-2012 flu season will not occur until Summer 2011. Please call (518) 474-4578 for any questions about the VFC Program.

Prebook Vaccine Info – Hospital (pdf)

Prebook Vaccine Info – All Other Providers (pdf) 


AAP - Member Center

http://www.aap.org/moc/indexEntry.cfm


Immunize NY! February 2011

Click here (pdf)


New Immunization Administration Codes

Member,

I’m contacting you to make you aware of new immunization administration codes for children and adolescents through 18 years of age that went into effect on January 1, 2011. These new codes  significantly increase reimbursement for the administration of vaccines by allowing for billing for each component of a vaccine using new codes 90460 and +90461.  Thus, for instance, with these new codes when billing for the administration of MMR vaccine, one would bill 90460, +90461, +90461 (essentially billing 3 times since there are 3 components to the vaccine).  Thus, one of our local commercial insurers has told us that they will be paying $277 for the administration of 5 vaccines at the 12 month check up instead of the $72 that they had been reimbursing previously for administration of these vaccines.  The only caveat for using the codes is that providers or RNs (not LPNs or medical assistants) must document that they educated the parent (or the patient if he/she is 18 years old) about the vaccinations being ordered, the most common side effects associated with the vaccines, and have answered any questions that they may have about the vaccinations.

All of the commercial insurers in the Rochester area have adopted use of the new codes, and I’m sure the same is the case throughout the rest of the state.  In our area, most Medicaid managed care plans have also adopted them.  However, because of a recent AAP alert (see below) regarding lack of adequate CDC funding to state VFC programs at the present time to support VFC payment of the enhance immunization administration fees, some Medicaid managed care and Child Health Plus plans and Fee-For-Service Medicaid have delayed adopting the use of the new codes.

Additional information about the new billing codes can be found at: http://practice.aap.org/popup.aspx?aID=2980&print=yes&isKeyContent=0

Stanley J. Schaffer, M.D., M.S.
Associate Professor of Pediatrics
Director, WNY Lead Poisoning Resource Center - Rochester Office
Golisano Children's Hospital
University of Rochester Medical Center
601 Elmwood Ave., Box 777
Rochester, NY  14642
Phone: (585) 275-0267
Fax: (585) 273-1037


Immunization Toolkit

CLICK HERE (DOC)

More info: vaccine@nysafp.org


Letter from Commissioner Daines to all New York State regulated health facilities

CLICK HERE (pdf)


Immunize NY!  Summer 2010 Edition
CLICK HERE (pdf)


Revised Recommendations for Rotavirus

CLICK HERE (pdf)


· Group Purchasing: Vaccine purchasing groups for physicians

This link lists information about vaccine purchasing groups, most of which provide discounted vaccine pricing. (xls)


· Manufacturers: Manufacturer discounts and return policies for practices
This link lists vaccine manufacturer’s discount and return policies. (xls)


· Negotiating Contracts:
Physician guide on how to effectively negotiate with insurers for adequate insurance reimbursement for providing vaccinations (doc)


· Medicare Vaccine Administration Fee Schedule:
Medicare annually publishes a vaccine administration fee schedule which is geographically adjusted. The Medicare vaccine administration fee schedule is considered one of the most accurate estimates of the cost of providing vaccinations. Practices should use it as a reference when they negotiate new contracts with payers.
2009 Medicare Vaccine Admin Rates (pdf)


· NYSIIS Compatible EMRs: EMR vendor products with NYSIIS compatibility
Click Here
Before contracting with an EMR vendor, check to make sure that the EMR system that you are considering is NYSIIS-compatible.


· Vaccine Codes:
Worksheet for billing with vaccine codes (xls)
Practices can download the attached document, delete the rows that apply to vaccines that they do not provide, and then use the rest of the document as a billing tool for immunizations that they provide.


· Helpful Immunization Links
• AAP Vaccine Finance Resources for Physicians: Supplement in Pediatrics with resources for physicians
http://pediatrics.aappublications.org/cgi/content/full/124/Supplement_5/S573

• AAP Vaccine Survival Guide: Worksheet for determining vaccine costs
http://www.aap.org/immunization/pediatricians/pdf/Vacc_survival_insert.pdf

• CDC Vaccine Management Guide: Physician guide on storage and handling of vaccines
http://www.cdc.gov/vaccines/pubs/downloads/bk-vac-mgt.pdf

• CDC Vaccine Price List: Vaccines prices for CDC and the private sector
http://www.cdc.gov/vaccines/programs/vfc/cdc-vac-price-list.htm

• CDC Vaccine Storage and Handling Toolkit: Physicians guide on proper preparation to disposal of vaccines
http://www2a.cdc.gov/vaccines/ed/shtoolkit/pages/prep_disposal.pdf

• CMS Administration Reimbursement Rates: Medicare vaccine administration reimbursement rates by state and geographic region within states
http://www.cms.hhs.gov/AdultImmunizations/Downloads/09AdminRates.pdf

• Immunization Action Coalition: Resources and vaccine information for providers including up-to-date vaccine immunization statements in English and a host of other languages. IAC also distributes an informative weekly e-mail posting called IAC Express which contains the latest immunization information
http://www.immunize.org/

• MMWR: Morbidity and Mortality Weekly Report: Published weekly by the CDC, MMWR lists up-to-date vaccine information. On-line subscriptions to MMWR are available at:
http://www.cdc.gov/mmwr/

• NYC Citywide Immunization Registry: Information resources for providers about the CIR including the UPIF guide for EMR interfaces
http://www.nyc.gov/html/doh/html/cir/a02.html

• NYS Insurance Department Complaint Form: Online form for providers to file a complaint about insurer issues (i.e., non-prompt payments)
http://www.ins.state.ny.us/provlhow.htm

• NYSIIS Information for Providers: Information resources for providers about NYSIIS
http://www.health.state.ny.us/prevention/immunization/information_system/providers/

• Vaccine Education Center at Children’s Hospital of Philadelphia. Headed by Dr. Paul Offit, the center provides helpful information about vaccine safety, addresses special considerations related to vaccination and offers educational materials on vaccination.
http://www.chop.edu/service/vaccine-education-center/

• Washington State Vaccine List: Vaccine and CPT codes list updated by Washington State. Washington State publishes the most up-to-date list of vaccines and vaccine CPT codes
https://fortress.wa.gov/doh/cpir/iweb/homepage/completelistofvaccinenames.pdf


Now You Can Help With Influenza Surveillance...In Only a Few Minutes a Week!

CLICK HERE (pdf)


NYSIIS Statewide Training Schedule July-December 2010

CLICK HERE (pdf)


Recommendation to Temporarily Suspend Usage of GlaxoSmithKline Rotarix

CLICK HERE (pdf)


Dear Provider letter on H1N1 vaccine - Richard F. Daines, M.D., Commissioner of Health

CLICK HERE (pdf)


CDC’s Advisory Committee on Immunization Practices (ACIP) Recommends Universal Annual Influenza Vaccination

Press Release
For Immediate Release: February 24, 2010
Contact: CDC Division of Media Relations
(404) 639-3286 (404) 639-3286

CDC’s Advisory Committee on Immunization Practices (ACIP) Recommends Universal Annual Influenza Vaccination

A panel of immunization experts voted today (February 24, 2010) to expand the recommendation for annual influenza vaccination to include all people aged 6 months and older. The expanded recommendation is to take effect in the 2010 – 2011 influenza season. The new recommendation seeks to remove barriers to influenza immunization and signals the importance of preventing influenza across the entire population.

The Advisory Committee on Immunization Practices (ACIP), which advises the Centers for Disease Control and Prevention (CDC) on vaccine issues, voted on the new recommendation during its February 24, 2010 meeting in Atlanta. The vote took place against a backdrop of incremental increases in the numbers and groups of people recommended for influenza vaccination in years past, and lessons learned from the world’s still ongoing first flu pandemic in 40 years.

Prior to today’s vote, ACIP recommendations for seasonal influenza vaccination – which focused on vaccination of higher risk persons, children 6 months through 18 years of age and close contacts of higher risk persons – already applied to about 85 percent of the U.S. population.

Discussion at the ACIP meeting focused on the value of protecting all people 19 to 49 years of age, who have been hard hit by the 2009 H1N1 pandemic virus, which is likely to continue circulating into next season and beyond. Another reason cited in favor of a universal recommendation for vaccination is that many people in currently recommended “higher risk” groups are unaware of their risk factor or that they are recommended for vaccination. The ACIP discussion also recognized the practicality and value of issuing a simple and clear message regarding the importance of influenza vaccination in the hopes that this would remove impediments to vaccination and expand coverage. Finally, new data collected over the course of the 2009 H1N1 pandemic indicates that some people who do not currently have a specific recommendation for vaccination may also be at higher risk of serious flu-related complications, including those people who are obese, post-partum women and people in certain racial/ethnic groups.

More influenza vaccine doses will be required to vaccinate all adults. However, based on current projections, more licensed types and brands of seasonal influenza vaccines will be available in the 2010-11 influenza season than has ever been available before. Historically, uptake of seasonal influenza vaccine has been less than half of the number of persons with a specific recommendation for vaccination.

Annual influenza vaccination is a safe and preventive health action that benefits all age groups. However, certain people have a higher risk for influenza complications, including people aged 65 years and older, children younger than 6 months of age, pregnant women, and people of any age with certain chronic medical conditions.

These people, their household and close contacts, and all health care personnel should continue to be a primary focus for vaccination efforts as providers and programs transition to routinely vaccinating all people 6 months of age and older.

The composition of the Northern Hemisphere’s 2010-2011 seasonal influenza was announced at the FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) meeting yesterday in Bethesda, MD. Next season’s vaccine will be trivalent (with three different vaccine viruses) and include an A/California/7/2009 (H1N1)-like virus, an A/Perth/16/2009 (H3N2)-like virus, and a B/Brisbane/60/2008-like virus. The H1N1 virus recommended for inclusion in the 2010-2011 seasonal influenza vaccine is a pandemic 2009 H1N1 virus and is the same virus used in the 2009 H1N1 monovalent vaccine.

Recommendations of the ACIP become recommendations of CDC once they are accepted by the director of CDC and the Secretary of Health and Human Services and are published in the Morbidity and Mortality Weekly Report.


Immunization Recommendations for Haitian Refugees

Dear NYSIIS Users and Stakeholders:

Please click here NYSDOH Health Advisory "IMMUNIZATION RECOMMENDATIONS FOR CHILDREN AND ADOLESCENTS DISPLACED BY THE JANUARY 12, 2010, EARTHQUAKE IN PORT-AU-PRINCE, HAITI."

The purpose of these recommendations is to provide guidelines to those institutions providing services to Haitian child and adolescent refugees who will be attending school in New York State.

Thank you.


H1N1 and Seasonal Flu Vaccine Information

Dear NYSIIS Participants and Stakeholders:

Attached are three important communications.

- 2/1/2010 Non-safety Related Voluntary Recall of certain lots of H1N1 Vaccine. Sanofi Pasteur found five distributed lots of single.dose, pre-filled syringe pediatric (0.25mL) vaccine and one distributed lot of single dose pre-filled syringe for older children and adults (0.5mL) vaccine that had potency below pre-specified limits. (pdf)

- 2/3/2010 Announcement of the Expiration Date Change of the Sanofi Influenza A (H1N1) 2009 Monovalent Vaccine in pre-filled syringes to February 15, 2010. (pdf)

- 2/5/2010 Letter reminding influenza vaccine providers to pre-book influenza vaccine now for the 2010-2011 influenza season. (pdf)

Thank you for your continued cooperation.
~The NYSIIS Team


State Health Commission waives restrictions on the use of thimerosal free flu vaccines due to a shortage in seasonal and H1N1

NYS Health Commissioner Richard Daines has waived the restriction on use of use of influenza vaccines containing more than the mercury levels described in PHL § 2112 (2) and (3), due to insufficient amounts of vaccine because of the flu emergency declared yesterday by the Governor. This authorization shall continue until May 1, 2010. All vaccinations should be given with the informed consent of the patient or the patient’s parent or person otherwise authorized to consent.

The Commissioner’s letter states that supplies of both the 2009 seasonal trivalent and 2009 H1N1 monovalent vaccines are inadequate to meet the immediate need to vaccinate all persons who seek vaccination including young children and pregnant women. He notes that DOH has received numerous calls from physicians, advocacy groups and individuals regarding difficulties in obtaining vaccine. NYSAFP has been in regular communication with DOH regarding flu developments and preparations for emergency distribution of vaccine in the event of an outbreak. We surveyed family physicians and determined that few family physician practices had received any flu vaccine in the initial distribution of supply. In discussions with DOH officials earlier this week, we recommended redistribution of existing supply to assure that all physicians receive some amount of vaccine to administer to high risk patients, rather than focus on high volume practices in distribution of the limited supply available. We also recommended that the existing supply be stretched as widely as possible by waiving the statutory restriction on use of vaccine containing thimerosol. We will continue to report to you on developments and welcome any feedback you feel would be helpful to our efforts to assure that vaccine supplies are adequately and equitably distributed.

Click here for the full text of the Commissioner’s letter (pdf)


New York State Department of Health 2009 H1N1 Influenze Planning Checklist for Medical Offices and Clinics - October 2009
Click here for document (pdf)


Latest flu allowances schedule available
Click here for document (pdf)


NYSDOH advisory regarding ordering H1N1 vaccine and tracking doses administered and inventory
UPDATE - October 26, 2009
Click here for document (pdf)


Advisory: NYSDOH 2009-2010 flu advisory for healthcare providers

Updated influenza advisory for the 2009-2010 season. The guidance in this advisory replaces all prior guidance with regard to surveillance, testing, and clinical management recommendations for influenza. For additional information contact the Bureau of Communicable Disease control at the email address listed in this advisory.
Click here (pdf)


How to pre-register your practice (located outside of New York City*) for novel influenza A (H1N1) monovalent vaccine to be administered to your pediatric patients (less than 19 years of age) and office staff.

To preregister for vaccine go to HPN, Physicians, then "NYSIIS and H1N1 Vaccine" link, then "Register for HCS Account" even if you already have such an account, and near the bottom find link to preregister for vaccine.
Click here (pdf)


NYSDOH Bureau of Immunization's Immunize NY! Seasonal Influenza 2009-2010 edition
Click here (pdf)


Dear NYSIIS Participants:

Please see the NYSDOH Health Advisory UPDATED RECOMMENDATIONS FOR THE USE OF HAEMOPHILUS INFLUENZAE TYPE B (HIB) VACCINE: REINSTATEMENT OF THE BOOSTER DOSE AT 12-15 MONTHS for important information.

The advisory is attached to this email in pdf format and can also be accessed online at: https://commerce.health.state.ny.us/hpn/ctrldocs/alrtview/postings/doc090723_0.pdf

Effective immediately, the CDC, in consultation with the Advisory Committee on Immunization Practices (ACIP), the American Academy of Family Physicians (AAFP), and the American Academy of Pediatrics (AAP), is recommending reinstatement of the booster dose of Haemophilus influenzae type b (Hib) vaccine for children aged 12–15 months who have completed the primary 3-dose series. Infants should continue to receive the primary Hib vaccine series at ages 2, 4, and 6 months. Children aged 12–15 months should receive the booster dose on time. Older children for whom the booster dose was deferred should receive their Hib booster dose at the next routinely scheduled visit or medical encounter. Although supply is sufficient to reinstate the booster dose and begin catch-up vaccination, supply is not yet ample enough to support a mass notification (i.e. reminder-recall) process to contact ALL children with deferred Hib booster doses.

For more information, please see the full article in the CDC’s Morbidity and Mortality Weekly Report available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5824a5.htm

Also, CDC has posted "Hib Vaccine: Q&A for Providers about the Return to the Hib Booster Dose" available at:
http://www.cdc.gov/vaccines/vpd-vac/hib/faqs-return-to-booster-hcp.htm

We hope you find this information useful.
~The NYSIIS Team


Literature Review of Costs and Revenues Associated with Vaccination of Children and Adolescents

Click here for complete article (.doc)


Hib Booster Dose Reinstated
The CDC, in consultation with ACIP, the American Academy of Family Physicians, and the AAP, is recommending reinstatement of the booster dose of Haemophilus influenzatype b vaccine for children aged 12–15 months who have completed the primary 3-dose series. Infants should continue to receive the primary Hib vaccine series at ages 2, 4, and 6 months. Children aged 12–15 months should receive the booster dose on time. Older children, for whom the booster dose was deferred, should receive their Hib booster dose at the next routinely scheduled visit or medical encounter. Although supply is sufficient to reinstate the booster dose and begin catch-up vaccination, supply is not yet ample enough to support a mass notification and recall of all children with deferred Hib booster doses.

For more information, go to the July 23, 2009 New York State Health Advisory Updated Recommendations for the Use of Haemophilus Influenzae Type B (Hib) Vaccine: Reinstatement of the Booster Dose at 12-15 monthsat:

https://commerce.health.state.ny.us/hpn/ctrldocs/alrtview/postings/doc090723_0.pdf


NYSIIS News - Winter 2010
Click here(pdf)


Guidance for the vaccination of women of reproductive age
Click here(.pdf)


Public Health Law 2112.
Click here information sheet on Public Health Law 2112 and how providers can obtain influenza vaccine that complies with this new law.(.pdf)


NYSAFP and Atlantic Health Partners offer vaccine discount purchase program.
Click here for news regarding a sales promotion with Sanofi Pasteur.(.doc)



*This page contains information and links regarding vaccine safety and immunizations provided by the New York State Department of Health, Immunization Bureau and the Centers for Disease Control. We will also include information from other sources regarding vaccine safety and immunizations.

CDC's Vaccine Information Statements
http://www.cdc.gov/vaccines/pubs/vis/default.htm#download

CDC's Instructions for Use of the Vaccine Information Statements
http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-Instructions.pdf

CDC Email Updates
http://www.cdc.gov/emailupdates/index.html