carl chu, pharmd hawaii department of health. paul v. effler, m.d., m.p.h
TRANSCRIPT
Carl Chu, PharmDCarl Chu, PharmDHawaii Department of HealthHawaii Department of Health
Paul V. Effler, M.D., M.P.H. Paul V. Effler, M.D., M.P.H.
Only one public school system statewideOnly one public school system statewide
Success implementing other school-based Success implementing other school-based vaccination programs (i.e., hepatitis B vaccine for vaccination programs (i.e., hepatitis B vaccine for 55thth graders) graders)
To be prepared for possible mass vaccinations of To be prepared for possible mass vaccinations of school children during an influenza pandemicschool children during an influenza pandemic
Evidence of substantial seasonal influenza attack Evidence of substantial seasonal influenza attack rates in children including reports of school rates in children including reports of school outbreaksoutbreaks
Preliminary dataPreliminary data
Ideal setting for assessing impactIdeal setting for assessing impact Hawaii’s geographic isolation means residents usually Hawaii’s geographic isolation means residents usually
receive medical care within statereceive medical care within state Statewide hospital discharge databank that may be used Statewide hospital discharge databank that may be used
to ensure comprehensive ascertainment of influenza to ensure comprehensive ascertainment of influenza hospitalizations (hospitalizations (http://www.hhic.org/about.html))
Two major health care providers/payersTwo major health care providers/payers Provide 72% coverage of civilian population (930,381 of Provide 72% coverage of civilian population (930,381 of
1,285,498 in 2006)1,285,498 in 2006) Should permit robust assessment of effect of program on Should permit robust assessment of effect of program on
health care encounters, including outpatient visits, health care encounters, including outpatient visits, statewidestatewide
Only 20% of 44,725 privately insured childrenOnly 20% of 44,725 privately insured children
Only 40% of 8,154 privately insured asthmatic Only 40% of 8,154 privately insured asthmatic childrenchildren
Only 50% of 68 privately insured diabetic childrenOnly 50% of 68 privately insured diabetic children
Preliminary dataPreliminary data
Grades K-8Grades K-8
All Hawaii public and private schools asked to All Hawaii public and private schools asked to participate participate
Offered TIV (shot) and LAIV (nasal spray)Offered TIV (shot) and LAIV (nasal spray)
Two clinics >6 weeks apart if school had children age Two clinics >6 weeks apart if school had children age <9 years who might need 2 doses<9 years who might need 2 doses
Voluntary written informed consent of Voluntary written informed consent of parents/guardians requiredparents/guardians required
Preliminary dataPreliminary data
JanJan Feb Feb MarMar AprApr MayMay JunJun JulJul AugAug SepSep OctOct NovNov DecDec JanJan
Order VaccinesOrder Vaccines
Staffing Staffing ArrangedArranged
Consents Consents Due/ReviewDue/Review
SchoolsSchoolsScheduledScheduled
ClinicsClinics
Consents Consents SentSent
SchoolsSchoolsAskedAsked
Promotion Promotion
59 working days59 working days
Preliminary dataPreliminary data
School ParticipationSchool Participation 340/377 (90%) of all schools with grades K-8340/377 (90%) of all schools with grades K-8
242/251 (96%) of public schools242/251 (96%) of public schools
98/126 (78%) of private schools98/126 (78%) of private schools
622 school-based clinics (277 second dose clinics)622 school-based clinics (277 second dose clinics)
Preliminary dataPreliminary data
Student participation:Student participation: 63,15363,153 (94%) of 67,203 students who consented(94%) of 67,203 students who consented
43% of 146,777 children at participating schools vaccinated 43% of 146,777 children at participating schools vaccinated 46% of 132,775 children aged 5-13 years46% of 132,775 children aged 5-13 years in Hawaii in Hawaii
according to censusaccording to census 18,172 18,172 children received 2children received 2ndnd dose dose 81,325 total flu vaccine doses given81,325 total flu vaccine doses given
School staff participation: ~School staff participation: ~9,281 9,281 school-based school-based staff vaccinated, representing (43%) of the staff vaccinated, representing (43%) of the workforce cohortworkforce cohort
Preliminary dataPreliminary data
Preliminary dataPreliminary data
ADMINISTERED
PREFERENCE
TIV
56%
LAIV
26%
Either
18%
0
200
400
600
800
1000
1200
1400
1600
0 to 5 6 to 10 11 to 15 > 15
Stu
den
ts
Minutes
72%
3%5%
20%
MeanMeanMediaMedia
nn ModeMode
0:050:05 0:040:04 0:020:02
**Based on n = 1,970 students at 199 schools; approx 10 Based on n = 1,970 students at 199 schools; approx 10 students/schoolstudents/school
Preliminary dataPreliminary data
Cost for 2007-2008 program:Cost for 2007-2008 program:
Preliminary dataPreliminary data
Vaccine: 1,049,096$ 50%Medical Supplies: 135,000$ 5%Print Materials: 148,278$ 5%Data Entry: 42,230$ 1%Nursing Services: 300,000$ 10%Staff: 130,199$ 5%Curriculum & Training: 35,300$ 1%Public Relations: 216,706$ 8%Courier: 19,300$ 1%Promotion & Incentives: 7,000$ 0%
TOTAL 2,083,108$
Average of $23.69 for every flu vaccine dose administered.Average of $23.69 for every flu vaccine dose administered.Average of $23.69 for every flu vaccine dose administered.
Keep kids healthy and in schoolKeep kids healthy and in school Help keep older adults and pre-school kids healthyHelp keep older adults and pre-school kids healthy Enhance our capability to respond to a potential Enhance our capability to respond to a potential
pandemicpandemic Strengthen relationships with all community Strengthen relationships with all community
partners, including public, private, professional, partners, including public, private, professional, and individualsand individuals
Mahalo!Mahalo!