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Tuesday Jul 19, 2016

Leveling the Playing Field: AAFP Tackles Flu Vaccine Supply Issues

Last summer, manufacturers started shipping influenza vaccine in August. Signs promoting "Flu Shots Available" soon popped up in front of retail clinics, and those same clinics and large regional grocery stores hawked the availability of their vaccine in broadcast ads and on in-store materials. The CDC, meanwhile, urged consumers to get vaccinated by October.

Getting people vaccinated is certainly a good thing -- no argument there. More than 200,000 Americans are hospitalized each year for influenza and flu-related complications, and the AAFP strongly recommends flu vaccination for all people ages 6 months and older who do not have contraindications.

The problem presented by the scenario mentioned above is that while Walgreens, CVS and supermarkets were rolling out their influenza vaccination campaigns, primary care practices in the same communities were waiting -- and waiting -- for their vaccine supplies to arrive. The issue we saw last summer wasn't limited to one manufacturer, one community or even one state. And it's not a new problem. As we AAFP officers visit state chapters around the country, we hear this story repeated again and again by members, along with a plea to prevent it from happening in the future.

Family physicians who receive their flu vaccine four to six weeks after other vaccine providers in their communities do face a conundrum. We often care for some of the most frail and vulnerable members of our communities, and those high-risk patients are faced with the choice of waiting until we have our supply (putting them at even greater risk) or getting immunized somewhere else.

And when patients do go elsewhere for immunizations, it disrupts continuity of care, and our practices face the double whammy of lost income and being stuck with too much supply.

AAFP policy calls for vaccine manufacturers and distributors to "deliver adequate, timely and complete orders of immunizations recommended by the AAFP to family physicians in a prioritized manner to most effectively achieve vaccination of patients within their medical home."

So why do retail clinics and grocery stores continue to receive their vaccine supplies several weeks ahead of physicians in the same communities? This was a key part of the conversation when leaders and staff from the AAFP recently met with representatives from one of the nation's largest vaccine manufacturers. The company's representatives said they have looked into complaints about this issue and found that shipments were not biased toward any particular business model or prioritized based on quantity. At the same time, however, they acknowledged they had no control over how their vaccines were handled by third-party vendors and emphasized that physicians have the option of ordering directly from the manufacturer. The representatives also said they could not speak for other manufacturers.

In addition, AAFP staff members participate in conference calls with vaccine manufacturers, CDC officials and other health care organizations at least once a month throughout the year to discuss a wide range of immunization issues. The Academy continues to advocate for fair and appropriate flu vaccine distribution as part of these conversations, and this topic undoubtedly will be covered during these calls again this summer.

And make no mistake -- we will be strongly emphasizing this topic (and other important immunization issues) when the AAFP hosts an immunization summit Dec. 5 with many of the nation's vaccine manufacturers. As more information about the underlying causes, impacts, opportunities and remedies become available, we will keep our members informed.

Wanda Filer, M.D., M.B.A., is president of the AAFP.

Comments:

There may be only one way to get Vaccines on time. Group purchase and advertise. Local ACO's and Primary Care Group Practices unite to order.Combine that with a renewal of Family Health Month programs. Also, share with FM solos.

Posted by Robert Nicewander on July 23, 2016 at 10:09 AM CDT #

I have ordered flu vaccine from vendors and manufacturers in the same season and am always weeks behind the big pharmacies. So that explanation is false. Also the summit on Dec 5 means another flu vaccine season down the drain. It's just business. CVS can provide medical care in a Minute Clinic, but I can't dispense medication. It's just business.

Posted by Robert L. D'Agostino, MD on July 23, 2016 at 03:59 PM CDT #

This has been a major issue for years! Our practice orders at least 1000 flu vaccines each season directly from the manufacturers (Sanofi Pasteur, Merck, and GSK). We are informed by them that there is a "vaccine shipment protocol" that automatically sends to retail pharmacies and grocery stores before private practice orders. If AAFP actually wants to help solve this problem, should advocate directly with these 3 manufacturers. Why wait til December when a simple phone call to these manufacturers would help THIS flu season. Please update us on this ASAP.

Posted by Craig White, M.D. on July 25, 2016 at 02:36 PM CDT #

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