Getting the shots! Let’s get all kids immunized Lawrence J. Losey, MD, FAAP Brunswick Pediatrics,...
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Transcript of Getting the shots! Let’s get all kids immunized Lawrence J. Losey, MD, FAAP Brunswick Pediatrics,...
Getting the shots!Let’s get all kids immunized
Lawrence J. Losey, MD, FAAPBrunswick Pediatrics, CMMG
Shot Schedule, 1979
2 Month DTP Oral Polio
4 Month DTP Oral Polio
6 Month DTP Oral Polio
12 Month MMR
18 Month DTP Oral Polio
5 Year DTP Oral Polio
Every 10 yrs Tetanus or Td booster
Shot Schedule, 2011(ignoring combo vaccines)
Birth Hep B1 Month Hep B2 Month DTaP IPV PN13 HIB Rota4 Month DTaP IPV PN13 HIB Rota6 Month DTaP PN13 (HIB) (Rota)9 Month Hep B IPV
12 Month
HIB PN13 Hep A
15 Month
DTaP MMR VZV
18 Month
Hep A
5 Year DTaP IPV MMR VZV11 Year TdaP MCV4 HPV16 Year MCV4
YearlyInfluenz
a
SkyrocketingCost
19819800
19961996 20002000 20062006 20092009
DTaP/DTaP/DTwPDTwP
37 96 114 105 152
Td/TdaPTd/TdaP 2 6 17 36 56
PolioPolio 5 51 68 91 125
MMRMMR 15 93 90 81 125
HepBHepB 42 51 64 100
VZVVZV 64 59 104 251
PCVPCV 0 219 277 333
MCV4MCV4 0 0 82 123
HepAHepA 0 0 61 78
Flu <3Flu <3 0 0 52 52
Flu >3Flu >3 0 0 22 167
RotaRota 0 0 190 296
HPVHPV 0 0 360 478
TotalTotal 59 352 618 1525 2554
How have we paid?In 80’s cost was minimal
In 90’s developed “Gentlemen’s Agreement” with MCO’s for universal coverage--about $1M/yr
Fell apart for multiple reasonsMore Vaccines
More expensive
More “self-funded”
Less “317” money from CDC
For brief period, only VFC children
State funding allowed “universal select” for school mandated
Solving the Cost
PL595 Passed last year, established Maine Vaccine Board
Provides funding mechanism to immunize ALL Maine children through insurance/TPA assessments
Vaccines to be available January 1, 2012
Vaccines for ALL diseases recommended by ACIP
Assessment budgeted at $6.98/PMPM (<19)
How will it work?
Maine Vaccine Board--10 members (3 Insurers, 3 providers, 1 from self-insured [employers], 1 from industry, one each from DHS & state treasurer)
Establish vaccine list, budget, assessment
Collect money from insurers and TPA and send to Maine Immunization Program
How do you join?
Same as current vaccine for VFC
Will need to use ImmPact2 for ordering
Can be simply aggregate reporting, not by dose (lose biggest benefit of registry then)
Will need to anticipate for ordering in fourth quarter (from Maine Immunization Program and private sources)
Unsure what insurance company will do in interim for payment for purchased vaccines
How do we prepare?
Aim for zero stock of privately purchased vaccine on 1/1/12--realistically need some to assure full vaccines until then
Participate in Maine Immunization Program--if currently using for VFC, you are all set
Use ImmPact for ordering and inventory (also use for full registry if possible)
Decide which vaccines and what schedule you will use