“EVERY SHOT COUNTS”

2016-2017 STATE INFLUENZA VACCINE

REQUIREMENTS TRAINING

FOR PUBLIC HEALTH CENTERS C O R O N A D O R O O M

A U G U S T 1 6 , 2 0 1 6

Nancy Knickerbocker

State Flu Vaccine Coordinator

County of San Diego

Immunization Program

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WHY DOES EVERY SHOT COUNT?

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♦Each year, on average, 5 to 20 percent of the U.S.

population gets the flu. Roughly $87.1 billion is taken out

of the economy each year due to influenza.

♦A study published in JAMA last year found that

adults who go a flu shot were 36% less likely to suffer

a heart attack or stroke within the next year than

those who weren’t vaccinated.

♦During the 2013-2014 flu season, 53 percent of

deaths occurred in children who were at high risk

of developing serious flu-related complications, but

47 percent of these children were healthy and had

no recognized chronic health problems.

WHY DOCUMENTING EVERY FLU SHOT COUNTS

♦Last season you administered more than

56,000 doses of flu vaccine! Thank you for

your hard work.

♦By being good stewards of State flu vaccine,

you not only reduced the burden of disease but

decreased the number of unused vaccine by

5,000 doses from the previous flu season. WOW!!

-The first State Flu Weekly report is due every

Monday after you receive your initial state flu

allotment.

-All vaccine doses must be reported. .

-We will need to know the date when you

will begin giving flu vaccine.

-The work week is considered from

Monday to Friday/Saturday.

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OTHER NEWS

Yes, it’s true: your manual flu vaccine count needs to

match your SDIR vaccine usage report, and your weekly

State Flu Weekly Usage Report. 5

♦Even if you do not give flu vaccine the week the Flu report is

due, submit the State Flu Weekly Report noting no vaccine

was administered.

County of San Diego Immunization Program (SDIP) Website

•The SDIP website (www.sdiz.org), under the ‘Health Care Professionals’

section, contains a new Influenza Information Webpage for Providers.

●Included in this webpage will be:

-flu-related PowerPoints

-guides for storage and handling

-pertinent forms

-influenza Vaccine Information Statements and more. 6

OTHER NEWS WORTH MENTIONING

▪ The State requires us to report

flu vaccine usage intermittently.

▪ Reports to the State are due on:

December 1st, February 1st, and

July 1st.

▪ We will be tracking expiration dates of

flu vaccine closely, notifying you to use

vaccine the shorter expiration dates first.

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2016-2017 Influenza Requirements

for Tracking State Flu Vaccine Usage

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STATE FUNDED FLU WEEKLY REPORT CHANGES

3) Enter the weekly report dates.

1) Fill in your Organization & Site info.

4) Enter all of your state flu products & their Lot #; tally

every dose of each vaccine administered by indicating

the patient’s age range, and finally total the number of

doses given per vaccine.

5) Every week you are required to do a manual count of your state

flu vaccines, enter the doses on hand, and the number of doses

wasted & extra. NOTE: EXPIRED DOSES ARE NOT WASTED DOSES!

6) Note if you transferred, received, or returned any

State flu vaccine during the reporting week.

7) Check if you entered vaccines into SDIR , are using an

EHR , or gave no flu vaccines, & attach your weekly SDIR Usage or EHR Vaccine Usage to this report.

8) Print your name, sign, and date this form before submission.

2) Fill in the date & amount of your

initial flu allocation.

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▪All unopened/expired State flu vaccine must be

returned to HHSA Rosecrans at the end of your

organization’s flu season (for Community Health

Clinics that is July 1st.)

▪Wasted and opened expired vials) must be noted in Section 2. on the

Weekly Flu report. Use ‘W’ for wasted doses; use ‘D’ for expired

unopened vials you are disposing of at the end of the season. Example of

section 2:

2. ACTUAL MANUAL COUNT OF STATE FLU INVENTORY DOSES AT THE END

OF THE WEEK (the week is Monday-Friday/Saturday)

Product Name & Lot # Number of

Doses

on Hand

Number of Wasted Doses (or

if you disposed of opened

expired vaccine, Code ‘W’ for

wasted, ‘D’ for disposed.)

Number of Extra

Doses (Multi–Dose

Vials only)

Example: FluLaval MDV , #F1234 19 W: 1-(Got only 9 doses

from vial)

Example: Fluzone MDV, # AB9876 16

Got one extra

dose from vial

ONCE YOUR WEEKLY FLU VACCINE REPORT IS COMPLETED

♦The subject line in the fax or email should be addressed as “State

Flu Vaccine Weekly Report-with the weekly date range and the name

of the Organization/Site/POD”.

♦Attach your weekly SDIR Usage or EHR to

the Weekly State Flu Vaccine Report for

the same date range.

♦The totals from your manual count, SDIR

count, and State Funded Weekly Flu Report

should match.

♦The reports can be emailed or faxed. FAX: 619-692-6619

Email to: sdir@sdiz.org.

WHAT’S NEW WITH PODS?

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♦ New this season: State Flu vaccine for Flu

PODs will be coming directly from your

vaccine inventory.

Remember to transfer State flu vaccine to

the SDIR #198 site prior to your flu POD.

Note State flu vaccine being transferred

to and from the POD site in SDIR and the

Weekly Flu Report.

State Flu Vaccine and SDIR

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▪SDIP staff will review that the flu

vaccine was entered correctly so that it

displays on SDIR reports and the yellow

card.

▪SDIR users must enter State flu

vaccine into the SDIR vaccine

inventory within 24hrs.

TO MAKE THIS EASIER, WE ARE PROVIDING YOU WITH SCREEN SHOTS OF HOW EACH STATE FLU VACCINE SHOULD BE

ENTERED INTO SDIR:

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SDIR DISCLOSURE STATEMENT

Reminder:

Parents/legal guardians

and patients must be

informed, at every visit,

that their child’s or their

immunization record and

TB test results will be

shared. They have rights

as outlined in the San

Diego Immunization

Registry Disclosure

Statement. 16

First Search for the Patient

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THE DEMOGRAPHICS TAB

▪IMPORTANT: Before a vaccine can be selected from the

“Add IZ from Inventory” link in the yellow Immunization tab,

it will be required that a User must indicate the patient’s

vaccine source under the ‘Vaccine Eligibility’ field.

▪For State funded flu vaccine, select the ‘State General

Funding’ under the ‘Vaccine Eligibility’ column by using the

down arrow. 18

ADD IMMUNIZATIONS FROM THE ‘ADD IZ FROM INVENTORY’ LINK

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▪When a User selects State General Funding under the ‘Vaccine Eligibility’

field in the ‘Demographics’ tab, only State General Fund vaccines will

display in ‘Add IZ from Inventory’ link.

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SCREEN SHOT FROM THE ‘ADD IZ FROM INVENTORY’ LINK: WHEN ‘STATE GENERAL FUNDING’, IS SELECTED FROM THE ‘DEMOGRAPHICS’ TAB

▪Notice under the ‘Vaccine Notes’ column, a description for age ranges for

influenza vaccine will be included. This description is automatically added

by SDIR when the vaccine is initially entered into the vaccine inventory by

the vaccine coordinator/manager.

▪The Lot Description (Lot Desc) column allows the vaccine coordinator to

add comments about the vaccine in the ‘Lot Details Section’ under the

‘Vaccine Inventory’ link in the ‘Utility’ tab/Administration tab.

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ENTERING NEW VACCINES. CLICK ON THE BLUE ‘ADD NEW VACCINE INVENTORY’ LINK.

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HOW YOU ENTER THE STATE FUNDED FLU VACCINE IN SDIR IS CRITICAL TO ACCURATE WEEKLY REPORTS!

▪Why? Because State

funded vaccine have

specific display names

connected with CVX

codes.

▪If you choose the wrong

vaccine display name

and/or manufacturer,

your SDIR weekly

report will be inaccurate.

▪If this occurs, you will have to delete all the shots entered incorrectly and

re-enter them using the correct vaccine display name and manufacturer. 23

ENTERING VACCINE INFORMATION

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3. *Enter vaccine doses in the ‘Incoming Quantity’ field only. If the vaccine comes in a multi-dose

vial, check on the box next to ‘Multi-Dose Vials’. DO NOT ENTER in ‘Quantity on Hand’ field.

6.The ‘Warning’ field will default to 30 days. The ‘Expiration/Warning Notice’ fields default to ‘Yes’.

7. When entering the vaccine lot number, always use the lot # on the vial. Capitalize any letters in

the lot #. If the vaccine lot # has a dash followed by a number do not enter them (e.g., if the lot # is

ABA12345-2, do not enter the -2).

9. Use the down arrow in the ‘Vaccine Source’ field to select State General Funding. Finally, click

the green ‘Insert’ button.

5. Enter ‘Date Received’ & ‘Expiration Date’ fields. 4. The ‘Use Today’ field will default to ‘Yes’.

8. You may enter a comment in the ‘Lot Description’ field.

2. Use the down arrow to select the vaccine ‘Manufacturer’. If there is only one ‘Manufacturer’ for a

vaccine, this field will automatically fill in with that manufacturer’s name.

1. Use down arrow to select vaccine.

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▪The Lot Description comments will appear under the ‘Lot Desc’

column under the ‘Add IZ from Inventory’ link.

■Please note the User will need to scroll all the way to the right to

view this information. 25

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HOW TO MAKE AN ADJUSTMENT TO YOUR VACCINE INVENTORY

Adjustments to your inventory are made whenever you:

▪Add vaccines (e.g., vaccines with the same lot #, same expiration

date, and same vaccine source)

▪Waste vaccines (This includes if you got less doses from a multi-dose vial.)

▪Transfer/receive vaccines to or from another provider, site, or POD.

▪Make any other changes to your vaccine inventory.

▪Next click on the blue ‘Inv ID’ number next to

the vaccine you want to adjust.

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Let’s waste a dose of Fluvirin MDV,

Inv ID # 3794, by ‘Making an Adjustment’

▪In your SDIR Vaccine Inventory, locate the Fluvirin #3794, and click on

its blue ‘Inv ID’ number. ■Go to ‘Make an Adjustment’ and note the wasted dose.

DOCUMENTING EXTRA DOSES OF FLU VACCINE IN SDIR FROM MULTI-DOSE VIALS

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1. Once you’ve clicked on blue ‘Inv ID’, go to the ‘Make an Adjustment’ section.

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2. Enter the “Quantity’ (doses that are extra), and ‘Date’ fields.

3. Under the ‘Type’ field, click the down arrow to ‘Other –Incoming’. Enter a ‘Comment’ (e.g., extra dose.)

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4. Click ‘Insert’.

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5. Information is then documented under the ‘Lot Activities Summary’.

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▪Start by clicking on the blue ‘Inv ID’ # of the Vaccine with the

Same Lot #, Same Expiration Date, and Same Vaccine Source.

▪Let’s add 30 doses of incoming Influenza LAIV with the same lot #, expiration date,

& same vaccine source as Influenza LAIV blue ‘Inv ID’ #129569. Notice there

are 20 doses in the ‘Qty’ (quantity) field.

▪A new incoming vaccine with the same lot number, same expiration date, &

same vaccine source, as an existing vaccine in your SDIR vaccine inventory,

is added to that vaccine by making an adjustment.

ADDING INCOMING VACCINES THAT HAVE THE Same Lot #,

Same Expiration Date , & Same Vaccine Source (VFC, Private,

317, or ST) AS VACCINES ALREADY IN YOUR INVENTORY.

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2. Enter ‘Quantity’ (30 doses) & the date you are adding this to the existing vaccine.

3. Under ‘Type’, use down arrow to select ‘Doses Received from State Provided Vaccines &

make a note under the ‘Comment’ field.

4. Click ‘Insert’.

5. The ‘Lot Activities Summary’ will note the added 30 vaccine doses.

6. The ‘Total Adjustment’ & ‘Quantity on Hand’ fields reflect the added 30 doses.

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1. Once you’ve clicked on blue ‘Inv ID’ # 129569, go to the ‘Make an Adjustment’ section.

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5. Information is then documented under the ‘Lot Activities Summary’.

2. Enter the “Quantity’ (doses you are transferring), and ‘Date’ fields.

4. Click the ‘Insert’ button.

3. Under the ‘Type’ field, click the down arrow to ‘Doses Transferred to Another Provider’. Enter

a ‘Comment’ (e.g., where vaccine is being transferred, by whom).

1. Once you’ve clicked on the blue ‘Inv ID’ # 3792, go to the ‘Make Adjustment’ section.

HOW TO ‘MAKE AN ADJUSTMENT’ FOR THE DOSES YOU WANT TO TRANSFER TO OTHER SITES.

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USE THE WEEKLY STATE FLU REPORT TO NOTE ALL TRANSFERS TO AND FROM OTHER SITES

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▪If you did not receive

or transfer any

vaccines during the

reporting week, check

‘NO’ in Section 3.

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IMPORTANT: You will also document how much flu vaccine you receive

or transfer to another site. After you receive your initial flu

allotment, you will document any further vaccines you

transfer, receive, or return in Section 3. See Example below:

3. DID YOU TRANSFER, RECEIVE, OR RETURN STATE FLU VACCINES (RETURN TO ROSECRANS

MEANS UNOPENED VIALS, PF SYRINGES or EXPIRED DOSES), DURING THE SAME WEEK OF THE

REPORTING PERIOD?

□ NO □ YES, please fill out the vaccine information in the section below:

DATE

Product Name & Lot # Number of

Doses

Method Name of SITE vaccines transferred to, received

from or returned to HHSA Rosecrans)

11/5/2016 EXAMPLE:

FluLaval

Lot # FL123456

60 □Transferred to

□Received from

□Returned to

HHSA

60 DOSES transferred to the

Northgate Flu POD site.

11/7/2016 EXAMPLE:

FluLaval

Lot#FL123456

10 □Transferred to

□Received from

□Returned to

HHSA

10 Doses received from the

Northgate POD site.

THINGS WE DO NOT WANT TO SEE IN SDIR

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Missing

documentation-where

did those doses go?

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F

♦Leftover SDIR inventory from a Flu POD. Where did these

doses go?

ARCHIVING STATE FLU LOTS

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♦All State flu lots must be at zero (0) doses before they can be

archived. This includes all PODs. You must explain where every

dose went in the ‘Make an Adjustment’ section.

♦Begin by clicking on the blue “INV ID’ link of the State flu lot to

be archived.

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1. Select No in the ‘Use Today’ Field.

2. Check the ‘Archived’ box.

3. Click the ‘Update’ button.

Archiving in 1, 2, 3 Steps

Running Your General State Funded Influenza ‘Vaccine Usage’ Report

▪It can be found by clicking on the ‘Utility’ tab, then the blue ‘Reports’ tab.

1. Click on the dark blue ‘Reports’ tab

2. Put your cursor on the ‘Immunization’ column

3. Click on ‘Vaccine Usage’ report link.

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THE VACCINE USAGE REPORT

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▪Select your Facility.

▪Enter the IZ date range.

•Next to the ‘Include’

field, use down arrow to

select ‘State General

Funding’ . •Select to run the report in

a PDF or Excel Format.

Click ‘Submit’.

CHANGES TO THE VACCINE USAGE REPORT

▪The ‘Vaccine Usage’ report gives you the number of vaccines given

by dose, age group, and date range entered.

▪The ‘Grand Total’ and ‘Patient Count’ are at the bottom of the report.

▪A copy of your weekly SDIR Vaccine Usage Report or EHR report must also

be attached to the State Flu Weekly Report and the counts must match. 40

THE SDIR DAILY IZ REPORT

Click ‘Submit’. 41

▪Select your Facility.

▪Enter the IZ date range.

•Next to the ‘Include’ field,

use down arrow to select

‘State General Funding’ .

•Select to run the report in

a PDF or Excel Format.

•Select the age range.

▪You can use the Daily IZ Report to compare the State Flu totals

with the Vaccine Usage Report.

▪Be aware the Daily IZ will also display State Tdap for those

Providers who are enrolled in the State Tdap Program for

pregnant women and their close contacts.

DAILY IZ REPORT

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●The Daily IZ report can be compared with the Vaccine Usage Report.

●It will display the total patients by vaccine source as well as the total

number of immunizations by vaccine source.

WHAT IF THE SDIR FLU VACCINE NUMBERS DON’T MATCH?

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The most common reasons why the numbers don’t add up:

▪All vaccines, transfers, doses wasted, &/or adjustments have not been entered into SDIR.

•Vaccines were entered into ‘Add IZ from Inventory’ with the wrong vaccine lot number or

in error. Another scenario: the vaccine was entered into the EHR instead of SDIR.

IMPORTANT: Always delete the vaccine if the lot number, the vaccine dose (e.g., an adult

dose was entered instead of pediatric dose), and/or the type of vaccine were incorrectly entered. Re-enter the correct vaccine information in ‘Add IZs from Inventory’.

•If you still can’t balance the numbers, use your patient information system/billing

report/EHR to generate the date range with the influenza vaccine and number and of

patients to whom you gave vaccines. We can also run a Lot Usage report for you.

•Relying solely on your SDIR Vaccine Usage Report instead of doing a manual count

and reconciling the vaccine numbers with the SDIR count.

•Computational errors. Check your weekly State Flu Usage Reports. The manual count,

SDIR/EHR/Vaccine Administration count, and State Flu Weekly Report should all match.

Finally, you can always call the

County of San Diego Immunization Program for

further assistance:

Nancy Knickerbocker,

State Flu Vaccine Coordinator

Phone: 619-692-5738

Fax: 619-692-6619

Email: Nancy.Knickerbocker@sdcounty.ca.gov

44 Updated 8/16