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Story from the Field

Name of Health Department/Agency: Seattle & King County Public Health Department
State: WA
Date Added: 12/21/2009
Themes: Vaccine Supply and Distribution
Issue Summary: National and Regional Pharmacy Chain Participation in H1N1 Vaccine Campaign in WA
Description of Issue(s): In Seattle, we incorporated pharmacies from the first day. Our first shipment of vaccine was 20,000 doses of flumist. We targeted that exclusively to healthcare workers and EMS. But not all healthcare providers had registered to receive vaccine, and not all EMS agencies had completed contracts with occupational health to order and administer their vaccinations.
Actions taken to address the issue(s): We asked Safeway to serve as a vaccination station only for HC workers and EMS who otherwise did not have access to vaccine (similar to what Texas did with Tamiflu in the spring for the public). Safeway selected 14 stores around the county, we gave them 100 doses per store. This guaranteed that any HC worker who qualified for flumist at least had access to it early in the event. We could not have done this without a close working relationship with our pharmacy partners.

After the first week, we continually faced the challenge of ensuring that vaccine got only to those who needed it most (which was most likely going to happen through doctors offices) while recognizing that not all HC providers ordered vaccine, so their patients would have absolutely no chance at receiving vaccination early unless there was another option. To bridge this gap, we incorporated pharmacies very early in our distribution strategy. We picked several large chains including Rite Aid, Walgreens, Safeway, Albertsons, QFY, Fred Meyer, and several local pharmacies. We spread the doses around geographically and required the pharmacies to screen for priority group status. We also tracked availability on an interactive website we developed on the fly (see below).

Outcomes that resulted from actions taken: The drawback here is that screening took place on the honor system. Your doctor is the only one who really knows if you have an underlying health condition. We did not ask anyone coming to a pharmacy to prove their condition. Yet we believe most people were honest and it did provide access to those priority group populations who otherwise had no chance. We allocated about 25% of our weekly allotment to pharmacies, the rest going to HC providers.

Drawbacks included dealing with corporate representatives who often left their store managers out of the loop. In a tight, highly visible logistics operation, communications in real time between all parties is key. Some bigger chains did not always practice this. Also, Rite Aid insisted all their vaccine go to Ohio first, then to Seattle. Since the vaccine was coming from California, this seemed quite odd to us and slowed them down by a few days, but that's how they wanted to do it.

Overall, they are great partners, very capable and a cornerstone of our dispensing strategy for pills, vaccine, information, etc.

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