2008 National Immunization Conference
Ad Hoc Questions and Answers

Question: 	The shipping data are not coming back to VACMAN accurately. The number of doses, date, and lot numbers are wrong.
Answer: 	The information in VACMAN comes to VACMAN from McKesson Specialty Distribution.  This falls into one of the CQI measures, which is data integrity.

Question: 	The reconciliation process of doses and monthly replenishment does not match up with McKesson Specialty Distribution reports and VACMAN data. Is anyone looking at this and when will we have reliable data?
Answer: 	Yes, we are looking at this and we are not sure when it will be corrected.

Question: 	What are the current problems with VACMAN and what is being fixed and when?
Answer: 	It appears that CDC may be getting the receipt information from McKesson Specialty Distribution, but the receipts are not being packaged to return to the grantees.  We are researching this issue. 

Question: 	What will the new patch on VACMAN do?
Answer: 	Fix the minimal order quantity problem, assist with data matching up, and other bugs reported with VACMAN 4.1.3.  (See below.) 

Question: 	With the new VACMAN, we can not run reports of doses shipped.
Answer: 	We will send a change request to the control board for this.

Question:	Can the report of orders pending be sent to the grantee?
Answer:	Grantees can review pending orders in VACMAN by looking at “Orders Entered, Not Yet Sent to CDC” and “Orders Sent to CDC, Not Yet Shipped” reports.

Question:	Why do we find out about cancelled orders only after calling CDC?
Answer:	Now we have a system in place where grantees receive cancelled orders by email.

Question:	How should we handle excise tax credit?
Answer:	We are preparing an All Grantee Message and will send that very soon.

Question:        We are still having problems with the daily shipping log.  We have situations where a provider has received the order and receipt of the order is not on the shipping logs for at least the next three days.  We reported to Leigh at McKesson Specialty Distribution.
Answer:           We did have some technical issues upon automating this report.  Our IT department has been working on these issues.  Please remember to report all problems to McKesson Specialty Customer Care.

Question:        When we receive the scanned packing slips or invoices from McKesson Specialty Distribution for our state and 317-FA purchases, they are not readable.
Answer:           Please contact McKesson Specialty Customer Care and a new copy can be sent.

Question:	I am frustrated with the data. Why does an order go through three different systems at McKesson Specialty Distribution?
Answer:           There are actually two systems at McKesson Specialty Distribution although we are looking at options to resolve any confusion by using SAP only.  It is not easy to do.  Our goal is to have it resolved by January 2009.

Question:        If DT arrives frozen, does it go against the grantee’s funded DT?
Answer:          No

Question:        Will the Sacramento facility meet same performance metrics as Memphis is supposed to?
Answer:          Yes, they are held to the same standards as Memphis.

Question:        VMBIP was supposed to free up resources, but now it is using these resources.  Are grantees going to get more resources and or funding?
Answer:	We realize that the ordering process is more labor intensive for grantees than what was done previously.  We are requesting some additional funding from the Office of Management and Budget to help with the ordering process until VTrckS is operational and providers do their ordering.  We have reduced the grants awards for distribution costs, because those costs are now being supported through the federal contract with McKesson Specialty Distribution.

Question:        What is the future of VACMAN’s replacement?
Answer:          The blueprint for VTrckS is being reviewed.  A blueprint is a process model that defines the VTrckS scope of functionality and identifies
process gaps, development requirements, etc.  Reviewing the blueprint requires extensive involvement from business subject matter experts and Information Technology.  We are including grantees in this process review. After the review process and approval is completed, we can begin building the system. We anticipate a completion date for the 2nd quarter of 2009 with piloting and roll-out to follow.  
 
Question:	Help me understand the Hib vaccine allocation process.
Answer:	This answer was from a May 1st communication from Dr. Greg Wallace:  “We used the grantee bulk order data for 2006 to determine the allocation basis.  We did not want to use 2007 bulk order data due to transitioning and draw down tools.

For CY2006, Maryland’s monthly average Hib purchases were 4,800 doses of PedVaxHib, 4,600 doses of ActHib and 100 doses of Comvax.  For a 3-dose schedule we took 75% of the ActHib number plus the total PedVaxHib plus Comvax since it is being replaced with ActHib during the shortage.  This gives a basis of 4,800 doses.

How much each grantee gets each month depends on the total amount available for the month and the grantees all get the same proportion.

This approach was done for all of the grantees.  I know this shortage is very difficult for the grantees and the providers because they must be using all they get as soon as it comes and then have to wait for more.  But going to a 2-dose schedule would mean up to 300,000 doses a month would not be recommended for use and would decrease protection.  So, I know that everyone is struggling to keep up with a 3-dose schedule, but going to 2 doses would mean vaccine not getting used in a shortage.

Also, perhaps of interest, we did a provider survey in April which showed that 18-30% of providers were still giving the 12-15 month booster dose while 12-15% weren't giving the 6-month dose presumably due to supply.  So, there may be an opportunity for provider education for those still giving the booster to defer and free up some doses.”

Question:	My state took a big hit because we were PedVax only and most of our PedVax in the field was in the recall. 
Answer:	The answer given at the NIC is out of date, and is being replaced with this one:  The Vaccine Supply and Assurance Branch obtained a modest amount of additional Hib vaccine from sanofi pasteur in April and allocated that vaccine selectively to states who were disproportionately affected by the Hib vaccine shortage.

Question:	Why do we get 25 percent of our HIB allocation each week?
Answer:	The answer given at the NIC is out of date, and is being replaced with this one:  Grantees are no longer restricted to ordering only 25% of their monthly Hib allocation per week.  Please use discretion in determining how much of the monthly allocation to order each week.  There should be sufficient doses to cover Hib orders as long as all grantees do not put all their orders in on the first of the month.  As long as grantees pace their ordering, we should not experience any more Hib inventory stock outs.  As you can see from McKesson' Specialty Distribution’s performance metrics, McKesson Specialty Distribution is shipping out the vast majority of orders within three shipping days, so please refrain from using the "urgent" order box in VACMAN for Hib orders unless absolutely necessary.

Change Request Précis VACMAN 4.1.4.

Expected release date is summer 2008.  
The following were approved by the Change Control Board (CCB).

Description

Cancellation Reasons.  Provide refined definitions with the status codes in VACMAN.

Vaccine Order Type Flag.  Add a flag on the order record to indicate that the order is 
Non-Federal (state funded).  

Override Flag for Minimum Orders.  Allow grantees to order less than the minimum 
order size (example 1 dose versus Unit x Pkg Size) for selected vaccines.  This 
functionality will be available only on the provider order or multi order screen.

Provider Enrollment versus Doses Ordered (CkProvProfile Doses Order).  Need to have
quantity of doses ordered bump up against provider profile information.

Add RecType to MSH.  Developers need the ability to rebuild stock records in the users’ 
datasets.  This change will allow us to automate returning lost stock records back to the 
users’ datasets.

Urgent Flag for Non-CDC Orders.  Grantees need the ability to designate non-CDC 
vaccine orders as Urgent.

Transaction Screen.  (1) User requests ability to type-in data on the Transaction Screen.  (2) Increase width of expiration date column in the lot drop down list. (3)  VACMAN is changing doses to zero after a record is saved if the user does not tab off of the Doses field.

Validate NDC and Minimum Order.  Registry grantees that cut and paste vaccines into 
the new orders table bypass all the validation checks in VACMAN, and we continue to 
get orders with invalid NDCs, etc.

Cancellation Report.  Add cancellation information to the existing backorders report 
available in VACMAN.

Orders Transmitted and Not Yet Shipped report.  Add filtering capability to report so that 
it is consistent with other report formats in VACMAN.  (Filter on date range and PIN, 
etc.)

The following contained a bug and CCB approval was not required.
Description

Import and Export of Non-Federal Orders.  WA tried to import order for DT and was  and unsuccessful

Flu Order Issue.  The flu screen allows users to order minimum order of 1 dose.  When the vaccine unit = 10 and pkgsize =1, minimum order should be 10.  The current logic allows users to order doses below the minimum requirement

Order History does not show multiple receipts.  The order history is not showing vaccine orders with multiple receipts.  When there are multiple receipts for an order the Order History should reflect the total number of receipts for the order (e.g., receipt 1 of 3, 2 of 3, etc.)

Provider Mailing Zip Code.  NE reported an issue with Provider Mailing Zip Code.  When the user tried the Copy Shipping information button to the mailing information, the mailing zip code was not saving the mailing zip code data.

Report Selection by Presentation.  Users are unable to select reports by vaccine presentation or maker or NDC number.  (Example:  Flu by specific presentation.  User retrieves data for all flu orders, but needs ability to validate McKesson Specialty Distribution inventory balances so should be able to narrow flu orders on the report).

Shortcuts not Working on the Doses Administered screen.  Shortcuts for Doses Administered, Non-CDC vaccines, is not working when user presses the Tab or Return keys.

Provider Search.  Utah reported when searching for PIN 7, the result returned PIN 70. 

Vaccine Dropdown - Not Delete Condition.  When a new contract file gets pushed to the grantees and updates the vaccine tables, users are still able to order vaccines that went off contract because it still appears in the dropdown.

2008 Flu Season Order Pre-Booking.  Grantees need the ability to pre-book flu orders prior to the start of the 2008 and 2009 flu season

Modify Backup Function.  The backup function has created a duplicate data folder within the VACMAN data directory; the application does not know which data folder to read and write to.

Import Bug.  When importing a Direct Ship order, if the first record is rejected, the remaining records are also rejected.  When importing Provider Orders, the system rejects on a good provider PIN.

Doses Admin Report bug.  The Doses Admin report is not showing the correct data.

Doses Distributed vs. Doses Admin Bug.  The Doses Distributed versus Doses Administered Report displays different data for a provider than the data on the Transaction Report for the same provider.

Doses Admin screen bug.  When user adds a Non-CDC vaccine, the screen will not display the Non-CDC vaccine correctly.

This document can be found on the CDC website at:
http://www.cdc.gov/vaccines/programs/vmbip/downloads/nic/08-nic-vmbip-ah-mt.rtf