Programs & Tools:

VFC-AFIX Quarterly Conference Call Minutes
January 11, 2006

Participants:

CDC/NCIRD: Nancy Fenlon, Amy Kirsch, Tasneem Malik

Grantees: AL, AK, AZ, CO, CT, FL, HI, ID, IL, IA, KS, MA, MI, MN, MS,MO, MT , NV, NJ, NYS, NC, OH, OR, PA, PHL, RI, San Antonio, SC, TN, TX, VT, VA,WI, WY

Vaccine University Update

• DTaP #4 - Four Month Interval: CPAWG committee held a conference call on December 8th. The recommendations from an earlier meeting with Drs. Rodewald and Kroger about the 4th DTaP given between 4 and 6 months of age were discussed. The ACIP footnote was the result of an ACIP committee expert panel decision. The CPAWG committee agreed upon the following steps to resolve the concern over the 4th DTaP when given between 4 and 6 months of age and the impact on the accuracy of several CoCASA reports:

  • The January CoCASA release remained on scheduled with the addition of a textbox disclaimer stating “Prior to recalling the patients on this list, please review the patient’s medical chart for the status of the 4th DTaP. In some cases the 4th DTaP may have been given off the ACIP recommended schedule but does not need to be repeated if administered between 4 and 6 months after the 3rd DTaP.” This disclaimer appears on the Invalid and Missing Immunization Reports.

  • CDC will not change the algorithms to reflect the 4th dose of DTaP as valid if given between 4 and 6 months after the 3rd dose of DTaP.

  • In the next release of CoCASA, there will be an asterisk next to the off schedule DTaP dose along with the disclaimer in the text box footnoted on the report. The asterisk and text box will appear on the Missing Immunization and Invalid Report.
    Several grantees expressed concern regarding the coverage level being low for providers who have given the 4th DTaP off the ACIP recommended schedule. If the mission and purpose of AFIX is to improve coverage levels through a continuous quality improvement approach of education and systems changes at the provider level, then as part of the FIX the appropriate interpretation and implementation of the ACIP recommended schedule should be discussed since administering DTaP #4 between 4 and 6 months after the 3rd dose is not the acceptable minimum standard.

• Vaccine University Evaluation Summary: 325 individuals registered for the conference of those registered 300 attended along with 6 walk-in participants for a total of 306 attendees. No grantee staff or CDC staff members were denied participation due to limits on attendance. 152 (50%) of the attendees returned evaluation forms and 115 individuals provided at least one comment. The overall conference rating: 85 (56%) rated the conference as Excellent, 49 (32%) rated it as very good.
  
  149 (98%) felt that Vaccine University should be a regular event. 87 (58%) stated that it should be annually and 52 (35%) that Vaccine University should be held every other year.
  
  The hotel was the biggest complaint followed by lack of snacks. The hotel issue will be addressed. The lack of snacks cannot be resolved CDC cannot purchase food for trainings or meetings. The lack of snack breaks will be more prominently disseminated to participants in the next edition of Vaccine University
  
  The Vaccine University Workgroup met on January 5th to review the evaluation results and comments and developed recommendations to forward to ISD Administration on the future of Vaccine University:

  • Recommend that Vaccine University be held every other year with the next edition to be held in 2007. The preferred season would be late spring (May - June) with the alternate date being late fall (early November before Thanksgiving).

  • Maintain a skeleton workgroup committee that would research a location for the 2007 edition- possibly at the CDC conference center or other nearby location such as the Emory Conference Center. The group would also explore how to expand the number of external members.

  • The workgroup would like the next edition of Vaccine University to incorporate more grantee based interventions used to improve their VFC, AFIX and Vaccine Management programs. This would make the content more how to improve your program coming from peers vs. being talked to by CDC. The workgroup would also extend opportunities to all grantees to become presenters at VU but develop a submission and selection method that would allow the workgroup to select the best practical information that would assist grantees in improving their programs. The process to select presenters may not necessarily be through abstract submissions.

  • The breakout session tracks will be more flexible with the ability to cross between VM/VFC and AFIX.

  • The workgroup will try to offer a variety of sessions for different experience levels from novice to experienced staff.

  • Maintain the length of VU at 2 ½ days - however try to end the full days earlier and possibly have the last session of the day be more informal and interactive.
    

• Rural States Exchange Group: A suggestion one grantee made at VU was to develop a conference call group for rural states to discuss and exchange ideas on situations that are unique to rural states. Rural state was not defined by the grantee so for the purposes of establishing membership in this group self identification would be fine. Please e-mail Nancy Fenlon @ ncf1@cdc.gov or notify her by phone at 404-639-8810) by Monday, January 30th if you are interested in establishing an exchange group and NIP/ISD AFIX staff will assist in establishing this group.

National Immunization Conference Update

NIC is scheduled for March 6 – 9, 2006 at the Omni Hotel in Atlanta. The conference is similar to last year with tracks that include: Policy and Legislation, Epidemiology and Vaccine Safety, Immunization Information Systems, Adult and Adolescent Immunization, Health and Risk Communications and Programmatic Issues. VFC and AFIX are located under the Programmatic Issues track.

• AFIX Activities: There are no workshops that are specific to just AFIX Activities at this year’s NIC. We will be having an Ad Hoc meeting on AFIX/CoCASA updates on Wednesday at lunch- it will most likely be a Q & A format – we will start around 12:30 pm to allow participants to get lunch and bring it with you to the meeting. The Ad Hoc meeting will finish up before the 2 pm session starts. The AFIX/CoCASA Ad Hoc meeting will be in the Dogwood Room. There will be a sign in front of the room.

  There is one QI workshop with some AFIX related information at that will be held on Monday March 6th from11 am – 12 noon, it is session A-5 “Improving Immunization Coverage Levels in Provider Offices and in the Community” (Dogwood Room).

• VFC Activities:

  • Monday, March 6th, 2006 B-1 2 pm – 3 pm “Preventing Cold Chain Errors”

  • Monday, March 6th, 2006 B-5 2 pm – 3 pm “Understanding Your State Medicaid Agencies: Partnerships to Improve the Effectiveness of Your VFC Program”

  • On Monday, March 6th from 12 pm – 2 pm there will be an Ad Hoc meeting: VFC 101 which is a repeat of the session conducted at Vaccine University in December 2005.

  • Tuesday, March 7th, 2006 E-5 11 am -12 noon “Every Dose Counts: Vaccine Accountability in the VFC program”

  • Tuesday, March 7th, 2006 G-5 4 pm -5 pm: Immunization Grant Workshop

  • The VMBIP Ad Hoc Meeting will be on Wednesday, March 8th not Sunday, March 5th as reported on the call. A room was not available for Sunday, March 5th. The VMBIP Ad Hoc Meeting is Wednesday, March 8th, 2006, 12 noon- 2 pm in the International Ballroom F.

CoCASA Release

CoCASA was released on the web Friday, January 6, 2006. Problems or questions should be addressed to the Help Desk 1-800-803-5212 or nipcocasa@cdc.gov. Please note that the software is too large to download from a dial up internet connect so please contact the help desk and request a CoCASA CD. Also CoCASA CDs will be sent to all AFIX coordinators within the next week.

VFC Management Survery

• The VFC Managment Survey is on the web and should be completed by March 1st. Here is the website www2a.cdc.gov/nip/grantee/AnnualReports.asp

• For the VFC Accountability portion of the survey (section III): If you have entered your 2005 VFC Site Visit Questionnaires into CoCASA, you should upgrade to the 1.3 version and then run the report titled: VFC Site Visit Questionnaire Results for CDC (in the VFC/AFIX Reports section of the reports tab).
  
  Use this report to directly enter questionnaire results into section III of the survey. If you are not using CoCASA, you will need to use the database you have to generate results for this part of the survey.

  Please note the following information related to the VFC Annual Program Management Survey.
  
  In the reports:
  • VFC Site Visit Questionnaire Results
  • VFC Site Visit Questionnaire Results for CDC
  there are two counts of providers who were given recommendations for corrective actions: (1) the number of providers that did not meet 1 or more VFC Guidelines for VFC Administration who were recommended corrective actions and (2) the number of providers that did not meet 1 or more VFC Guidelines for Proper S & H who were recommended corrective actions.
  
  These counts actually include ALL corrective action recommendations that were entered into the software (those for issues defined as high-risk as well as any other corrective actions made). Therefore, the number of providers listed in the report who received corrective action recommendations may exceed the number of providers who were non-compliant with only a high risk issue. Please do not worry about this discrepancy. Go ahead and enter the numbers listed in the 'VFC Site Visit Questionnaire Results for CDC report' into Section III of the VFC Program Management Survey.

• For questions on the survey, contact the CoCASA helpdesk.

• For 2006, use the same version of the VFC Site Visit Questionnaire as you used for 2005. All of the questions are the same. You can modify optional and/or custom questions for 2006, if you like.

Open Discussion

• VOFA

  Question: What version of the revised VOFA are grantees to work on?
  Answer: Please use the Working Draft version in the VOFA software. The Returned Recommended file is read only.
  
  Question: What changes were made in the revised version of VOFA?
  Answer: Hepatitis A and Tdap vaccine estimates for the VFC populations for each grantee were added. The estimated amount of 317 DA funding available for 2006 for each grantee is included so you should revise the 317 DA request based on the estimated available funds. Review the monthly purchasing plans for each vaccine product and revise if necessary. Review the influenza vaccine estimates. If you would like to purchase hepatitis A vaccine and Tdap with 317 DA funds, you may include the request at this time. However, the amount of 317 funds is limited so you may need to make adjustments elsewhere. You may request MMRV at this time as well

• CoCASA User Group: Stephanie Sanchez of Michigan would like to form a users group as CoCASA is being implemented. Please notify Stephanie at sanchezs@michigan.gov, of your interest by January 25th, 2006.

Next Call: Wednesday April 12, 2006 2 pm -3:30 pm

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