COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

May 20, 2005

BOARD MEETING DATE:

June 7, 2005

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director, Health Department
Scott Morrow, Health Officer
Brian J. Zamora, Director, Public Health & Environmental Protection

SUBJECT:

2004-05 Flu Response Report

RECOMMENDATION:

1.

Accept the report highlighting the Health Department’s response to the 2004-05 flu season.

2.

Recognize the medical providers who contributed vaccine to the County in support of flu response.

VISION ALIGNMENT:

Commitment: Ensure basic health and safety for all

Goal(s): 5: Residents have access to healthcare and preventive care.

This report contributes to this goal by reporting on activities that allowed for distribution of influenza vaccination during a period of severe vaccine shortage.

BACKGROUND:

The Health Department is responsible for planning the community’s response to the annual need for flu vaccine. Public Health typically provides about 5% of the total flu vaccine given in San Mateo County each year. We focus our effort on populations which are most vulnerable. In the Summer of 2004, the Immunization Staff in Public Health developed the annual flu response plan. This plan includes ordering vaccine, planning and staffing 30 clinics at community and senior centers, and informing the public. The first flu clinic was scheduled for early October with the last clinic scheduled before the Thanksgiving holiday.

DISCUSSION:

On October 5, 2004, Chiron Corporation notified the Centers for Disease Control and Prevention that its license to manufacture flu vaccine had been suspended. The result of the suspension is that no vaccine was shipped to the United States from Chiron’s plant in England. This impacted San Mateo County severely because most private and almost all public vaccine had been ordered from distributors who were ultimately to be supplied by Chiron.

On October 8, 2005, Dr. Scott Morrow, Health Officer, requested that the County Manager declare a Local Emergency in the county. This was ratified by your Board in special session. The State also declared a State of Emergency. Subsequent to the emergency declaration, orders were issued to all medical providers to cease giving influenza vaccine to other than high-risk patients. Since this shortage would clearly result in rationing, we felt it was important to do so by the most effective and ethical means possible. Dr. Morrow met with the medical community to develop the county’s influenza vaccine distribution plan. The distribution plan was disseminated to the public by an aggressive use of the media, flu hotline, website, and phone queue. Over a period of several months, the State provided additional vaccine in five phases and it was distributed according to this plan.

While a large portion of the medical community assisted during this difficult time, we would like to particularly note the following providers who donated vaccine:

Mills-Peninsula Medical Center Pharmacy

Stuart Katz,M.D., Physician Surgery Center

Bruce Maltz, M.D., Allura Skin and Laser Center

Providers who provided vaccine at cost::

Palo Alto Medical Foundation Pharmacy

Sutter VNA & Hospice (Mary Housley, RN,)

Anna S. Pollack, M.D., Peninsula Pediatric Medical Group

Kidcare

Abonto-Tolentino Pediatrics

Tsung and Virmani Medical Group

In the final analysis, the County distributed some 20,000 doses of vaccine to County residents through the medical community and through the Health Department. We have been fortunate that flu illnesses in the County have been moderate although the local medical system has been stretched. The 2004-05 flu season will be memorable for the collaborative success of the Health Department staff with the private and public medical community to rally to provide the best service to the public during a public health crisis.

FISCAL IMPACT:

The County response to the flu vaccine shortage cost $142,312. The expenses were $168,872 but that was offset with $26,504 of reimbursement for the vaccine. Most of the expenses were covered by the Public Health Division’s operating budget, and the rest were covered by the budgets of the other Health Department divisions that reassigned staff to the effort.