Dear Provider Letter: How Approved Immunization Providers Pre-Register for Novel Influenza A (H1n1) Monovalent Vaccine to be Administered to Your Patients, Residents and Staff

September 21, 2009

Dear Provider:

This letter provides information about how approved immunization providers (outside of New York City*) may pre-register for novel influenza A (H1N1) monovalent vaccine to be administered to your patients, residents and staff.

As you are aware, the novel H1N1 influenza virus, in conjunction with regular seasonal influenza viruses, has the potential to cause significant illness, hospitalizations and deaths this flu season. Influenza vaccination is the most effective method to prevent influenza infection. A novel influenza A (H1N1) monovalent vaccine is expected to be available by mid-October 2009. In cooperation with the federal government and local health departments, the New York State Department of Health (NYSDOH) will make the monovalent vaccine available to health care providers in New York State (outside New York City). This undertaking will require the active participation of a wide range of immunization providers will play a key role in delivering influenza vaccine to their patients, residents and staff.

The following populations are recommended by CDC to receive novel influenza A (H1N1) monovalent vaccine as soon as possible:

  • Pregnant women
  • Household contacts and caregivers for children younger than 6 months of age
  • Healthcare and emergency medical services personnel
  • All people from 6 months through 24 years of age
  • Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza

The full recommendations are available in the Morbidity and Mortality Weekly Report, August 28, 2009/58 at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5810a1.htm.

Both the vaccine and the supplies required to administer the vaccine will be provided by the Federal government at no charge. Reimbursement for vaccine administration is likely to be covered by most private health insurers and will be covered by public health insurance (Medicaid/Medicare) plans.

Issues regarding the liability and costs associated with administering the H1N1 influenza monovalent vaccine are being addressed. The United States Department of Health and Human Services has issued a Public Readiness and Emergency Preparedness "PREP" Act declaration for novel H1N1 influenza countermeasures. This declaration provides liability protections to providers of H1N1 influenza vaccine.

Pre-registering intent to receive novel H1N1 influenza monovalent vaccine (all ages):

The allocation and distribution of the vaccine in New York State (outside New York City) will be managed by the NYSDOH in coordination with county health departments. In order to receive novel H1N1 influenza monovalent vaccine, providers must pre-register with NYSDOH. The information you provide will assist in allocating H1N1 vaccine throughout the State, taking into consideration the targeted population groups to receive the H1N1 vaccine.

(*To obtain H1N1 vaccine in New York City, contact the NYC Department of Health and Mental Hygiene at http://www.nyc.gov/html/doh/html/cir/a03c.html or call 212-676-2323.)

1. Pre-registration:

All providers interested in receiving novel H1N1 influenza monovalent vaccine must pre-register at https://hcsteamwork1.health.state.ny.us/pub/top.html

  • This pre-registration process is designed for you to express interest only and does not obligate you to receive/administer vaccine nor does it guarantee you will receive vaccine if supplies are limited.

2. Requirements for receipt of vaccine:

  • In order to receive novel H1N1 influenza monovalent vaccine, providers must sign a federally-mandated Provider Agreement agreeing to appropriately store and handle the vaccine, to give vaccines only to the CDC targeted groups (noted above) , and to report vaccine usage (see next bullet).
  • There is a federal requirement that providers of vaccine to adults (age 19 years and older) report at a minimum, vaccine doses administered by age group on a weekly basis. NYSDOH will set up a mechanism for this reporting.

Once your pre-registration is received and the remaining details of the vaccination campaign have been finalized, you will be contacted by the vaccine program to sign the federal Provider Agreement and instructed how to order vaccine.

Special Provisions for Immunizing Pediatric Patients Under the Age of 19 Years:

New York State Law requires that all vaccinations of pediatric patients (less than 19 years of age) be entered into the New York State Immunization Information System (NYSIIS), the state's immunization registry. All providers that are interested in receiving novel H1N1 influenza monovalent vaccine for use in pediatric patients (less than 19 years of age) must complete the following three steps (these can be completed by accessing this website): https://hcsteamwork1.health.state.ny.us/pub/top.html

1. Establish a NYSDOH Health Commerce System (HCS) account

  • The Health Commerce System (HCS) (also referred to as the Health Provider Network or the HPN) is a secure web-based system designed by the NYSDOH specifically for electronically exchanging health-related data and information between health care providers and NYSDOH.
  • Note: this is the same account that providers currently use and should already have an account.
  • Completing the on-line HCS application request form will bring the user to the H1N1 vaccine pre-registration form and the HCS application information will pre-populate appropriate fields to expedite the H1N1 vaccine pre-registration process.

2. Pre-register interest in receiving H1N1 vaccine with the NYSDOH vaccine program

  • This pre-registration process is designed for you to express interest only and does not obligate you to receive/administer vaccine nor does it guarantee you will receive vaccine if supplies are limited.
  • Users with a current HCS account can use their log in to pre-populate the vaccine pre-registration form and expedite the process.
  • Once your registration is received and the remaining details of the vaccination campaign have been finalized, you will be contacted by the vaccine program to sign the formal provider agreement that has been supplied by the Federal government, agreeing to appropriately store and handle the vaccine, to give vaccines only to the CDC targeted groups, and to report vaccine usage.

3. Establish access to the New York State Immunization Information System (NYSIIS), also known as the immunization registry (see attached fact sheet).

  • Participating in training establishes a NYSIIS user account.
  • 47 electronic health record/billing vendors are approved to automatically upload immunization information into NYSIIS.
  • The website above provides additional information on an online orientation to NYSIIS and training opportunities for new users.

Reporting Using the New York State Immunization Information System (NYSIIS) for H1N1 Monovalent Vaccine.

Using NYSIIS affords providers a number of advantages: 1) automatically generates the federally mandated weekly vaccine usage reports, 2) monitors vaccine inventory to enable prompt reordering, 3) generates reminder lists and letters for the second influenza vaccine dose, if required, 4) provides a legal record of the vaccination, 5) enables correct ascertainment of prior influenza vaccine history if patients receive some influenza vaccine doses (seasonal and/or monovalent H1N1) at other provider sites, and 6) enables NYSDOH to more closely monitor possible vaccine adverse events.

Your participation in the H1N1 influenza monovalent vaccine campaign is essential to ensuring that New Yorkers receive the most effective protection against H1N1 influenza. For more information on the novel H1N1 influenza monovalent vaccine, please go to the NYSDOH website at: http://www.nyhealth.gov/diseases/communicable/influenza/h1n1/ or the Centers for Disease Control and Prevention's (CDC) website at: http://www.cdc.gov/h1n1flu/. If you have any further questions, please contact the NYSDOH H1N1 hotline at 1-800-808-1987.

If you are not able to provide vaccine you can still contribute by educating and referring your patients and by volunteering at a public health-sponsored clinic. For information on volunteering, please go to www.nyhealth.gov/ServNY.

Your participation in the H1N1 influenza monovalent vaccine campaign is essential to ensuring that New Yorkers receive the most effective protection against H1N1 influenza. For more information on the novel H1N1 influenza vaccine, please go to the NYSDOH website at: http://www.nyhealth.gov/diseases/communicable/influenza/h1n1/ or the Centers for Disease Control and Prevention's (CDC) website at: http://www.cdc.gov/h1n1flu/. If you have any further questions, please contact the NYSDOH H1N1 hotline at 1-800-808-1987.

Sincerely,

Guthrie S. Birkhead, M.D., M.P.H.
Deputy Commissioner
Office of Public Health