BACKGROUND:
Maricopa County has a population of 3.7 million and covers 9000 square miles. The delivery of flu vaccine has primarily been the domain of private providers including those who operate large community-based clinics. MCDPH provides VFC flu vaccine at its routine childhood immunization clinics. In late October Arizona Department of Health Services provided to MCDPH 12,270 doses for distribution to high-risk persons.

OBJECTIVE:
To provide for the equitable distribution of limited vaccine supply to high risk persons.

METHOD:
A mail application process was developed and marketed to the community via all media channels. Mail was selected because it is available to all and eliminates barriers associated with telephones/computers. Each applicant was entered into a database which then randomly selected those who would receive the vaccine. Eligible children age 2-18 were referred to existing clinics to receive VFC vaccine. Seven regional clinics were scheduled based on the MCDPH Mass Vaccination Plan and selected individuals were notified of clinic details by return mail. Those 19-64 years were required to provide documentation from their physician identifying their medical condition in accordance with CDC guidelines. Photo ID was also required. Simultaneously nursing homes/hospitals were queried regarding their supply/demand and 5,730 were distributed to them. The remaining 6,540 doses were administered at the clinics.

RESULT:
The lottery/application process assured that all 12,270 doses were distributed to high-risk individuals within two weeks.

CONCLUSION:
Flu shortages cause fear and anxiety in populations and effective/efficient education/delivery strategies must be implemented quickly.

LEARNING OBJECTIVES:
Understand implications of a lottery as supply management strategy