Maine.gov



November 16, 2011

The Maine Immunization Program (MIP) is pleased to support the Maine Vaccine Board (MVB) in implementing Public Law 2009-595. This law is to reinstate the universal status of childhood immunizations which will take effect on January 1st, 2012. The MVB has decided on a list of vaccines that will offer you broad brand-choices, including combination vaccines. MIP has created the means to order these vaccines through ImmPact2. By offering combination vaccines we hope to reduce missed opportunities during patient visits and improve the immunization rates in Maine.

Our goal is to make this transition as smooth as possible. In order to guide you through this transition here is a timeline for the remainder of 2011.

• Around December 1st, 2011 the 2012 Annual Provider Agreement will be available for your submittal through ImmPact2.

• After your Provider Agreement has been approved, you will be able to order from the MVB selected list of vaccines. ( This list is attached.)

• You should receive your vaccine order by the end of December 2011.

• Start offering ALL children in your practice MIP supplied vaccine on January 1, 2011.

Once your 2012 Annual Provider Agreement has been approved, place your vaccine order as soon as possible. Please be sensitive of holiday shipping schedules and days that your office may be closed during the month of December.

To benefit you during this transition we encourage you to visit the Maine Vaccine Board’s website and review the “Question and Answer” document. You can locate this site at .

For general question contact the Maine Immunization Program at immunizeme@ or 1-800-867-4775.

|2012 Vaccine Board Approved List of Vaccines |

| | | | | | |

|Vaccine Antigen |Vaccine Component |Brandname/Tradename|NDC Number |Manufacturer |Packaging |

|Diphtheria, Tetanus, |#Dtap |Tripedia |49281-0298-10 |Sanofi Pasteur |10-pack 1 dose vials |

|Pertussis (Dtap) | | | | | |

|  |Dtap |Daptacel |49281-0286-10 |Sanofi Pasteur |10-pack 1 dose vials |

|  |Dtap |Infanrix |58160-0810-11 |GlaxoSmithKline |10-pack 1 dose vials |

|  |Dtap, IPV |Kinrix |48160-0812-52 |GlaxoSmithKline |10-pack 1 dose, tip lock |

| | | | | |syringe, no needle tip |

|  |Dtap, Hep B, IPV |Pediarix |58160-0811-52 |GlaxoSmithKline |10-pack 1 dose, tip lock |

| | | | | |syringe, no needle tip |

|  |Dtap, IPV, HIB |Pentacel |49281-0510-05 |Sanofi Pasteur |5-pack,1 dose vial |

|  |

|Polio |IPV |IPOL |49281-0860-10 |Sanofi Pasteur |10 dose vial |

|  |Dtap, IPV |Kinrix |48160-0812-52 |GlaxoSmithKline |10-pack 1 dose, tip lock |

| | | | | |syringe, no needle tip |

|  |Dtap, Hep B, IPV |Pediarix |58160-0811-52 |GlaxoSmithKline |5-pack 1 dose, tip lock |

| | | | | |syringe, no needle tip |

|  |Dtap, IPV, HIB |Pentacel |49281-0510-05 |Sanofi Pasteur |5-pack,1 dose vial |

|  |

|Hepatitis B (Hep B) |Hep B |Engerix |58160-0820-11 |GlaxoSmithKline |10 pack-1 dose vials |

|  |Hep B |Recombivax |00006-4981-00 |Merck |10-pack 1 dose vials |

|  |Dtap, Hep B, IPV |Pediarix |58160-0811-52 |GlaxoSmithKline |5-pack 1 dose, tip lock |

| | | | | |syringe, no needle tip |

|  |

|Haemophilus |HIB |PedvaxHIB |00006-4897-00 |Merck |10-pack 1 dose vials |

|influenzae type b | | | | | |

|(HIB) | | | | | |

|  |HIB |ActHiB |49281-0545-05 |Sanofi Pasteur |5-pack-1 dose vials |

|  |Dtap, IPV, HIB |Pentacel |49281-0510-05 |Sanofi Pasteur |5-pack,1 dose vial |

|  |

|Hepatitis A (Hep A) |Hep A |Vaqta |00006-4831-41 |Merck |10-pack 1 dose vials |

|  |Hep A |Havrix |58160-0825-11 |GlaxoSmithKline |10-pack 1 dose vials |

|  |

|Rotavirus |Rotavirus |Rotarix |58160-0854-52 |GlaxoSmithKline |10 pack-1 dose vials |

|  |Rotavirus |Rotateq |00006-4047-41 |Merck |10 pack - 1 dose 2mL |

| | | | | |tubes |

|  |

|Pneumococcal (PNU 13)|PNU 13 |Prevnar |00005-1971-02 |Wyeth |10-pack 1 dose syringes, |

| | | | | |No Needle |

|  |

|MMR |MMR |MMRII |00006-4681-00 |Merck |10 pack-1 dose vials |

|  |*MMR, VAR |ProQuad |00006-4999-00 |Merck |10 pack-1 dose vials |

|2012 Vaccine Board Approved List of Vaccines |

|  |

|Varicella |Varicella |Varivax |00006-4827-00 |Merck |10 pack-1 dose vials |

|  |*MMR, VAR |ProQuad |00006-4999-00 |Merck |10 pack-1 dose vials |

|  |

|Human Papillomavirus |HPV-Quadrivalent |Gardasil |00006-4045-41 |Merck |10 pack-1 dose vials |

|(HPV) | | | | | |

|  |

|Meningococcal (MCV4)|Meningococcal Conjugate |Menactra |49281-0589-05 |Sanofi Pasteur |5-pack, 1 dose vial |

| |(groups A, C, Y and | | | | |

| |W-135) | | | | |

|  |Meningococcal Conjugate |Menveo |46028-0208-01 |Novartis |5-pack, 1 dose vial |

| |(groups A, C, Y and | | | | |

| |W-135) | | | | |

|  |  |  |  |  |  |

|  |

|Tetanus, Diphtheria |Tdap |Boostrix |58160-0842-11 |GlaxoSmithKline |10 pack 1 dose vials |

|and Pertussis (Tdap) | | | | | |

|  |Tdap |Adacel |49281-0400-10 |Sanofi Pasteur |10 pack 1 dose vials |

|  |

|Influenza |Influenza/Age 6 months |Fluzone |49281-0388-15 |Sanofi Pasteur |10-dose vial |

| |and older | | | | |

|  |Influenza/Age 6-35 months|Fluzone |49281-0111-25 |Sanofi Pasteur |10-pack, 1 dose syringe |

| |(preservative free) | | | |(.25ml) |

|  |Influenza/Age 36 months |Fluzone |49281-0011-50 |Sanofi Pasteur |10-pack, 1 dose syringe |

| |and older (preservative | | | |(.50ml) |

| |free) | | | | |

|  |Influenza/Age 36 months |Fluarix |58160-0878-52 |GlaxoSmithKline |10-pack, 1 dose syringe |

| |and older (preservative | | | |(.50ml) |

| |free) | | | | |

|  |Influenza Intranasal (Age|FluMist |66019-0109-10 |MedImmune |10-pack, 1 dose sprayer |

| |2-49 years)(preservative | | | | |

| |free) | | | | |

|# In 2011, Sanofi Pasteur will discontinue the production of Tripedia | | |

|*MMR, VAR=Is not on the Federal Contract due to Supply issues with the Manufacture | |

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