Influenza Vaccine Supply
*
Contact Information
Contact Information
Provider Name
Name of Person Completing Survey
Phone Number
Email Address
Prevention Partnership Number(if you have one)
Prevention Partnership Number(if you have one)
Prevention Partnership Number
Please enter the number of doses of privately purchased flu vaccine on hand.
Please enter the number of doses of privately purchased flu vaccine on hand.
Fluzone(Sanofi Pasteur) .25 mL prefilled syringe
Fluzone(Sanofi Pasteur) .5 mL prefilled syringe
Fluzone(Sanofi Pasteur) Single dose vial
Fluzone(Sanofi Pasteur) Multidose vial
Agriflu(Novartis) .5 mL prefilled syringe
Agriflu(Novartis) Single dose vial
Agriflu(Novartis) Multidose vial
Fluvirin(Novartis) .5 mL prefilled syringe
Fluvirin(Novartis) Multidose vial
Fluarix(GlaxoSmithKline) .5 mL prefilled syringe
FluLaval (distributed by GlaxoSmithKline) Multidose vial
Afluria(CSL Biotherapies) .5 mL prefilled syringe
Afluria(CSL Biotherapies) Multidose vial
Fluzone High Dose(Sanofi Pasteur) .5 mL prefilled syringe
Fluzone Intradermal (Sanofi Pasteur) .1 mL prefilled microinjection system
Flumist (MedImmune) 0.2 mL prefilled intranasal sprayer
Do you feel that you have an adequate supply of flu vaccine to accommodate your patients?
Do you feel that you have an adequate supply of flu vaccine to accommodate your patients?
If needed, do you have privately purchased vaccine that you would be willing to sell to a different provider?
If needed, do you have privately purchased vaccine that you would be willing to sell to a different provider?
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