PURCHASING MEMORANDUM

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NUMBER: CL-602 DATE: March 3, 2005 Pricing Clarification MMCAP has received several calls concerning the prices invoiced for vaccine received during the current flu season. All orders filled by Aventis Pasteur (now Sanofi Pasteur) must be paid at the Aventis Pasteur bid price of $83.20/10 dose vial. All members were notified of this fact on the MMCAP web page on October 19, 2004: "Prices for vials will be at the Aventis Pasteur bid price of $83.20 per 10-dose vial." http://www.mmd.admin.state.mn.us/mmcap/flu_nm/publish/news_81.html Please refer to contract PC59776 with Aventis Pasteur when issuing new purchase orders. We suggest you contact your finance office for instructions on how to proceed with your outstanding purchase orders with ASD. CL602p04.doc/T07dmn

NUMBER: CL-602 DATE: December 6, 2004 URGENT UPDATE - Flu Vaccine Shortage CDC has issued a new vaccine ordering process for the 2004 season. The New York State Department of Health and New York City Health Departments will be purchasing the influenza vaccine through this new process and will then be distributing the supply through the County Health Departments. Any questions regarding this new process should be directed to the NYS Department of Health at 518-473-4437. Please refer to contract PC59776 with Aventis Pasteur when issuing new purchase orders. We suggest you contact your finance office for instructions on how to proceed with your outstanding purchase orders with ASD. Be sure to include the contract number on all remittances for vaccines purchased. We will provide more information as we receive it Any questions, please contact.

AWARD NUMBER: CL-602 DATE: October 15, 2004 GROUP: 10200 - Influenza Vaccine STATE AGENCIES & CONTRACTORS. Urgent Update - Flu Vaccine TO: ALL STATE AGENCIES AND OTHERS AUTHORIZED TO USE STATE CONTRACTS The CDC has authorized Aventis Pasteur to deliver fifty percent of all prebooked orders to NYS OGS MMCAP ordering facilities. Therefore, all facilities that prebooked Fluzone through Aventis will receive fifty percent of their order by early next week, regardless of facility type. Facilities will receive a TOTAL of fifty percent of their order. If you have already received a partial delivery of vaccine, you will only receive an amount equal to fifty percent of your total order. If you have already received fifty percent of your order or more you will not receive more in this phase of shipping. The CDC has also authorized Aventis Pasteur to deliver fifty percent of all prebooked orders of the Chiron product ordered through OGS Statewide MMCAP contracts with ASD Healthcare and GIV. This process will take any where from six to eight weeks but it will ensure that all NYS Contract customers get at least fifty percent of their flu vaccine order. The CDC will continue to work with Aventis Pasteur and state and local health departments to identify people, by region, on the vaccination priority list. The doses remaining after the first phase is completed will be shipped to other high-need areas. Finally, if your agency or facility has ordered vaccine to vaccinate healthy people (i.e., a public flu clinic), Aventis Pasteur is asking that you call to decrease your order so that the vaccine can be distributed to those in greatest need. We also suggest you continue to refer to the CDC guidelines for additional details and recommendations regarding vaccinations. Further information, updates and recommendations can be found on the CDC website at http://www.cdc.gov/flu and the NYSDOH website at http://www.health.state.ny.us/. We will provide more information as we receive it. CL602p03.doc/T07dmn

NUMBER: CL-602 DATE: October 8, 2004 URGENT UPDATE - Flu Vaccine Shortage As we advised in our October 7, 2004 Bulletin, FluMist an intranasally administered, live attenuated influenza vaccine might be available from General Injectables & Vaccines (GIV). GIV advised this afternoon that although they are taking orders, they will not guarantee that orders will be filled at this time. They are conducting an inventory of product and will compare it against on-hand orders to ascertain whether or not they can accommodate any or all orders taken. We encourage users to contact GIV by telephone at 1-877-FluMist or 1-877-358-6478 for ordering instructions. Please be advised that if you are a first time GIV customer you will be expected to complete a credit application while on the phone and you will be asked to fax a copy of your DEA license. We also suggest you continue to refer to the CDC guidelines for additional details and recommendations regarding vaccinations. Further information, updates and recommendations can be found on the CDC website at http://www.cdc.gov/flu and the NYSDOH website at http://www.health.state.ny.us/. We will provide more information as we receive it.

NUMBER: CL-602 DATE: October, 7, 2004 URGENT UPDATE - Flu Vaccine Shortage Many facilities and contract users have been contacting OGS regarding options for obtaining flu vaccine now that Chiron will be unable to supply to their worldwide distributors, including our contractor ASD. The New York State Department of Health (NYSDOH) is working with the CDC and other federal agencies to create and implement appropriate guidelines for statewide distribution and administration of available influenza vaccine under these new circumstances. The following information is provided to assist you in your decision making process: 1. Priority groups for vaccination have been identified and include: *all children aged 6 23 months; *adults aged 65 years and older; *persons aged 2 64 years with underlying chronic medical conditions; *all women who will be pregnant during the influenza season; *residents of nursing homes and long-term care facilities; *children aged 6 months 18 years on chronic aspirin therapy; *health-care workers involved in direct patient care; *and out-of-home caregivers and household contacts of children aged <6 months. 2. Encourage FluMist for the recommended population (see below): * for healthy persons aged 5 49 years who are not pregnant; * health-care workers (except those who care for severely immunocompromised patients in special care units); * persons caring for children aged <6 months.

CL-602 Vaccine Shortage Update PAGE 2 FluMist is an intranasally administered, live attenuated influenza vaccine. Since FluMist is a live attenuated vaccine, it is only for the specific patient populations listed above. FluMist also needs to be frozen - stored at 5 degrees F or below (-15 degrees C), and must be thawed before administration. As of 4 PM on 10/6/04, GIV was still taking orders for FluMist but were working with the CDC to determine how that should be distributed. We encourage users to contact GIV by phone (1-800-877 FluMist 1-800-358-6478) for ordering instructions. 3. We suggest that if you have questions regarding the availability of influenza vaccine, you should contact your county health department, or the NYSDOH Immunization Program at 518-474-4437. We also suggest you take the time to read the CDC guidelines for additional details and recommendations regarding vaccinations. Further information, updates and recommendations can be found on the CDC website at http://www.cdc.gov/flu and the NYSDOH website at http://www.health.state.ny.us/. OGS will provide more information as we receive it