Objective: To understand immunization programs' experience managing the 2007 to 2009 Haemophilus influenzae type B (Hib) vaccine shortage and identify ways in which the US immunization system can be improved to assist in responses to future shortages of routine vaccines and large-scale public health emergencies.
Methods: An Internet-based survey was conducted from July 2009 to October 2009 among the 64 city, state, and territorial immunization program managers (IPMs).
Results: Fifty-eight percent (37 of the 64) of IPMs responded. Forty percent of responding IPMs indicated not having enough Hib vaccine within their Vaccines for Children program to fulfill the temporary 3-dose recommendation issued in December 2007 in response to the Hib vaccine shortage. While 73% of IPMs indicated success in monitoring provider inventory and 68% indicated success in monitoring doses administered during the shortage, fewer than half indicated success in monitoring providers' compliance with shortage-specific recommendations regarding Hib vaccine. Forty-six percent of IPMs used their immunization information system (IIS) to monitor provider compliance with recommendations regarding Hib vaccine use, and of these, nearly 60% reported success in monitoring provider compliance with recommendations compared with 35% of IPMs who did not use their IIS in this way. Forty-two percent of IPMs felt that the Centers for Disease Control and Prevention (CDC) was successful in determining stockpiled vaccine allocations to their program, and 56% felt that the CDC was successful in communicating its rationale for their immunization program's Hib allocation during the shortage.
Conclusions: Experiences from the 2007 to 2009 Hib vaccine shortage offer insights on how the US immunization system and system-wide response to vaccine shortages can be improved. Results from this survey suggest that improving vaccine transfer between jurisdictions and using IIS to track provider compliance with shortage recommendations are 2 ways that can help the US immunization system respond to future vaccine shortages and large-scale public health emergencies like influenza pandemics.
The aim of this study is to identify the ways in which the US immunization system can be improved to assist in responses to future shortages of routine vaccines and large-scale public health emergencies.
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia (Mss Chamberlain, Seib, Kudis, Whitney, and Drs Buehler, Omer, Berkelman); Association of Immunization Managers, Rockville, Maryland (Mss Wells and Hannan); Emory Vaccine Center, Emory University, Atlanta, Georgia (Dr Orenstein); Task Force for Global Health, Decatur, Georgia (Dr Hinman); and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia (Dr Omer).
Correspondence: Allison T. Chamberlain, MS, 1518 Clifton Rd, CNR Floor 3, Atlanta, GA 30322 (email@example.com).
This study was supported by a grant from the Centers for Disease Control and Prevention (CDC), grant 5P01TP000300 to the Emory Preparedness and Emergency Response Research Center, Emory University (Atlanta, Georgia). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC.
We thank the American Immunization Registry Association for their contributions in developing the survey instrument, and we thank the immunization program managers for participating in this survey.
The authors report no conflicts of interest.