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Using an Immunization Information System to Facilitate a Vaccine Recall in New York City, 2007

Papadouka, Vikki PhD, MPH; Metroka, Amy MSW, MPH; Zucker, Jane R. MD, MSc

Journal of Public Health Management and Practice: November/December 2011 - Volume 17 - Issue 6 - p 565–568
doi: 10.1097/PHH.0b013e3182214746

Background: In December 2007, Merck & Co, Inc, initiated a voluntary recall of 10 lots of PedvaxHIB, and 2 lots of COMVAX when the potential of contamination was identified during routine testing of the manufacturing equipment. Merck recommended that providers stop vaccinating children using these vaccine lots.

Objective: To describe how the New York City (NYC) Immunization Information System was used in the effort to recall vaccines.

Methods: Immediately following Merck's announcement, NYC's Bureau of Immunization used the New York Citywide Immunization Registry (CIR) to (a) fax and e-mail all pediatric facilities a letter informing them of the recall and asking that they immediately remove recalled vaccines from their refrigerators; (b) identify facilities that had used the recalled lots, on the basis of data reported to the CIR, and contact them individually by phone; and (c) monitor the success of the recall by examining the number of recalled doses administered and reported to the CIR before and after the recall.

Results: The alert was faxed and e-mailed to 1928 pediatric facilities informing them of the recall. In addition, the Bureau of Immunization identified 105 facilities that had reported doses of vaccine from the recalled lots to the CIR and called to ask them to check their refrigerators for remaining supplies and discontinue use of this vaccine. The number of doses with the affected lot numbers reported to the CIR decreased sharply following CIR recall notification. Furthermore, the Centers for Disease Control and Prevention and Merck reported the return of nearly 50% of publicly and privately purchased vaccines from the recalled lots that had been distributed to NYC providers.

Conclusion: Immunization Information Systems can be effective tools for quickly identifying providers in possession of recalled vaccine lots, particularly when lot numbers are well reported, and for facilitating rapid vaccine recall in support of vaccine safety.

The article describes how the New York City Immunization Information System was used in the effort to recall vaccines.

New York City Department of Health and Mental Hygiene (Drs Papadouka and Zucker and Ms Metroka); and National Center for Immunization and Respiratory Diseases, Centers of Disease Control and Prevention, Atlanta, Georgia (Dr Zucker).

Correspondence: Vikki Papadouka, PhD, MPH, Citywide Immunization Registry, New York City Department of Health and Mental Hygiene, 42-09 28th St, CN 21, Long Island City, NY 11101-4232 (

Disclaimer: The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the New York City Department of Health and Mental Hygiene nor the Centers for Disease Control and Prevention.

This work was supported by the Centers for Disease Control and Prevention, Immunization Grant Program (grant H23/IP222539). The authors thank Laura Pabst, Denise Rogers, Gary Urquhart, Warren Williams, and Sheila Palevsky for their helpful comments on earlier versions of this document.

Disclosure: The authors declare no conflict of interest.

Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.