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Published on: February 23, 2014
Pediatricians' adherence to pneumococcal conjugate vaccine shortage recommendations in 2 national shortages
Gerry Fairbrother1, Karen Broder, Mary Allen Staat
1Center for Epidemiology and Biostatistics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, 3333 Burnet Ave, MLC 7014, Cincinnati, OH 45229-3039, USA. gerry.fairbrother@cchmc.org
Insights
Pediatricians improved adherence to deferring pneumococcal conjugate vaccine doses for healthy children during shortages. However, severe shortages led to non-vaccination of high-risk children, highlighting policy gaps.
Area of Science:
- Pediatric Infectious Diseases
- Vaccine Supply Chain Management
- Public Health Policy
Background:
- Heptavalent pneumococcal conjugate vaccine (PCV7) shortages have impacted pediatric immunization schedules.
- Understanding pediatrician experiences and adherence to recommendations during shortages is crucial for public health preparedness.
Purpose of the Study:
- To compare pediatrician experiences and adherence to PCV7 shortage recommendations across two distinct shortage periods.
- To identify factors influencing nonadherence to recommendations during the second PCV7 shortage.
- To gauge pediatrician opinions on national immunization policies during vaccine shortages.
Main Methods:
- A survey was administered to pediatrician immunization providers in the greater Cincinnati metropolitan area.
- Data collected included PCV7 supply, immunization practices during shortages, and provider attitudes toward shortage policies.
Main Results:
- High rates of PCV7 shortages were reported by 86% (first) and 84% (second) of pediatricians.
- Adherence to deferring the fourth PCV7 dose for healthy children significantly increased from 62% to 89% between shortages.
- Adherence to administering the fourth dose to high-risk children remained low (43% to 45%), with severe shortages linked to non-vaccination of this group.
Conclusions:
- Adherence to PCV7 deferral recommendations for healthy children improved over time.
- Severe PCV7 shortages negatively impacted the vaccination of high-risk children, indicating a need for improved supply chain strategies.
- Pediatricians largely supported national vaccine shortage recommendations for liability protection.
Objectives:
The goals were (1) to compare pediatricians' heptavalent pneumococcal conjugate vaccine shortage experience and adherence to shortage recommendations during 2 heptavalent pneumococcal conjugate vaccine shortages, (2) to assess factors associated with nonadherence to second shortage recommendations, and (3) to assess opinions about national immunization policy during vaccine shortages.
Methods:
We mailed surveys to all pediatrician immunization providers in the greater Cincinnati, Ohio, metropolitan area. We assessed heptavalent pneumococcal conjugate vaccine supply and immunization practices during the shortages and provider attitudes regarding immunization shortage policy.
Results:
The response rate was 61% (171 of 282 providers). Most pediatricians experienced heptavalent pneumococcal conjugate vaccine shortages (first shortage: 86%; second shortage: 84%). The rate of adherence to recommendations to defer the fourth heptavalent pneumococcal conjugate vaccine dose for healthy children was significantly higher during the second shortage, compared with the first shortage (first shortage: 62%; second shortage: 89%). Adherence to recommendations to administer the fourth dose to high-risk children remained unchanged (first shortage: 43%; second shortage: 45%). Controlling for other factors, pediatricians who reported a severe second shortage had greater odds of not fully vaccinating high-risk children, compared with those who reported no shortage. Contrary to recommendations, many pediatricians did not maintain tracking systems during the heptavalent pneumococcal conjugate vaccine shortages (first shortage: 37%; second shortage: 46%). Most pediatricians (91%) thought that national vaccine shortage recommendations were needed to protect them from liability.
Conclusions:
The rate of adherence to recommendations to defer heptavalent pneumococcal conjugate vaccine doses for healthy children increased significantly from the first shortage to the second shortage. The nonadherent practice of deferring the fourth dose for high-risk children was associated with more severe shortages and, potentially, an inability to vaccinate.
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