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Vaccine administration error rates at a large academic medical center and its affiliated clinics - Familiarity
Lauren Reed1, Beth A Tarini2, Margie C Andreae1
1Division of General Pediatrics, University of Michigan Medical School, Michigan Medicine, Ann Arbor, MI 48105, United States.
Insights
Vaccine administration errors are rare, with rates stabilizing over time. Errors are more common with less frequently administered vaccines or those with age-specific dosing, suggesting a need for enhanced safety checks.
Area of Science:
- Pediatric Healthcare
- Vaccinology
- Patient Safety
Background:
- Vaccine administration errors can impact patient safety and public health.
- Understanding error rates is crucial for improving immunization practices.
Purpose of the Study:
- To track vaccine administration errors and error rates over time.
- To analyze errors by patient age and vaccine type.
Main Methods:
- Retrieved vaccine administration data from electronic medical records (2006-2017).
- Analyzed errors from an incident reporting system.
- Calculated error rates stratified by patient age, vaccine type, and year.
Main Results:
- Identified 552 errors out of 1,431,206 vaccine doses (0.04% error rate).
- Highest error rates observed in 2, 3, and 19-year-olds and with Td, rabies, and pneumococcal polysaccharide vaccines.
- Error rates initially increased but then stabilized towards the end of the study period.
Conclusions:
- Vaccine administration errors are infrequent and appear to be stabilizing.
- Errors are more likely with less common or age-specific vaccines, indicating a need for targeted safety interventions.
- Recommendations include enhanced safety checks for rarely used vaccines and consideration of simplified dosing schedules by manufacturers.
Objective:
The purpose of this study was to track and describe the absolute number of vaccine administration errors and corresponding error rates over time and by patient age and vaccine type.
Methods:
Total vaccines administered to patients aged 0 through 19 years 364 days from 1/1/2006 through 12/31/2017 at a large academic health system in the Midwest United States with primary, specialty and school-based clinics, and a pediatric hospital were obtained from an electronic medical record. Vaccine administration errors over the same time period for the same patient criteria were analyzed from the health system's incident reporting system and further compared to the frequency of all incidents reported. Vaccine administration error rates were calculated. Data were analyzed by patient age, vaccine type and year administered.
Results:
Of the 1,431,206 vaccine doses given, 552 vaccine administration errors were identified (0.04%). The highest error rates occurred in children aged 2, 3, and 19 years. Vaccine types with the highest error rate were Td, rabies and pneumococcal polysaccharide vaccines. Overall vaccine doses given and errors reported increased over the study period. However, the increase was disproportionate, resulting in an increase in the error rate initially followed by a stabilization at the end of the study period.
Conclusions:
Vaccine administration errors are uncommon. The error rate appears to be stabilizing. Errors are more likely at ages when vaccines are not commonly given, with vaccines that have age-specific dosing and with vaccines that are given less often. This suggests more safety checks are needed for vaccines that are rarely used or given off-schedule, and manufacturers should avoid vaccines with age-specific dosing.
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