Consequences of a shortage and rationing: Evidence from a pediatric vaccine

Area of Science:

• Health Services Research
• Vaccine Policy
• Pediatric Health

Background:

• Shortages and rationing are frequent in healthcare, but their consequences remain understudied.
• The pediatric Haemophilus Influenzae Type B (Hib) vaccine faced an 18-month shortage, necessitating rationing.

Purpose of the Study:

• To investigate the impact of the Hib vaccine shortage and subsequent rationing on vaccination uptake and long-term health outcomes.
• To analyze the effects on healthcare utilization and patient behavior.

Main Methods:

• Utilized insurance claims data to track vaccination status across different birth cohorts.
• Analyzed variations in exposure to the shortage to determine its effects on vaccine uptake and healthcare patterns.

Main Results:

• The shortage decreased primary Hib vaccine doses by 4% and booster doses by 26%, indicating provider adherence to rationing.
• Long-term follow-up revealed incomplete catch-up vaccination, with shortage-exposed cohorts 4% less likely to receive boosters later.
• The shortage led to increased provider switching, additional visits, and adverse effects on other healthcare services.

Conclusions:

• Healthcare rationing during vaccine shortages significantly impacts vaccination coverage, with lasting consequences for vulnerable populations.
• The study highlights the need for robust vaccine supply chains and strategies to mitigate the downstream effects of shortages on child health and healthcare systems.