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短縮期間中の肺炎球菌結合ワクチンの公的・私的供給の変動
Gary L Freed1, Matthew M Davis, Sarah J Clark
1Division of General Pediatrics, University of Michigan, 300 N Ingalls 6E08, Ann Arbor, MI 48109-0456, USA. gfreed@umich.edu
JAMA
|February 13, 2003
まとめ
2001年のヘプタヴァレンント肺炎球菌結合ワクチン (PCV7) の不足の間,公的および私的な供給は州によって大幅に変化しました. CDCの勧告にもかかわらず,ワクチンの投与方針を変更した実践はほとんどありませんでした.
科学分野:
- 予防接種についてです.
- ワクチンのサプライチェーン管理
- 小児公衆衛生の小児科
背景:
- 2001年末には,ヘプタバレンント肺炎球菌結合ワクチン (PCV7) の不足が34の州免疫プログラムに影響を及ぼした.
- 疾病管理予防センター (CDC) は,特定の小児群のPCV7を優先する改訂された勧告を発行しました.
- 保健医療実践レベルでのPCV7不足の影響は,ほとんど不明のままでした.
研究 の 目的:
- 公的市場と民間市場間のPCV7供給の格差を調査する.
- 医療従事者が経験するPCV7の不足の性質と範囲を特徴づける.
主な方法:
- 半構造化されたインタビューは,12州の405の民間診療所のワクチン注文スタッフと実施されました.
- データ収集は2001年10月19日から11月2日の間に行われた.
- ワクチンの供給は"問題なし"",一貫した供給を得ることに問題"または"在庫切れ"として分類された.
主要な成果:
- 診療所の51%が公的なPCV7のストックアウトを報告し,64%が民間PCV7のストックアウトを報告した.
- 調査されたほとんどの州では,民間PCV7.7よりも,公共のPCV7が在庫切れの頻度が低いことが判明しました.
- 民間PCV7管理方針を修正したのは23%,公的PCV7管理方針を修正したのは27%に過ぎません.
結論:
- PCV7の供給と配給は,公的および私的な情報源の間,また,短縮期間中に異なる州間で,著しい変動を示した.
- PCV7の優先順位付けに関するCDCの改訂された勧告は,実務レベルでのワクチン投与スケジュールに最小限の影響を及ぼしました.
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