title: Impact of vaccine shortages on immunization programs and providers.
abstract: BACKGROUND
  During 2001 and the first half of 2002, the United States experienced severe shortages of five of the eight universally recommended vaccines for children.
  
  
  OBJECTIVE
  To evaluate the impact of shortages of diphtheria-tetanus-acellular pertussis vaccine (DTaP), pneumococcal conjugate vaccine (PCV7), and tetanus and diphtheria vaccine (Td) shortages on state and urban area immunization programs and immunization providers between September 2001 and January 2002.
  
  
  METHODS
  (1) Survey of state and urban area immunization program managers. Outcome measures included changes in vaccine distribution and suspension of daycare/Head Start and school entry immunization requirements for Td, DTaP, and PCV7. (2) Interviews with Vaccines for Children Program immunization providers scheduled to receive a routine site visit between January 21 and February 1, 2002. Outcome measures included problems experienced with vaccine orders, implementation of Advisory Committee on Immunization Practices (ACIP) interim recommendations for DTaP and PCV7, and length of time with no DTaP or PCV7 vaccines in stock.
  
  
  RESULTS
  Over 85% of immunization programs changed the way they distributed PCV7, DTaP, and Td vaccines to providers, including limiting the amount of vaccine ordered or distributing partial orders. Additionally, 76% of programs experienced problems purchasing or receiving varicella vaccine. Sixty-eight percent of programs suspended school entry requirements for Td. Immunization providers reported problems with orders of Td (56%), PCV7 (45%), DTaP (30%), and varicella (29%). Approximately 16% and 29% of providers implemented the interim ACIP recommendations for DTaP and PCV7, respectively. However, 21% of providers suspended administration of all doses of PCV7 because they ran out of vaccine before learning of the shortage.
  
  
  CONCLUSIONS
  From suspension of school entry requirements to delaying administration of vaccine, the recent vaccine shortages affected immunization programs' and providers' ability to administer vaccines in a timely manner.
authors.affiliation: National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. sstokley@cdc.gov
authors.forename: Shannon
authors.initials: S
authors.lastname: Stokley
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Santoli
authors.forename: Bayo
authors.initials: B
authors.lastname: Willis
authors.forename: Vanda
authors.initials: V
authors.lastname: Kelley
authors.forename: Anjella
authors.initials: A
authors.lastname: Vargas-Rosales
authors.forename: Lance E
authors.initials: LE
authors.lastname: Rodewald
mesh_terms: D001428:Bacterial Vaccines / Q000600:supply & distribution*; D002648:Child; D002656:Child Day Care Centers; D017408:Guidelines as Topic; D006302:Health Services Research; D006801:Humans; D017589:Immunization Programs; D007407:Interviews as Topic; D011315:Preventive Medicine; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D001428:Bacterial Vaccines