title: A systematic analysis of influenza vaccine shortage policies.
abstract: OBJECTIVE
  The aim of this study was to apply SWOT analysis (strengths, weaknesses, opportunities, threats) to a domestic shortage of influenza vaccine, to identify lessons learned, and to generate effective solutions for future public health rationing emergencies.
  
  
  METHODS
  SWOT and TOWS techniques were employed to characterize the vulnerability of the USA to disruptions in the supply of influenza vaccine. A group of five researchers reviewed relevant literature, engaged in group brainstorming, and categorized elements according to the SWOT framework.
  
  
  RESULTS
  Three strengths, five weaknesses, five threats and seven opportunities were identified in the areas of vaccine production, purchasing and distribution, and provision. Four future recommendations emerged with respect to government investment, communications, sanctioning of physicians, and incident command.
  
  
  CONCLUSIONS
  Application of the SWOT technique is highly relevant to the health policy realm and can assist public health planners in planning for future resource scarcity.
authors.affiliation: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Suite 492, Baltimore, MD 21205, USA. luscher@jhsph.edu
authors.forename: Lori
authors.initials: L
authors.lastname: Uscher-Pines
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Barnett
authors.forename: Jason W
authors.initials: JW
authors.lastname: Sapsin
authors.forename: David M
authors.initials: DM
authors.lastname: Bishai
authors.forename: Ran D
authors.initials: RD
authors.lastname: Balicer
mesh_terms: D000818:Animals; D002645:Chickens; D004196:Disease Outbreaks / Q000517:prevention & control; D004333:Drug Administration Routes; D004345:Drug Industry / Q000458:organization & administration; D018073:Haemophilus Vaccines / Q000008:administration & dosage / Q000600:supply & distribution*; D015276:Health Care Rationing / Q000458:organization & administration; D006801:Humans; D007251:Influenza, Human / Q000517:prevention & control; D014481:United States; D015053:Zygote