Delivering vaccines: a case study of the distribution system of Vaccines for Children.
OBJECTIVE
To evaluate the efficacy of the centralization by the Centers for Disease Control and Prevention of their pediatric vaccine distribution system.


METHODS
In March 2007, the Centers for Disease Control and Prevention began a pilot program to reform the Vaccines for Children (VFC) program. All California VFC providers were required to place vaccine orders under the centralized logistic system of the Vaccine Management Business Improvement Project (VMBIP). For this study, VFC ordering, use, and delivery data were collected from 2 large southern California healthcare providers that collectively served more than 200,000 children. Data collection occurred between January 2005 and June 2008.


METHODS
This case study measures the change in the mean VFC delivery times before and after the VMBIP. The data underwent simulation to estimate the number of days per year a provider would have zero VFC inventory before and after the VMBIP.


RESULTS
After the VMBIP was implemented, delivery times increased from 1.6 to 12.3 business days (P <.001). The probability that VFC deliveries took longer than 1 week increased from 7% before the VMBIP to 89% afterward. Our simulation demonstrates that for 7 of 11 vaccines investigated there was a statistically significant increase in the number of days a provider would be without VFC (P <.01).


CONCLUSIONS
Although the VMBIP was implemented to save costs, this study finds that during the VMBIP's initial implementation timeline, providers experienced longer delivery delays and a higher probability of a VFC stockout.
Department of Economics, University of California, San Diego, La Jolla, CA 92093-0534, USA. jshafrin@ucsd.edu
Jason T
JT
Shafrin
John M
JM
Fontanesi
D002140:California; D002487:Centers for Disease Control and Prevention, U.S.; D017598:Efficiency, Organizational; D019982:Organizational Case Studies; D010372:Pediatrics; D014481:United States; D014612:Vaccines / Q000600:supply & distribution*
D014612:Vaccines