KEYWORDS:
vaccine supply, barrier to vaccination

BACKGROUND:
In summer 2001, anecdotal reports surfaced regarding shortages of several vaccines, including PCV7, DTaP, and Hib. The extent of supply problems and their impact on vaccine providers was unknown.

OBJECTIVE(S):
To explore the extent of vaccine supply problems and the associated impact on private vaccine providers.

METHOD(S):
From 12 state VFC lists, 35-66 private physician offices were selected. Interviews were conducted in October/November 2001 with the staff persons responsible for ordering public and private-sector vaccines.

RESULT(S):
Interviews were completed with 405 of 547 eligible practices (74%); 84% of interviewees were clinical staff who administered vaccines. Overall, 80% of practices reported problems obtaining a consistent supply of private PCV7, while 70% reported problems with public PCV7 supply. The proportion of practices per state with PCV7 supply problems ranged from 70% to 96% for private PCV7, and from 43% to 82% for public PCV7. Overall, 64% of practices were completely out-of-stock for private PCV-7 at some point, and 51% for public PCV-7. For DTaP, 30% of practices had private-sector supply problems (state range 9% to 50%), while 35% had public-sector supply problems (range 8% to 73%). Supply problems were less common for Hib (11% private, 4% public) and varicella (8% private, 4% public). The effects of supply problems on vaccine providers include: the logistical complexity of maintaining call-back lists for different vaccines, need for altering practice vaccination schedules, parent confusion and concern, and liability issues. Long-term impacts may involve practice or state vaccination rates.

CONCLUSIONS(S):
Vaccine supply problems are a significant issue for private physician offices. There is likely a need for CDC guidance, education, and information materials regarding catch-up schedules, explanations for parents, and practice assessments during shortage situations.

LEARNING OBJECTIVES:
To appreciate the extent and impact of supply problems for childhood vaccines.