KEYWORDS:
Influenza vaccine distribution, local public health agencies

BACKGROUND:
Influenza vaccine is the linchpin of any plan to decrease influenza-related morbidity and mortality among our most vulnerable subpopulations, yet the current influenza vaccine delivery and distribution systems have severe shortcomings that have not been adequately addressed.

OBJECTIVE:
To quantify the experiences of local public health agencies (LPHAs) and describe lessons learned from two consecutive influenza seasons when influenza vaccine was in short supply and there was delayed delivery.

METHOD:
The Maryland Partnership for Prevention (MPP) surveyed and interviewed all Maryland health officers (n=22; covering 24 LPHAs) during the 2001-02 influenza season regarding their experiences with acquiring influenza vaccine (as part of the state-sanctioned contract as well as purchasing vaccine outside of the state-sanctioned contract) and the outcomes of those experiences.

RESULT:
Seventy percent of LPHAs delayed, reduced, or cancelled their influenza clinics due to the shortages and delayed delivery of influenza vaccine. When seeking to purchase outside the state-sanctioned contract, LPHAs noted price variability up to 500% of standard per-vial prices.

CONCLUSION:
Vaccine shortages and delays hurt the reputations of LPHAs and the relationships they form with their constituencies. Therefore, a new mechanism for influenza vaccine delivery must be structured so that limited influenza vaccine supplies can be efficiently allocated and distributed to entities ordering via private and/or public contracts.

LEARNING OBJECTIVES:
To describe the need to revise the current influenza vaccine distribution system to alleviate the negative impact that service disruptions have on LPHAs’ ability to acquire and administer influenza vaccine to the most vulnerable high-priority populations.