KEYWORD1:
Computerized immunization registry
Vaccine recall
Vaccine re-administration

BACKGROUND:
In December 2001 40 lots of Hepatitis A vaccine were voluntarily recalled. Eight Denver Health Clinic sites had received recalled vaccines and administered 1,360 doses (to 1,339 patients) during the period 7/16/99-12/19/01.

OBJECTIVE:
To evaluate the utilization of a computerized immunization registry to manage a vaccine recall and to evaluate patient response to the recall.

METHOD:
The registry was queried to identify patients who had received recalled vaccines. The first patient notification occurred on 3/14/2002 via letters generated from the registry. A note was electronically appended in the registry that the patient was notified of the recalled vaccine by a mailed letter. A new vaccine was created in the registry and named “Recalled HepA.1.” The vaccination history in the patient record was changed to this new vaccine name and all other documentation (manufacturer, lot number, provider, site, date, VIS form & date) remained associated with this history. The registry “recommend” function was changed to not count “Recalled HepA.1” vaccine. Patients returning for repeat doses are monitored through the registry. Second notification letters have not been sent.

RESULT:
Following notification of recalled vaccine, 646 (48%) of the original 1,339 patients have been re-vaccinated. 147 letters were unable to be delivered and those patients (11%) were identified as moved within the registry. 546 patients (41%) have not returned for vaccine re-administration.

CONCLUSION:
A computerized immunization registry can assist with the management of a vaccine recall.
Although patient response to a single reminder letter about recalled vaccine was significant, a number of patients could not be notified, and a large number did not follow up for re-vaccination.
LEARNINGOBJECTIVES:
To identify how an immunization registry may be used to manage a vaccine recall.