KEYWORDS:
Interim CDC Guidelines, Pneumococcal Conjugate Vaccine, Nationwide Shortage

BACKGROUND:
In August of 2001, the sole manufacturer of the pneumococcal conjugate vaccine (PCV-7) first announced problems in meeting the national demand for the vaccine. Subsequently, CDC published it first interim quidelines restricting use of PCV-7 in September of 2001 and the guidelines were implemented in County of Los Angeles Department of Health Services (LACDHS) community clinics during the same month. More restrictive guidelines were published by CDC in December, 2001. There was uncertainty whether either of the guidelines would result in the restriction of vaccine usage to high priority groups because of the complexity of the immunization schedule.

OBJECTIVE:
To determine the effectiveness of the CDC Interim guidelines on PCV-7 in restricting vaccine usage to high risk groups.

METHOD:
Monthly usage data for PCV-7 in LACDHS clinics, by age category, was analyzed for the period August 2001 through August 2002, to identify differences in utilization of the vaccine before and after implementation of each of the interim guidelines.

RESULT:
The first decrease in vaccine doses administered to non- high risk children occurred two months after CDC's first interim guidelines were published. The decrease was accelerated after the second more restrictive CDC guidelines. This was reflected by an increase in the percentage of vaccine administered to children under 2 yrs of age which rose from 71% (6023 out of 8449 doses) at the beginning of the study period to 96 % (1712 out of 1792 doses) at the end.

CONCLUSION:
Promulgation of interim CDC usage guidelines for vaccines in short supply can result in better prioritization of the limited vaccine to medically high risk groups.

LEARNING OBJECTIVES:
To review a strategy for prioritizing vaccine usage during shortages.