BACKGROUND:
Shortages of pneumococcal conjugate vaccine (PCV) were experienced in the first half of 2004. To maintain adequate vaccine for high risk children, the Advisory Committee for Immunization Practices recommended delay of administration of the 3rd and 4th doses of PCV (PCV3 and PCV4, respectively) to healthy children, but no delay in administration of the 1st and 2nd doses of PCV (PCV1 and PCV2, respectively).

OBJECTIVE:
Assess the pattern of PCV administration during periods of vaccine shortage and changing recommendations. Demonstrate the usefulness of immunization registries in evaluation of immunization delivery.

METHOD:
Using their immunization registry, Southern California Kaiser Permanente evaluated PCV doses administered to all enrolled children at age 3 months, 5 months, and 7 months in 2004. PCV coverage prior to shortage-related recommendations was compared to coverage after recommendations were made to discontinue PCV dose 3 and 4 to healthy children.

RESULT:
Immunization coverage levels with PCV1 for children age 3 months remained similar (range 80-86%) between January and July 2004. The same pattern was seen with PCV2 for children age 5 months. PCV3 immunization coverage for children age 7 months dropped significantly (p< .0001) from 73% coverage in February to 17% coverage in April, one month after ACIP recommendations to suspend this dose to healthy children. PCV3 coverage among 7 month olds remained <20% through July 2004.

CONCLUSION:
The Southern California Kaiser Permanente immunization registry demonstrated that Kaiser's providers decreased delivery of PCV 3 to enrolled children in accordance with ACIP recommendations.

LEARNING OBJECTIVES:
Attendees will understand that immunization registries are useful in assessing provider practices.
Attendees will understand that Southern California Kaiser providers followed ACIP recommendations and decreased administration of PCV3.