Learning Objectives for this Presentation:
By the end of this presentation participants will be able to understand the relationship between vaccine supply, shipping delays, and effects on primary care practices.

Background:
A significant shortage of influenza vaccine occurred in 2004, followed by shipping delays during 2005 and 2006. Delayed vaccine can have financial impacts on practices, especially when patients receive vaccine elsewhere. To better define the impacts of providing influenza vaccine, the AAFP—through a CDC cooperative agreement—has conducted four annual membership surveys.

Objectives:
none

Methods:
Surveys were mailed to randomly selected samples of clinically-active AAFP members in 2004 (n=2192), 2005 (n=4720), 2006 (n=5000) and 2007 (n=2000), and contained 5, 10, 9 and 8 questions pertaining to influenza issues, respectively. Summary statistics were evaluated. Comparisons between years and among demographic groups were made using chi square and ANOVA.

Results:
Modest return rates were achieved (2004: 46.5%; 2005: 48.3%; 2006: 52.4%; 2007: 44.1%). A decline in influenza vaccine providers occurred between 2005 (94.9%) and 2006 (90.0%; P<0.001). During the 2005/06 influenza season, 32% reported leftover vaccine; this increased to 50.2% for 2006/07. Moreover, there was a shift to an increasing percentage of unused vaccine (P=0.002). A majority (57.3%) of family physicians reported delays in vaccine orders in 2006. Despite the delays, there were no significant changes in the percentage of physicians providing influenza vaccine or planning to give this vaccine in the subsequent year. Availability of vaccine elsewhere (36.9%) and inability to cover costs (33.8%) were the most common reasons cited by physicians who were not planning to order influenza vaccine for 2007/08.

Conclusions:
A significant shortage of influenza vaccine in 2004 appears to have reduced provision of this vaccine by a small percentage of family physicians. Delays of vaccine appear to create end of season surpluses which can have financial implications.