Balancing Act: Launching Pentacel during the Hib Shortage

Background:
In December, 2007 a national Hib shortage was declared. Hib vaccine supplies were restricted and interim recommendations made for completion of 3 of the 4 doses in the series. The introduction of a Hib containing combination vaccine in August of 2008 complicated management of the shortage. The goal of the Washington State Department of Health Immunization Program CHILD Profile (IPCP) was to manage the shortage and implementation the new vaccine successfully with the least confusion possible.

Setting:
Washington State

Population:
State and local health departments, providers, children 0-18

Project Description:
Data analysis was used to determine the best strategy to integrate the Hib containing combination vaccine. The goal was to limit confusion by targeting providers and health districts. Strategies included: maintaining consistency across provider organizations with multiple geographic locations, focused communication, consultation and education efforts. Longer term strategies were developed when the shortage was extended for an additional 8 months. Allocations were created for geographic areas. Provider orders were monitored against the state allocation by local health departments, and by state staff using an excel spreadsheet. Communication strategies included: e-mail list serve, internet and provider professional organizations.

Results/Lessons Learned:
Washington Hib orders never exceeded the allocation in any month of the shortage. Washington data on allocation balances matched McKesson/CDC data with one exception. Providers received information in a timely manner and successfully implemented the new vaccine. Revisiting state demographics indicated more Hib containing vaccine was needed than received for the 3 dose series. Additional combination vaccine was obtained to fill the gap for providers who were unable to meet the 3 dose series, and guidance was given regarding recall for children unable to receive the primary series.