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Tuesday, March 31, 2009
Grand Hall area
Background:
In December 2007, Merck & Co. initiated a voluntary recall of 10 lot numbers of PedvaxHIB® and 2 lot numbers of COMVAX® due to potential contamination, and temporarily suspended production of Hib vaccines. Since Merck & Co. produced approximately half of the nation's Hib vaccine supply, a shortage of Hib-containing vaccines ensued leading to CDC's interim recommendation to defer the Hib booster dose administered at 12-15 months of age, except to high risk children. Providers expressed concern about the effect of these recommendations on their overall coverage levels.
Objectives:
To measure the impact of Hib shortages on two-year-olds' immunization coverage rates among sites receiving AFIX visits in NYC.
Methods:
The NYC BOI adjusted its coverage algorithm to account for the interim recommendations for the usage of Hib-containing vaccines. The coverage rates for both, regular and interim Hib recommendations, were calculated and compared for 85 practices assessed from May to August 2008. The impact of the Hib shortage was also measured for the 4:3:1:3:3:1 series.
Results:
Overall 4:3:1:3:3:1 series coverage was 81% (range: 23% to 100%). When calculating the 4:3:1:3:3:1 series coverage accounting for interim recommendations of deferring the Hib booster, coverage was only 3 percentage points higher at 84% (range: 44% to 100%). DTaP had the lowest coverage in 58% of the sites and Hep B in 27% of the sites; Hib had the lowest coverage in only 4% of sites. When comparing single antigens, Hib coverage was 6 percentage points higher when adjusting the algorithm to exclude the Hib booster (92% vs. 98%).
Conclusions:
This analysis indicates that Hib did not affect series coverage greatly. It is likely too soon to see the full impact of Hib vaccine shortages among two-year-olds; therefore, this analysis will continue. As coverage declines, tracking changes in disease rates will be important.