Use of An Immunization Information System (IIS) to Facilitate Timely Recall of Potentially Contaminated Vaccine

Background:
In December 2007, Merck & Co. initiated a voluntary recall of 10 lots of PedvaxHIB, and two lots of COMVAX when the potential of contamination was identified during routine testing of the manufacturing equipment. Merck recommended that providers stop vaccinating children using the affected lot numbers.

Objectives:
To understand how an IIS can be used in the effort to recall potentially contaminated vaccine.

Methods:
Immediately following Merck's announcement, New York City's Bureau of Immunization (BOI) used the New York Citywide Immunization Registry (CIR) to (a) fax all pediatric providers a letter informing of the recall and asking providers to immediately remove affected vaccine from their refrigerator (b) identify the providers who had used the contaminated lot numbers based on lot data reported to the CIR and (c) determine the number of children who received the affected lot numbers.

Results:
Using CIR's contact information, the BOI faxed a letter to all ~1500 pediatric providers informing them of the recall. In addition, BOI identified 2,495 doses in the CIR whose lot number matched the recalled lots. All 105 providers who administered those lot numbers were called and asked to check their refrigerators for remaining supplies and to discontinue use of this vaccine. Most providers (n=81) reported having received the fax and being aware of the recall. 20 providers asked to be sent the fax again because they had not received it, or had misplaced it. 4 providers could not be reached, despite multiple attempts, and were left phone messages.

Conclusions:
An IIS can be used to quickly and effectively identify and target providers who are in possession of potentially contaminated lots of vaccine and to determine the scale of the problem in case children need to be recalled. IISs are effective tools to help remove rapidly contaminated vaccine from circulation and protect public health.