Improving Communications During a Vaccine Shortage: Lessons Learned From the 2008 - 2009 Haemophilus Influenzae Type B (Hib) Shortage

Background: Researchers from the Emory University Preparedness and Emergency Response Research Center and the Association of Immunization Managers are collaborating on studies aimed at learning how state, city, and territorial immunization programs respond to vaccine shortages to help improve public health preparedness through maximizing the capabilities of the U.S. vaccination system.  In a 2009 survey of state and territorial immunization program managers, the 2008/09 Haemophilus influenzae Type-B (Hib) shortage was used as a case study to ask immunization programs (IPs) specific questions regarding their management of the shortage. 

Objectives: Examine the ability of IPs to manage the 2008/09 Hib shortage, focusing on successes, challenges, and lessons learned regarding monitoring inventories and communicating with providers.

Methods: The survey was administered via email to 64 state/city/territorial IP managers in July 2009. Data were analyzed using Feedback Server 2008 (Data Illusion, Stockholm, Sweden) and SAS 9.2 (Cary, NC).

Results: Fifty-six percent (36/64) of IP managers responded to the survey. Thirty-five percent of respondents indicated that their jurisdiction did not have enough vaccine during the 2008 Hib shortage to fulfill the 3-dose revised recommendations issued by CDC. To monitor providers adherence to revised recommendations, many tools were utilized: 47% of IP managers used their immunization information system (IIS), 25% used phone calls or emails, 28% relied on anecdotal reports, and 11% had no mechanism in place to track provider adherence. Thirty-eight percent also indicated using other methods. To communicate with providers, IP managers believed blast faxes, emails and postal mail to be the most effective methods; posting information to their health department websites, supplying providers with communication materials, and including information in newsletters were believed to be the best ways to communicate with the public.

Conclusions: The Hib shortage forced many IPs to remain in close contact with vaccine providers and the public due to frequent changes in vaccine schedule recommendations.  IP managers employed a variety of communication methods to both push information out and collect situational information on vaccine administration.  This survey indicates the need for similar communications studies of vaccine providers and the public to determine the best ways for IPs to send and receive information related to vaccine shortages.