Disparate Timing In the Delivery of Influenza Vaccine In Pediatric Offices

Background:  Children who receive Vaccines for Children (VFC) influenza vaccine are less likely to be immunized than their privately insured counterparts. There is also evidence that administering vaccine in September and October saves $6-9 million annually. Due to additional distribution steps, VFC vaccine may be shipped later than privately purchased vaccine. Delays in VFC vaccine delivery create a disparity of care and place an extra burden on pediatric practices.

Objectives:  To assess the difference in the timing of VFC and privately purchased influenza vaccine delivery to private pediatric offices.

Methods:  In November 2010, a geographically diverse convenience sample of approximately 800 pediatricians was asked to complete a web-based survey.  Physicians were ask to provide the exact date of delivery for their first shipment of VFC and privately purchased influenza vaccine.

Results:  Fifty-seven pediatricians in 24 states completed the survey. The difference between mean first delivery date of VFC and private multidose vaccine is 4 weeks; between VFC and private preservative free vials is 4.5 weeks; between VFC and private FluMist is 6 weeks. Although many states only had 1 respondent, several state-level observations were made. Five states (IL, PA, NY, NJ, and MD) received VFC influenza vaccine 6-12 weeks later than privately purchased vaccine.  Three states (TN, NC and WA) did not report similar relative delays. North Carolina received VFC vaccine as early as privately purchased vaccine but in small shipments.

Conclusions:  In this limited sample, the delivery of VFC vaccine lagged behind that of privately purchased vaccines, yet state-level variability exists. This variability appears to be, in part, due to state-level ordering and distribution practices, creating disparity in care. States who distribute vaccine efficiently should share best practices with other VFC grantees.