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July 2003 • Volume 37 • Number 7

Infectious Diseases

Only Hib is somewhat precarious
For the First Time in Several Years, CDC Deems Vaccine Supply to Be Stable

Joyce Frieden
Associate Editor, Practice Trends

WASHINGTON — Dean Mason is a happy man.

“For the first time in a long time, we can say that the vaccine supply is okay,” said Mr. Mason, program support branch chief at the Centers for Disease Control and Prevention's National Immunization Program Immunization Services Division.

Take the supply of DTaP vaccine, for example. “We are awash in DTaP vaccine,” Mr. Mason said at a meeting of the CDC's National Vaccine Advisory Committee. Supplies of MMR vaccine are good too: CDC had a goal of stockpiling 4 million doses and currently has 3.5 million doses stockpiled, with another 549,000 purchased and awaiting delivery. Supplies also are good for varicella and pneumococcal vaccines.

But there is one vaccine that he is a little worried about. “Hib [Haemophilus influenza b] is the vaccine we'll most closely need to monitor,” he said. The reason is that Wyeth, one of three manufacturers, has had some supply problems.

“Their Hib supply for the last 6 months of 2002 was almost nonexistent,” Mr. Mason said. “[Two other manufacturers] were able to supply it in sufficient quantities to make up, but Wyeth must begin supplying by September 2003” or the stockpile will fall behind. In conversations with CDC officials, the company has said it's committed to resuming its Hib supply, he added.

Even with the good news about supply, the CDC is not resting on its laurels. Instead, the agency has hired an outside contractor, the Logistics Management Institute (LMI), to develop a strategic plan for keeping up the stockpile. LMI has been asked to submit a plan to the National Immunization Program by the end of this month.

Although the supply is stable, problems with distributing vaccines under the Vaccines for Children (VFC) program still persist, Mr. Mason said, noting that VFC representatives have documented the problems in site visits to physician offices. “There are significant issues with vaccine storage at inadequate temperatures and with rotating stock,” he said. “It troubles me that vaccines are sitting in the [physician's] fridge that are expired.”

Another problem is that some physicians are giving VFC vaccines to privately insured children and then billing for the vaccinations as if they had paid for the vaccines themselves. That makes Mr. Mason wonder whether doctors should be required to keep track of the vaccine they get from the program.