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One-third of FPs Failed to Follow ACIP Recommendations During Hib Vaccine Shortage
Nearly 20 Percent of FPs Surveyed Were Unaware of Interim Recommendation to Defer Booster Dose
By News Staff
Researchers said that physicians in both specialties were less likely to adhere to recommendations if they thought their practices had adequate supplies of Hib vaccine.
In response to the recall and resulting vaccine shortage, the CDC, the AAFP and the AAP recommended temporarily deferring the Hib booster in healthy children not at high risk for invasive Hib disease. CDC officials further urged clinicians to track children in whom the booster was deferred so they could be recalled for immunization when the supply problem improved.
Merck subsequently suspended production of the two Hib-containing vaccines, and the interim recommendations stayed in place for more than 18 months.
The CDC, the Academy and the AAP reinstated the booster dose in June 2009 after vaccine manufacturer Sanofi Pasteur helped fill the Hib vaccine gap with increased distribution of its monovalent Hib vaccine, ActHIB, and its combined diphtheria, tetanus toxoids, acellular pertussis, inactivated poliovirus and Hib, or DTaP-IPV/Hib, vaccine, which is marketed as Pentacel.
In August 2009, GlaxoSmithKline's monovalent Hib vaccine, Hiberix, was approved by the FDA for booster doses in children ages 15 months to 4 years, further alleviating the shortage. Soon thereafter, the CDC recommended that physicians recall children who had not received a Hib booster dose.
Merck's PedvaxHib returned to the market in January 2010, but COMVAX remains unavailable. (Editor's Note: COMVAX returned to the market in August 2010.)
Effects of the Shortage
In addition, 21 percent of pediatricians and 37 percent of family physicians surveyed said they thought the interim recommendations were unclear. However, the study's researchers hypothesized that the lack of clarity actually had less to do with the recommendations themselves than it did with the varying formulations of the Merck and Sanofi vaccines and the fact that the competing products required different numbers of doses to complete their respective primary series.
Regardless, the authors contended that the difficulties such vaccine shortages impose on primary care practices, coupled with the potential for losing ground in the battle against once-prevalent vaccine-preventable diseases, "point to the need for national policy efforts to stabilize vaccine supplies."
Merck Resumes Distribution of Monovalent Hib Vaccine
Recall of PedvaxHIB Led to Nationwide Shortage, Booster Deferrals
CDC, AAFP Recommending Recall of Children in Need of Hib Booster Dose
Approval of Hiberix Expected to Bolster Supply
Pediatrics: "Knowledge of Interim Recommendations and Use of Hib Vaccine During Vaccine Shortages"
CDC: Hib Vaccination