Supply

See below for general resources related to vaccine supply. In the case of disrupted supply, the following resources can keep you informed, and provide information to help keep your patients up to date.

• CDC describes how state immunization programs distribute Vaccine for Children (VFC) Program vaccine on its VFC Program Distribution of Pediatric Vaccines page. 

• Learn more about managing vaccine supply on the AAP Vaccine Storage and Handling page.

• Check out the latest 2018-2019 Influenza Vaccine Supply Update page.

• The Influenza Summit has provided information on how influenza vaccine can be ordered and from whom on its Influenza Vaccine Products page.

• The latest information on current national vaccine supply shortages is available on the
  CDC Vaccine Shortages & Delays page.
  

• The American Society of Hospital Pharmacists (ASHP) releases bulletins on current drug shortages
  on its Drug Shortages List page.

Current Pediatric Vaccine Shortage

Influenza

Supply Delay

This year the World Health Organization and the Food and Drug Administration decided to delay selection of the A/H3N2 strain to be included in the 2019-2020 seasonal influenza vaccine by one month, due to late-emerging A/H3N2 viruses. Authorities used this time to collect additional data that would help assure the best possible selection of the A/H3N2 strain for inclusion in the 2019-2020 seasonal flu vaccine. Because of this delay, influenza vaccine manufacturers may begin to distribute flu vaccine later than in typical years. Below is a table describing when manufactures anticipate beginning to distribute flu vaccine for the 2019-2020 season. This information was presented at the June 2019 meeting of the Advisory Committee on Immunization Practices.

Supply Shortage for Live-attenuated Influenza Vaccine

The supply of nasal spray flu vaccine will be limited during the 2019-'20 season due to manufacturing constraints, according to AstraZeneca. The reduced supply of FluMist Quadrivalent, a live attenuated influenza vaccine (LAIV), will impact both the public and private sectors, according to a company spokesperson. AstraZeneca plans to spread distribution throughout the season and said the reduced supply will not impact vaccine quality. Centers for Disease Control and Prevention (CDC) officials said the LAIV shortage is not expected to cause an overall shortage of flu vaccine.

Health care providers may need to check with multiple suppliers or purchase a different brand of vaccine. Those replacing LAIV also will need to consider factors like the ages of their patients and the setting for vaccine administration.

There is no change in the recommendations for influenza vaccine administration. In March, the AAP announced it will not have a preference between LAIV and inactivated influenza vaccine next season. The move is a change from the current season in which the AAP considered inactivated influenza vaccine the primary choice, while saying LAIV could be used for children who would not otherwise receive a vaccine.

AAP announces the limited supply of nasal spray flu vaccine to members via AAP News, Nasal spray flu vaccine supply will be limited next season.

Hepatitis B

Pediatric hepatitis B vaccine Recombivax HB will be in short supply through the middle of 2020. In a letter to providers in 2017, Merck said demand around the world and manufacturing process updates caused the shortage of Recombivax HB in both pediatric and adult formulations. This shortage impacts the following package sizes for the pediatric/adolescent formulation: ten (10) 5 mcg/0.5 mL single-dose pre-filled Luer-Lok® syringes with tip caps and 5mcg/0.5mL - 10 single-dose 0.5mL vials. More information can be found on the Merck Supply Status page.

There is no change in the recommendations for hepatitis B vaccine administration – 3 dose series (birth, 1-2 months of age and 6-18 months of age). During this shortage, the Centers for Disease Control and Prevention (CDC) recommends prioritizing the birth dose and completion of the infant series over child and adolescent catch-up vaccination unless those patients are at risk for infection. For more information about hepatitis B and current hepatitis B vaccination recommendations, see the AAP Vaccine Preventable Diseases and Policy page.
 
GlaxoSmithKline (GSK) has an adequate supply of hepatitis B vaccine to make up for the shortage, according to the CDC. GSK produces single-component Engerix-B and the combination vaccine Pediarix. For more information regarding ordering supply from GSK, visit the GSK Direct Website or reference the GSK Direct Customer Resource Guide.

CDC clinical guidance during this supply shortage is available at https://www.cdc.gov/vaccines/hcp/clinical-resources/shortages.html.

AAP announces the hepatitis B shortage extension to members via AAP News, Merck HepB vaccine shortage extended; GSK has supply.

AAP announces further extension of the hepatitis B vaccine shortage to AAP members via AAP News, Merck HepB vaccine shortage extended through mid-2020.