Vaccine
http://www.sciencedirect.com/science/journal/0264410X
Volume 30, Issue 5  pp. 821-982 (20 January 2012)

Regular Papers
Effects of a nationwide Hib vaccine shortage on vaccination coverage in the United States
Original Research Article
Pages 941-947
Tammy A. Santibanez, Abigail Shefer, Elizabeth C. Briere, Amanda C. Cohn, Amy V. Groom

Abstract
Background
A shortage of Haemophilus influenzae type b (Hib) vaccine that occurred in the United States during December 2007 to September 2009 resulted in an interim recommendation to defer the booster dose, but to continue to vaccinate as recommended with the primary series during the first year of life.

Objectives
To quantify effects of the Hib shortage on vaccination coverage and to determine if any demographic subgroups were disproportionately affected.

Methods
Data from the 2009 National Immunization Survey (NIS) were divided based on child’s age at the onset of the shortage. Comparisons were made in primary series coverage by 9 months between children <7 months versus ≥7 months at the start of the shortage. Comparisons in primary series plus booster dose completion by 19 months were made between children who were <12 months versus ≥12 months at the start of the shortage.

Results
Nationally, there was a difference in Hib primary series completion by 9 months among children age <7 months versus ≥7 months at the start of the shortage (73.9% versus 81.2%, P < 0.001). There was a large difference in the percentage of children fully vaccinated with the primary series plus booster dose by 19 months among children age <12 months versus ≥12 months at the start of the shortage (39.5% versus 66.0%, P<0.001). There were differential effects of the shortage on primary series coverage among states and for some demographic characteristics.

Conclusions
As expected booster dose coverage was reduced consistent with interim recommendations, but primary series coverage was also reduced by 7 percentage points nationally.