Using an immunization information system to facilitate a vaccine recall in New York City- 2007

BACKGROUND: In December 2007- Merck & Co- Inc- initiated a voluntary recall of 10 lots of PedvaxHIB- and 2 lots of COMVAX when the potential of contamination was identified during routine testing of the manufacturing equipment. Merck recommended that providers stop vaccinating children using these vaccine lots. OBJECTIVE: To describe how the New York City (NYC) Immunization Information System was used in the effort to recall vaccines. METHODS: Immediately following Merck's announcement- NYC's Bureau of Immunization used the New York Citywide Immunization Registry (CIR) to (a) fax and e-mail all pediatric facilities a letter informing them of the recall and asking that they immediately remove recalled vaccines from their refrigerators/ (b) identify facilities that had used the recalled lots- on the basis of data reported to the CIR- and contact them individually by phone/ and (c) monitor the success of the recall by examining the number of recalled doses administered and reported to the CIR before and after the recall. RESULTS: The alert was faxed and e-mailed to 1928 pediatric facilities informing them of the recall. In addition- the Bureau of Immunization identified 105 facilities that had reported doses of vaccine from the recalled lots to the CIR and called to ask them to check their refrigerators for remaining supplies and discontinue use of this vaccine. The number of doses with the affected lot numbers reported to the CIR decreased sharply following CIR recall notification. Furthermore- the Centers for Disease Control and Prevention and Merck reported the return of nearly 50% of publicly and privately purchased vaccines from the recalled lots that had been distributed to NYC providers. CONCLUSION: Immunization Information Systems can be effective tools for quickly identifying providers in possession of recalled vaccine lots- particularly when lot numbers are well reported- and for facilitating rapid vaccine recall in support of vaccine safety.