allocates these vaccines to states, which
then distribute them to health care providers.
For years, members of the AAP Section on Administration and Practice
Management (SOAPM) have used the
group’s Listserv to discuss concerns
that they receive flu vaccines for these
children long after privately purchased
vaccines, a situation which AAP surveys
SOAPM Chair Christoph R. Diasio,
M.D., FAAP, said it is “distressing” for
practices not to vaccinate children with
public insurance because the supply
“A lot of times if you don’t give the
vaccine that day, they don’t get the vac-
cine,” he said. “Life is full and busy.”
Borrowing private vaccine supply for
VFC-eligible children is prohibited in
some states and tends to be complicated
in others since the VFC stock is federally
funded, according to Dr. Diasio.
He and Dr. Remley agree that the situation creates inequity between children
with private insurance who can access
vaccines earlier and those with public
insurance who may have to wait.
“If those delays are significant, it really
means we’re not treating all children the
same, something that for any pediatrician is incredibly difficult to do,” Dr.
In recent years, the CDC has tightened up its process and now inventories
and allocates vaccines to the states in just
over two days. However, delays at the
state level have persisted. Dr. Remley,
who is a former state health commissioner, and other AAP leaders, implored
the CDC to look for new solutions.
Melinda Wharton, M.D., M.P.H.,
director of the Immunization Services
Division of the CDC’s National Center for Immunization and Respiratory
Diseases, said the CDC used a new
approach this flu season to figure out
where delays were occurring.
“What we saw was there was a lot of
variability,” she said.
Each state has different resources and
processes for ordering and distributing
the vaccines, which can contribute to
delays in some areas.
The CDC shared its findings with
state immunization managers so they
could see how their state stacked up. It
also recently held a webinar to pass along
best practices from those who distribute
vaccines quickly. Those practices include
beginning distribution even while waiting for some of the supply and removing
steps from the ordering process.
The system, Dr. Wharton said, is fur-
ther complicated by different types of
vaccines and different manufacturers,
so delays won’t disappear entirely next
season. Still, she said the CDC has taken
a good first step and will continue to
communicate with state managers.
“I think we’re hopeful that with …
them really being able to see how they’re
doing, that it will be possible for many
programs to identify process improve-
ments that can result in getting vaccines
out in a more timely way,” she said.
Pediatricians can help by connecting
with their state immunization manag-
ers directly or via their AAP chapters to
make sure they are putting best practices
Dr. Diasio said he appreciates the
CDC’s efforts, spurred by the Acade-
“Having the ability to connect us
(SOAPM members) electronically
was an AAP member benefit,” he said.
“And having the AAP really speak for
the cause of children was incredibly
VFC continued from front page
• AAP policy Recommendations for
Prevention and Control of Influenza
in Children, 2016–2017, http://bit.
• Flu information for parents, http://bit.