AAP advocacy spurs improvements to flu vaccine distribution
MelissaJenco, News Content Editor
Pediatricians may receive flu vaccines for low-income children more quickly next season.
At the Academy’s urging, federal and state health officials are working to improve
distribution of Vaccines for Children (VFC) program orders.
“This will make a big difference for children,” said AAP CEO/Executive Vice President
Karen Remley, M.D., M.B.A., M.P.H., FAAP. “It will make a big difference for communities
because they’ll be able to increase their immunity and protection from flu faster
in the fall so less children will get sick, less children will miss school, more parents
won’t (miss) work. Importantly, we’ll be able to start treating all children the same.”
The VFC program provides vaccines to children who are uninsured, underinsured, eligible
for Medicaid, American Indian or Alaska Native, and serves about half the children
in the U.S., according to the Centers for Disease Control and Prevention (CDC). The
CDC allocates these vaccines to states, which then distribute them to health care
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
SOAPM Chair Christoph R. Diasio, M.D., FAAP, said it is “distressing” for practices
not to vaccinate children with public insurance because the supply hasn’t arrived.
“A lot of times if you don’t give the vaccine that day, they don’t get the vaccine,”
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 further 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
“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 improvements that can
result in getting vaccines out in a more timely way,” she said.
Pediatricians can help by connecting with their state immunization managers directly
or via their AAP chapters to make sure they are putting best practices in place.
Dr. Diasio said he appreciates the CDC’s efforts, spurred by the Academy’s advocacy.
“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