Filia Antonietta, Rota Maria Cristina, Grossi Adriano, Martinelli Domenico, Prato Rosa, Rezza Giovanni
Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.
Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.
Vaccine. 2022 Mar 18;40(13):1987-1995. doi: 10.1016/j.vaccine.2022.02.041. Epub 2022 Feb 19.
National immunisation programmes require an adequate supply of vaccines to function properly but many countries, globally and in Europe, have reported vaccine shortages. A comprehensive view of vaccine shortages and stockouts in the EU/EEA is missing in the published literature. This study was conducted in the framework of the European Joint Action on Vaccination (EU-JAV). Twenty-eight countries, including 20 EU-JAV consortium member states and an additional 8 EU/EEA countries, were invited to participate in a survey aimed at collecting information on vaccine shortages and stock-outs experienced from 2016 to 2019, their main causes, actions taken, and other aspects of vaccine supply. Twenty-one countries completed the survey (response rate 75%), of which 19 reported at least one shortage/stock-out event. Overall, 115 events were reported, 28 of which led to a change in the national immunisation programme. The most frequently involved vaccines were DT- and dT-containing combination vaccines, hepatitis B, hepatitis A, and BCG vaccines. The median duration of shortages/stock-outs was five months (range <1 month-39 months). Interruption in supply and global shortage were the most frequently indicated causes. Only about half of countries reported having an immunization supply chain improvement plan. Similarly, only about half of countries had recommendations or procedures in place to address shortages/stockouts. The survey also identified the occurrence of shortages/stockouts of other biological products (e.g. diphtheria antitoxin in 12 countries). Public health strategies to assure a stable and adequate vaccine supply for immunization programmes require coordinated actions from all stakeholders, harmonized definitions, strengthening of reporting and monitoring systems, the presence of an immunization supply chain improvement plan in all countries, and procedures or recommendations in place regarding the use of alternative vaccines or vaccination schedules in case of shortages/stockouts.
国家免疫规划需要充足的疫苗供应才能正常运作，但全球和欧洲的许多国家都报告了疫苗短缺的情况。已发表的文献中缺少对欧盟/欧洲经济区疫苗短缺和缺货情况的全面看法。本研究是在欧洲疫苗接种联合行动（EU-JAV）的框架内进行的。包括20个EU-JAV联盟成员国和另外8个欧盟/欧洲经济区国家在内的28个国家被邀请参与一项调查，旨在收集2016年至2019年期间经历的疫苗短缺和缺货情况、其主要原因、采取的行动以及疫苗供应的其他方面的信息。21个国家完成了调查（回复率75%），其中19个国家报告了至少一次短缺/缺货事件。总体而言，共报告了115起事件，其中28起导致了国家免疫规划的改变。最常涉及的疫苗是含DT和dT的联合疫苗、乙型肝炎疫苗、甲型肝炎疫苗和卡介苗。短缺/缺货的中位持续时间为五个月（范围<1个月至39个月）。供应中断和全球短缺是最常指出的原因。只有约一半的国家报告有免疫供应链改进计划。同样，只有约一半的国家有应对短缺/缺货的建议或程序。调查还发现了其他生物制品的短缺/缺货情况（例如，12个国家的白喉抗毒素）。确保免疫规划有稳定和充足疫苗供应的公共卫生战略需要所有利益攸关方采取协调行动、统一定义、加强报告和监测系统、所有国家都有免疫供应链改进计划，以及在短缺/缺货情况下使用替代疫苗或接种时间表的程序或建议。
