Evaluating the adequacy of pediatric vaccine stockpiles

While the Chiron-induced flu vaccine shortage in 2004 received far more public attention, there have been a number of shortages of universally-recommended pediatric vaccines since 2001. Among the vaccines in limited supply at some point in the past five years are measles/mumps/rubella, varicella, and diphtheria/tetanus/pertussis, among others. There's little doubt that the likelihood of temporary shortages is increased by the presence of only a single manufacturer of many recommended pediatric vaccines. Ensuring an adequate supply of those vaccines recommended to be administered to all children is very much an ethical issue.

The reasons for the current shape of the U.S. vaccine marketplace are many and well documented elsewhere. While some may hope for a wholesale redesign of the vaccine production marketplace, a more immediate response implemented by the CDC has been the creation of a 6-month stockpile of many recommended pediatric vaccines. The stockpile is intended to provide a buffer against short-term disruptions.

The current issue of Vaccine has an interesting paper that examines the adequacy of current stockpile levels to respond to shortages. The paper is titled "Stockpile levels for pediatric vaccines: How much is enough?" (free abstract, subscription required for full text). Using mathematical modeling, the authors' data validate the belief that current levels are adequate for a 6-month shortage of the vaccines included in the stockpile. Not surprisingly, the current stockpiles are very likely too small for a shortage of 8 months or longer, depending on how severe the shortage is. It should be noted that most recent pediatric vaccine shortages have lasted over one year.