ATLANTA — The problem of how to reduce vaccine-related errors was raised during the lively question-and-answer session at the conference, which was sponsored by the Centers for Disease Control and Prevention.
The panelists—Dr. Iyabode Akinsanya-Beysolow, Dr. William Atkinson, Dr. Andrew Kroger, and Donna Weaver, R.N., all of the Centers for Disease Control and Prevention's National Center for Immunization and Respiratory Diseases—fielded a variety of vaccine-related questions from the audience.
One audience member reported that, in the last year, the number of vaccine errors she has seen had gone up fourfold, and there is no system to capture them. Without capturing the data, she added, it is difficult to make the case to manufacturers for label changes.
“Point well taken,” Dr. Atkinson replied. The Vaccine Adverse Event Reporting System is not built to capture administration errors, he noted. “We just don't have the kind of epidemiologic analysis we'd like to have.”
Ms. Weaver emphasized the importance of training and orientation for each new person and each time there is a new vaccine. And after training, she advised, test your office staff to make sure they indeed developed the proper knowledge and skills.
Convincing manufacturers to improve labeling can be helpful, but providers can make important changes in their own offices, she counseled. She cited several simple examples, including carefully labeling diluents and keeping each diluent with the right vaccine.
Educational programs, posters, and other resources are available from the CDC and other organizations to help enhance vaccine safety in the office, she said. In particular, she mentioned California's www.eziz.org
The other topics discussed included the following:
▸ Confusing the diphtheria, tetanus, acellular pertussis (DTaP) vaccine for children and the tetanus, diphtheria, and acellular pertussis (Tdap) vaccine for adolescents and adults. Practices continue to make this mistake, one audience member reported. Dr. Akinsanya-Beysolow advised storing each vaccine on a different shelf. Label each shelf with the name of the vaccine and the age of the patient “in big, big neon letters.”
She also echoed Ms. Weaver's remarks about the importance of adequate training.
▸ More to come on pertussis, Tdap. The pertussis work group has started meeting again after taking about a year off, Dr. Atkinson reported, and he predicted a flurry of information “emerging from their discussions.” Another issue he expects the group to address is the use of Tdap in patients 65 and older.
An audience member asked if the CDC planned to refine its guidance regarding Tdap during pregnancy. It might. ACIP's recommendation to defer the vaccine until after pregnancy is based on data from 1945, Dr. Kroger said.
▸ Allaying fears about live attenuated influenza vaccine (LAIV). An audience member asked about the use of LAIV among health care providers, noting “no one would use it” because of the fears generated by the warning about using it around immunocompromised individuals. Dr. Atkinson explained that warning would be removed, and that it had been “a real distraction.” Compounding the concerns, noted an audience member, is that various professional groups issue “countermessages.”
Disclosures: None of the panelists reported any conflicts of interest.