A 5-year look-back at the notification and management of vaccine supply shortages in Germany

Abstract

Background Unavailability of vaccines endangers the overall goal to protect individuals and whole populations against infections. Methods The German notification system includes the publication of vaccine supply shortages reported by marketing authorisation holders (MAH), information on the availability of alternative vaccine products, guidance for physicians providing vaccinations and an unavailability reporting tool to monitor regional distribution issues. Aim This study provides a retrospective analysis of supply issues and measures in the context of European and global vaccine supply constraints. Results between October 2015 and December 2020, the 250 notifications concerned all types of vaccines (54 products). Most shortages were caused by increased demand associated with immigration in Germany in 2015 and 2016, new or extended vaccine recommendations, increased awareness, or changes in global immunisation programmes. Shortages of a duration up to 30 days were mitigated using existing storage capacities. Longer shortages, triggered by high demand on a national level, were mitigated using alternative products and re-allocation; in a few cases, vaccines were imported. However, for long lasting supply shortages associated with increased global demand, often occurring in combination with manufacturing issues, few compensatory mechanisms were available. Nevertheless, only few critical incidents were identified: (i) shortage of hexavalent vaccines endangering neonatal immunisation programmes in 2015;(ii) distribution issues with influenza vaccines in 2018; and (iii) unmet demand for pneumococcal and influenza vaccines during the coronavirus disease (COVID)-19 pandemic. Conclusion Vaccine product shortages in Germany resemble those present in neighbouring EU states and often reflect increased global demand not matched by manufacturing capacities.

Vector competence of Swedish Culex pipiens mosquitoes for Japanese encephalitis virus

“…Further exploration of the environmental conditions necessary for JEV transmission in temperate climates is crucial for public health preparedness, especially since the current shifts in climate and ecological landscapes may favour the emergence of JEV in previously unaffected regions. Studying viruses for which vaccinations are available is crucially highlighted not only by the reported shortage of the JEV vaccine according to agencies like the German Robert Koch Institute [ 65 ], but also by the fact that recommendations for vaccination hinge upon comprehensive risk assessment, which emphasizes the importance of understanding the vectors involved in the transmission of these viruses. Vaccine shortages further emphasize the necessity for multifaceted preparatory measures beyond merely making vaccines available, with knowledge of vectors as one essential part of this.…”

Fractional dosing to improve vaccination coverage, vaccine hesitancy, and cost-effectiveness in Africa: a systematic review

“…Additionally, fractional doses may also have less side effects [34], vaccine antigen overload, cost, and stock-outs [35,36,17] than standard dose. Vaccine shortages and stockouts during outbreaks happen frequently in underdeveloped countries, and occasionally in developed countries [37][38][39][40]. In a country, the shortage/stockout events can occur at the national and at subnational level.…”