Other HHS agencies and programs also provide support for national, state,  and local immunization efforts nationwide. Shortages Prompt Actions to Reduce Immunization Requirements

Recent vaccine shortages have necessitated temporary modifications to  the recommended immunization schedule and have caused states to scale  back immunization requirements. At the state level,  immunization programs are rationing the amount of vaccines distributed  to providers. Many states have also suspended existing immunization  requirements, allowing children who have received fewer than the  previously recommended number of vaccinations to attend day care or  school. Underlying Factors Could Allow Shortages to Recur

While the recent shortages have been largely resolved, the vaccine supply  remains vulnerable to any number of disruptions that could occur in the  future—including those that contributed to recent shortages and other  potential problems, such as a catastrophic plant fire. If approved, several of these  vaccines would expand the number of suppliers for these products. No Clear Path Yet to Resolve Ongoing Supply Issues

Federal agencies and advisory committees are exploring options to help  stabilize the nation’s vaccine supply, but few long-term solutions have  emerged. CDC vaccine stockpiles have been used successfully to help mitigate  temporary supply disruptions in the past and were considered a priority  strategy by workshop participants. Some of this  information may already be available within HHS, but other information is  available only from manufacturers or state immunization programs. Conclusions

A steady and reliable supply of childhood vaccines is critical to maintain  the substantial U.S. public health achievements in combating infectious  diseases. On one hand,  manufacturers have economic incentives to bring new childhood vaccines  to market.
What GAO Found

Immunizations are considered one of the leading public health achievements of the 20th century. Mandatory immunization programs have eradicated polio and smallpox in the United States and reduced the number of deaths from several childhood diseases, such as measles, to near zero. A consistent supply of many different vaccines is needed to support this effort. Recent childhood vaccine shortages have prompted federal authorities to recommend deferring some immunizations and have caused states to reduce immunization requirements. At the state and local levels, 49 state immunization programs reported rationing one or more vaccines. Shortages have also prompted most states to waive or change immunization requirements for school and day care programs so that children who have not received all mandatory immunizations could enroll. Many factors contributed to recent vaccine shortages, and while these have largely been resolved, the potential exists for future shortages. On the supply side, some manufacturers had production problems, causing them to fall below their expected output, while others discontinued making some vaccines altogether. On the demand side, one manufacturer could not keep pace with the greater-than-expected demand for a new recommended vaccine. Federal agencies and advisory committees are exploring ways to help stabilize the nation's vaccine supply, but few long-term solutions have emerged. One option--expanding vaccine stockpiles--is being widely considered as a short-term strategy to help cushion disruptions in vaccine supply. Stockpiles have been used successfully to help mitigate supply disruptions in the past.