From refrigerator to arm: issues in vaccination delivery.

This report summarizes the first meeting of a panel of immunization experts who met in Washington, DC, on May 4-5, 2012. The panel consisted of experts from national immunization policy organizations; state, regional, and local immunization programs; and vaccinating health care practices. The primary objective of this meeting was to identify issues in the vaccine delivery process as a critical first step in the determination of where and how improvements can be made. Vaccines are one of the greatest achievements in public health. However, in order to maintain the integrity of vaccines and the success of vaccination programs, proper handling of vaccines from the receipt of shipment through administration to the patient is critical. Continuous improvement of the vaccine delivery process is important to ensure appropriate vaccine handling by all vaccine providers. The overarching consensus of the participants of this meeting was that the major challenge in vaccine delivery is the complexity throughout all areas of the vaccine delivery process, which is often underestimated, particularly in the areas of vaccine preparation and administration. The lack of detailed, consistent standards encompassing all areas of the vaccine delivery process, and the gaps in oversight, education, and training of vaccine providers, particularly providers of adult vaccines, were also identified as major issues. The next step for this panel is to reconvene to explore potential solutions to address the identified issues.