Administration of Expired Injectable Influenza Vaccines Reported to the Vaccine Adverse Event Reporting System--United States, July 2018-March 2019.
The VAERS adverse event findings suggest that expired IIV does not pose additional risks for adverse events beyond those of seasonal IIV. Vaccine failure was not assessed. In most reports, factors that contributed to administration of expired vaccine were not specified; however, one cluster of reports from a pharmacy stated that four persons received expired vaccine doses that had been mistakenly shipped from another pharmacy. Seven reports detailed that patients were offered revaccination with the current season's influenza vaccine; of these, three confirmed revaccination.
As a spontaneous reporting surveillance system, VAERS likely captures only a small fraction of expired IIV administered; therefore, this error might be more common than VAERS data indicate. CDC's Vaccine Storage and Handling Toolkit contains guidance pertaining to prevention of and mitigation of administration of expired vaccines and is available online (https://www.cdc.gov/vaccines/hcp/admin/storage/ toolkit/index.html) (4). Vaccine stock should be rotated and examined for expired doses regularly. Any expired vaccines and diluents should be removed immediately to avoid inadvertent administration (4).
Vaccines should be inspected for expiration before they are administered or transported to other facilities. Facility vaccine coordinators need to be aware of the standard expiration date of June 30 for IIV and make plans for the safe disposal or return of any remaining doses of IIV after that date. Sometimes unused vaccine may be returned for credit, even if the doses must be discarded. State immunization programs or vaccine manufacturers should be contacted to determine whether such provisions apply. Any person who receives an expired influenza vaccine should be revaccinated with the current season's influenza vaccine.
Corresponding author: Elisabeth M. Hesse, EHesse@cdc.gov, 404-498-5084.
All authors have completed and submitted the ICMJE form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.
(1.) Grohskopf LA, Sokolow LZ, Broder KR, Walter EB, Fry AM, Jernigan DB. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices--United States, 2018-19 influenza season. MMWR Recomm Rep 2018;67(No. RR-03). https://doi.org/10.15585/mmwr.rr6703a1
(2.) Varricchio F, Iskander J, Destefano F, et al. Understanding vaccine safety information from the Vaccine Adverse Event Reporting System. Pediatr Infect Dis J 2004;23:287-94. https://doi.org/10.1097/00006454-200404000-00002
(3.) CDC. Seasonal influenza vaccine supply & distribution. Atlanta, GA: US Department of Health and Human Services, CDC; 2019. https:// www.cdc.gov/flu/prevent/vaccine-supply-distribution.htm
(4.) CDC. Vaccine storage and handling toolkit. Atlanta, GA: US Department of Health and Human Services, CDC; 2019. https://www.cdc.gov/vaccines/hcp/admin/storage/toolkit/index.html
Elisabeth M. Hesse, MD [1,2]; Beth F. Hibbs, MPH ; Maria V. Cano, MD 
 Epidemic Intelligence Service, CDC;  Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, CDC.
Caption: FIGURE. Number of reports (n = 102) with documented dates of administration of expired injectable influenza vaccine--Vaccine Adverse Event Reporting System, United States, July 2018-January 2019
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|Title Annotation:||Notes from the Field|
|Author:||Hesse, Elisabeth M.; Hibbs, Beth F.; Cano, Maria V.|
|Publication:||Morbidity and Mortality Weekly Report|
|Date:||Jun 14, 2019|
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