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Incidence of live-attenuated influenza vaccine administration beyond expiry date in children and adolescents aged 2-17 years in the UK: a population-b

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Editor, Senior Moderator
BMJ Open. 2017 Jul 17;7(7):e016520. doi: 10.1136/bmjopen-2017-016520.
[h=1]Incidence of live-attenuated influenza vaccine administration beyond expiry date in children and adolescents aged 2-17 years in the UK: a population-based cohort study.[/h] Caspard H[SUP]1[/SUP], Wise RP[SUP]2[/SUP], Steffey A[SUP]1[/SUP], Brody RS[SUP]3[/SUP]; *MedImmune is a member of the AstraZeneca group.
[h=3]Author information[/h]

[h=3]Abstract[/h] [h=4]OBJECTIVES:[/h] To estimate the proportion of live-attenuated influenza vaccine (LAIV) doses administered beyond expiry date in children and adolescents during influenza seasons 2013-2014 and 2014-2015 in the UK.
[h=4]DESIGN:[/h] This was a retrospective cohort study. Two cohorts of children and adolescents who received LAIV from 1 September 2013 to 31 March 2014 and from 1 September 2014 to 31 March 2015 and aged 2-17 years at time of LAIV administration were identified from the Clinical Practice Research Datalink (CPRD).
[h=4]SETTING:[/h] More than 500 primary care practices in the UK.
[h=4]POPULATION:[/h] Proportions of vaccine doses administered beyond expiry date were assessed among 47 396 and 67 099 LAIV recipients with a documented vaccine lot identifier in influenza seasons 2013-2014 and 2014-2015, respectively.
[h=4]INTERVENTION:[/h] None.
[h=4]MAIN OUTCOME MEASURE:[/h] Administrations of expired LAIV were ascertained by comparison of vaccination dates in CPRD records with expiration dates in AstraZeneca/MedImmune lot distribution data.
[h=4]RESULTS:[/h] Overall, 245 LAIV recipients, 80 in 2013-2014 and 165 in 2014-2015, received a dose after its expiration date, yielding proportion estimates of 1.7 per 1000 doses (95% CI 1.3 to 2.1) in season 2013-2014 and 2.5 per 1000 (95% CI 2.1 to 2.8) in season 2014-2015. This proportion increased above 1.0% after December during each season. Most (84% in influenza season 2013-2014 and 59% in influenza season 2014-2015) received an expired dose <30 days after its expiration date. The proportion was higher in London (relative risk 1.93 (95% CI 1.25 to 2.99)) and when the number of LAIV recipients registered in the practice was lower than the median number per practice (relative risk 2.69 (95% CI 1.99 to 3.62)).
[h=4]CONCLUSIONS:[/h] Administration of expired LAIV doses occurs infrequently.
? Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.


[h=4]KEYWORDS:[/h] Influenza; expiration date; lot distribution data; medication error; paediatric; vaccination

PMID: 28716794 DOI: 10.1136/bmjopen-2017-016520
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