Vaccine Presentation in the USA: Economics of Prefilled Syringes versus Multidose Vials for Influenza Vaccination

Claudia C Pereira; David Bishai


Expert Rev Vaccines. 2010;9(11):1343-1349. 

In This Article


Influenza vaccines have traditionally been delivered in clinical settings, but recent years have seen a shift towards more vaccines being offered in workplaces, retail centers and at schools. In all of these settings, efficiency and streamlining are extremely important.[7] Patients with wavering interest in influenza vaccination and consumers are likely to be deterred by long waiting times. Efficiency is especially important in mass vaccination settings where the goal is to deliver vaccines as quickly as possible.[8] The success of mass influenza vaccination clinics relies on the ability to offer rapid access to low-cost influenza vaccinations in a safe and organized manner. This is particularly important in the USA at present because the Advisory Committee on Immunization Practices (ACIP), which advises the CDC on vaccine use and policy, voted unanimously to recommend universal seasonal influenza vaccination for all Americans aged 6 months and older, starting in the 2010/2011 season.[9]

Prior studies comparing MDVs and PFSs have been conducted in Canada, Japan and countries in Europe. A study conducted by Scheifele and colleagues in Canada concluded that PFSs could save nurses' time in mass immunization clinics. Authors noted that PFSs reduced nursing service time by 9–12 person-hours per 1000 doses, depending on the PFS packaging (individual or trays), thus reducing labor costs by 25–33%.[2] An earlier study in 1996 conducted in European hospitals compared prefilled disposable syringes with conventional vial-based systems for parenteral injections and demonstrated that PFSs led to a cost reduction of 1.5 French Francs (or 1996 GB£0.15) per injection.[3] A study conducted in a hospital in Japan demonstrated that for PFSs, the operation time during the preparation of vaccination was reduced by 31.7% in comparison with vial preparations.[1] The authors emphasized that PFSs are especially important in influenza vaccination, because vaccinations for large numbers of people are concentrated into a few months of the year. Safety and convenience become more critical with high throughput vaccination. According to the Japanese study, healthcare professionals in Japan are eager for further development of PFSs for vaccines and medications not yet available and support increased availability of the products currently available in PFSs.[1] No published studies for the USA have addressed efficiency in influenza vaccination, hence the rationale for the study presented here.


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