Advances in immunization technology and knowledge of diseases have led to an ongoing stream of new vaccines.
Advances in immunization technology and knowledge of diseases have led to an ongoing stream of new vaccines. The large number of them and their long, often complex, nonproprietary (generic) names have spurred the use of abbreviations, most often in the form of acronyms that attempt to describe the vaccine components.
The CDC Advisory Committee on Immunization Practices (ACIP) provides a list of standardized abbreviations or acronyms for FDA-approved vaccines (see www.cdc.gov/vaccines/acip/committee/guidance/vac-abbrev.html). The list includes vaccines, but not all (eg, nonroutine vaccines such as typhoid, yellow fever, rabies, and others) are included. According to the CDC, the abbreviations and acronyms are intended to provide a uniform approach to referencing vaccines in ACIP recommendations in publications such as US immunization schedules. The CDC believes that this list will promote accuracy, consistency, and convenience and will reduce errors and ambiguity in vaccine labeling, medical practice, and scientific publications. However, health care practitioners do not appear to be specifically encouraged to use the standard abbreviations when prescribing immunizations or documenting administration on an immunization record.
The Institute for Safe Medication Practices National Vaccine Errors Reporting Program (ISMP VERP) contains many cases of repetitive mix-ups among vaccines that reporters felt were caused by similar abbreviations or acronyms. For example, 1 report involved confusion between Hib (Haemophilus influenzae type b conjugate vaccine, PedvaxHIB) and HPV (in this case, the correct abbreviation is 9vHPV for human papillomavirus 9-valent vaccine, recombinant, Gardasil 9). During an office visit, a health care practitioner administered 9vHPV to a 2-month-old baby who was supposed to receive Hib. This is not the first report of a mix-up between these 2 vaccine abbreviations, but it is the first that involved an infant.
Mix-ups among vaccine abbreviations or acronyms most frequently reported to the ISMP VERP from September 2012 to February 2017 included:Tdap and DTaP
Consider the following recommendations to reduce the risk of vaccine errors associated with abbreviations and acronyms:
Dr. Gaunt is a medication safety analyst and the editor of ISMP Medication Safety Alert! Community/ Ambulatory Care Edition.