Vaccine Inventory and Logistics of High-Cost Travel Immunizations

An expert discusses how a pharmacy determines which less common travel vaccines (like typhoid, yellow fever, or rabies preexposure prophylaxis) to stock by performing a demand analysis based on patient demographics and needs, Jeffery Goad, PharmD, MPH, president of the National Foundation for Infectious Diseases, said. The decision is a careful balance between meeting patient needs and managing the high logistical cost and risk associated with these specialized products. The pharmacy faces several primary logistical challenges in managing this inventory. First, the high acquisition cost of these vaccines results in a significant financial burden if they are not used. Second, some specialized vaccines have a short shelf life. Third, certain products demand strict cold chain requirements, sometimes involving ultra–low temperature storage that exceeds the capacity of a standard pharmacy refrigerator. Finally, low, unpredictable demand makes accurate forecasting difficult, increasing the risk of waste due to expiration.

For the most common travel vaccines stocked (hepatitis A/B and Tdap), inventory management focuses on maintaining sufficient stock levels to meet predictable, varying demand while minimizing waste. Because demand for these is more stable, the pharmacy can establish automated reorder points based on historical usage data, maintaining just-in-time inventory to limit overstocking. Crucially, strict monitoring of the dedicated vaccine refrigerator temperature is paramount, as mishandling even common vaccines compromises patient protection and necessitates costly replacement.

For oral vaccines, such as the oral typhoid vaccine or the oral cholera vaccine, the pharmacist’s counseling protocol is vital to ensure correct administration techniques that preserve the live microbial components and guarantee efficacy. The unique instructions for these live oral vaccines center on timing relevant to food and drink, which requires the pharmacist to counsel patients on necessary fasting requirements to prevent damage or dilution in the stomach. The counseling must clearly outline the specific dosing schedule and the importance of completing the full series for protection, along with any necessary separation from antibiotics that could interfere with the live vaccine’s effectiveness.