Combination vaccines: Choices or chaos? A practitioner's perspective

Combination vaccines are necessary and important for the continuing success of our immunization program, especially when more vaccines are added to th e already crowded immunization schedule. However, the multiplicity of compe ting vaccine products, with various overlapping antigen menu and subtle imm unologic differences, may be confusing to the busy practitioner. The cost-e ffectiveness of the use of combination vaccines will depend on a number of factors, including fair and competitive pricing, appropriate reimbursement for vaccine administration fees, and critical economic algorithms for vacci ne selection and purchase.