1938 federal food, drug, and cosmetic act animal testing

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1938 federal food, drug, and cosmetic act animal testing

Pub. (j)(5)(D). (1) as so designated substituted subsection (b) for this subsection and redesignated former pars. (Implementation of pilots due 9 months after enactment), Additional Record keeping for High Risk Foods. Regulations for section: Provided, however, That regulations. Prior to amendment, par. Subsec. The FDA can refuse entry into the U.S. of food from a foreign facility if the FDA is denied access by the facility or the country in which the facility is located. (j)(5)(B)(iii)(III). You are still responsible for making sure your ingredients are safe when used according to the labeling, or as they are customarily used, no matter what kinds of ingredients you use. The Animal Drug User Fee Act permits FDA to collect subsidies for the review of certain animal drug applications from sponsors, analogous to laws passed for the evaluation of other products FDA regulates, ensuring the safety and effectiveness of drugs for animals and the safety of animals used as foodstuffs. Medical Device User Fee and Modernization Act (MDUFMA III). As part of FDASIA, reauthorizes user fees from industry to fund reviews of medical devices in exchange for FDA to meet certain performance goals. FDA also does not have regulations for the term "organic" for cosmetics. (j)(2)(D). Similarly, importers of cosmetic ingredients that are also classified as food products must meet the registration requirements of the Bioterrorism Act of 2002. Subsec. The law was prompted after many reported incidents of foodborne illnesses during the first decade of the 2000s and was largely crafted by members of the Grocery Manufacturers Association. L. 98417, Sept. 24, 1984, 98 Stat. This act has been credited with essentially creating the modern generic drug industry. Dont use terms such as natural as part of an ingredient statement, because ingredients must be listed by their common or usual names, without additional description. Subsec. What local requirements are there for starting a cosmetics business? 1999Subsec. I verify under penalty of perjury that the foregoing is true and correct as of the date of the submission of this petition., with the date on which such information first became known to the party and the names of such persons or organizations inserted in the first and second blank space, respectively. Available at: www.ashp.org/DocLibrary/News/August-1-table.aspx.17, Among other changes, the Senate bill would require the FDA to revise the definition of a shortage of a medically necessary drug to account for drug-use factors.3,18 The legislation redefines a drug shortage as a period of time when the total supply of all versions of a drug available at the user level will not meet the current demand for the drug at the user level.18 Further, this legislation requires prescription drug manufacturers to provide the FDA with early notice of any manufacturing discontinuance, interruption, or other adjustment, that would likely result in a shortage of a product.8,15,18 The legislation also gives the FDA the authority to establish a schedule of civil penalties to be applied to manufacturers that have not provided the required notification.8, The bill further addresses FDA responsibilities with respect to drug shortages.18 It calls for the FDA to develop evidence-based criteria to identify drugs that are vulnerable to a shortage.3,18 Contingency plans for production would then be required for drugs that are identified as vulnerable.3,18 The legislation also mandates the FDA to make it a priority to inspect facilities that manufacture, propagate, compound, or process a drug involved in a drug shortage or that have recently corrected a production problem.18 In addition, the bill requires the FDA to distribute, to the maximum extent practicable, information on drug shortages to health care provider and patient organizations.18, On June 21, 2011, similar legislation (the Preserving Access to Life-Saving Medications Act of 2011) was introduced in the House of Representatives by Diana DeGette (D-Col.) and Thomas J. Rooney (R-Fla.).17 The House and Senate bills are similar; the major difference is that the House bill includes biological products and defines civil monetary penalties, whereas the Senate bill doesnt do either (see Table 1).17 However, neither the House nor Senate legislation covers unapproved drugs.17, Prospects for both bills are uncertain. L. 1179, 1(a)(1)(A), substituted active moiety (as defined by the Secretary in section 314.3 of title 21, Code of Federal Regulations (or any successor regulations)) for active ingredient (including any ester or salt of the active ingredient) wherever appearing. ASHP guidelines on managing drug product shortages in hospitals and health systems. Option #1: Name the allergens in the ingredients list.Option #2: Use a Contains statement. Pub. The site is secure. [3], Kelsey retired from the FDA in 2005, at age 90, after 45 years of service. In June 2004, the FDA cleared Hirudo medicinalis (medicinal leeches) as the second living organism to be used as a medical devices. 1962Subsec. The U.S. Supreme Court upholds the 1962 drug effectiveness law and endorses FDA action to control entire classes of products by regulations rather than to rely only on time-consuming litigation. Pub. Therefore, a worthless remedy cannot escape the law by not stating the condition it is supposed to treat. [2], The Center for Disease Control and Prevention (CDC) estimated in 2011 that each year 48 million people (1 in 6 Americans) get sick, 128,000 are hospitalized, and 3,000 die of foodborne diseases. (i) and (ii), respectively, of subpar. (8). Regulations published to Accelerate the Review of Drugs for life-threatening diseases. Sec. L. 112144, 1134(a), added subsec. What do I need to know about using color additives in cosmetics? The resulting proposed law was unable to get through the Congress of the United States for five years, but was rapidly enacted into law following the public outcry over the 1937 Elixir Sulfanilamide tragedy, in which over 100 people died after using a drug formulated with a toxic, untested solvent. (q)(5)(A). In modern day, statistics show that animal testing is a flawed system, with over 50% of drugs that pass animal trials failing in human clinical trials. (B). Thompson C. Senator proposes drug shortage law. A discussion of some actions that the FDA can take to help resolve drug shortages follows. FDA regulates cosmetics under the Federal Food, Drug and Cosmetic Act (FD&C Act).Under this law, cosmetics must not be adulterated or misbranded. Subsec. Pub. The reasoning is simple: The better the system handles producing, processing, transporting, and preparing foods, the safer our food supply will be.[8]. (iii), directed that notice of an amended application be given when the amended application had been submitted. (s). 2002Subsec. Subsec. (5). In two instances, state governments have sought to legalize drugs which have not been approved by the FDA. Pub. Causes of drug shortages in 2011 as of September. It can be a contaminant in consumer products; this has resulted in (4) as (5). 2749 - Food Safety Enhancement Act 2009 - So, what's really in it? Pub. (j)(8). [12] The House went on to approve the bill by a vote of 215 to 144 on December 21, 2010. FDA forms the Drug Efficacy Study Implementation (DESI) to implement recommendations of the National Academy of Sciences investigation of effectiveness of drugs first marketed between 1938 and 1962. Subsec. University of Utah Drug Information Service.7), Many factors can contribute to drug-manufacturing difficulties, including antiquated equipment, a shift of a companys resources from manufacturing to research and development, loss of production and compliance personnel, and many others.2 Changes in a products formulation and limited production capabilities can also delay product availability.2,5 The FDA also approves a specific manufacturing line to produce a specific drug at a specific facility.14 Therefore, pharmaceutical manufacturers cant just set up production of a drug in short supply somewhere else in a facility.14 Manufacturers also often use the same manufacturing equipment for many drug products, so it is difficult to increase production of one product without causing manufacturing shortages and delays for another.5 Consequently, sometimes it is possible to increase drug production only by buying more equipment or contracting with other companies to produce the drug.5 However, this isnt an easy solution, because there is often a significant lag between a supply shortfall and a production increase at another facility.13 Antitrust laws may also prevent companies from sharing manufacturing information.9, Disruptions in the supply of raw or bulk materials are frequently responsible for drug shortages. (u)(4). Drug Importation Act passed by Congress requires U.S. Customs Service inspection to stop entry of adulterated drugs from overseas. [14][15] President Barack Obama signed the bill into law on Tuesday, January 4, 2011. Pub. Pub. Such appeal shall be taken by filing in the United States court of appeals for the circuit wherein such applicant resides or has his principal place of business, or in the United States Court of Appeals for the District of Columbia Circuit, within sixty days after the entry of such order, a written petition praying that the order of the Secretary be set aside. 8. [31] The FDA previously submitted their proposed regulations to the Office of Management and Budget (OMB) for review, and in that process the OMB weakened the regulations in a variety of ways. Tamper-resistant Packing Regulations issued by FDA to prevent poisonings such as deaths from cyanide placed in Tylenol capsules. The Secretary shall not consider a petition for review unless the party submitting such petition does so in written form and the subject document is signed and contains the following certification: I certify that, to my best knowledge and belief: (a) this petition includes all information and views upon which the petition relies; (b) this petition includes representative data and/or information known to the petitioner which are unfavorable to the petition; and (c) I have taken reasonable steps to ensure that any representative data and/or information which are unfavorable to the petition were disclosed to me. At the same time, the brand-name companies can apply for up to five years additional patent protection for the new medicines they developed to make up for time lost while their products were going through FDA's approval process. The Secretary shall determine what constitutes good cause under the preceding sentence. (Implementation due 2 years after enactment). L. 87781, 102(b), inserted and whether such drug is effective in use after is safe for use. Subsec. It came about following a series of food abuses and the considerable political fall-out that followed as the public began to lose confidence in food safety. Draize test; Purpose: Test cosmetics (allergic/toxic reaction) The Draize test is an acute toxicity test devised in 1944 by Food and Drug Administration (FDA) toxicologists John H. Draize and Jacob M. Spines. Jenks S. Efforts underway to curb drug shortages. Under this law, cosmetics must not be adulterated or misbranded. (j)(8)(A). L. 105115, title I, 122, Nov. 21, 1997, 111 Stat. (i) and struck out former cl. Subsec. People for the Ethical Treatment of Animals (PETA; / p i t /, stylized as PeTA) is an American animal rights nonprofit organization based in Norfolk, Virginia, and led by Ingrid Newkirk, its international president.PETA reports that PETA entities have more than 9 million members globally. 703, provided that: Pub. The Biologics Control Act is passed to ensure purity and safety of serums, vaccines, and similar products used to prevent or treat diseases in humans. In U.S. v. Johnson, the Supreme Court rules that the 1906 Food and Drugs Act does not prohibit false therapeutic claims but only false and misleading statements about the ingredients or identity of a drug. ", "Roll Call Votes 111th Congress - 2nd Session", "Senate OKs food safety measure Meredith Shiner", "In Lame Duck Flux, Food Safety Bill All But Dead", "House Vote 661 Passes Food Safety Bill", "A Friday and Saturday night read - H.R. L. 108173, 1101(b)(1)(B), added par. Brewing beer generally creates a much safer product than non-alcoholic beverages and foods, naturally protected from certain mycotoxins and bacteria, however it can still becontaminated by foreign bodies and chemicals at various stages within the manufacturing process. (C) If the applicant made a certification described in clause (iv) of subsection (b)(2)(A), the approval shall be made effective immediately unless, before the expiration of 45 days after the date on which the notice described in subsection (b)(3) is received, an action is brought for infringement of the patent that is the subject of the certification and for which information was Under the final rules the FDA is obligated to inspect every brewery in the USA over the next few years. Pub. The law grants the FDA a number of new powers, including mandatory recall authority, which the agency has sought for many years. Pub. Subsec. To ensure development of the Internet Web site by the date described in paragraph (1), the Secretary may, on a temporary or permanent basis, implement systems or products developed by private entities. So in original. Before you send a question to FDA, please check here. 2010Subsec. For each study or clinical trial required to be conducted under this paragraph, the Secretary shall require that the responsible person submit a timetable for completion of the study or clinical trial. (b)(4), (5). Along with being frustrating, drug shortages can also lead to rationing; cancellation of procedures; or the use of alternative treatments that have a worse safety profile, are more expensive, or are more prone to overdoses or medication errors.1,4 Because of the shortages of cancer drugs, oncologists often have to delay or alter carefully timed chemotherapy regimens.1 Sometimes cancer patients need to be triaged, and drugs for which there are no substitutes are preserved for those who are considered to have the best prognosis and are more curable.1, For example, cytarabine is highly effective in treating several forms of leukemia and lymphoma, but it must be administered as quickly as possible, especially to patients with AML.1 The availability of cytarabine can therefore literally represent life or death for these patients.1 During the cytarabine shortage, stocks ran low in many hospitals and some facilities ran out completely.1 Many health care facilities therefore had to ration the drug, giving priority to those who they thought most urgently needed it.1, Clinical outcomes can be compromised if a less effective agent is used or a proper therapeutic alternative is unavailable.3 For example, in 2009, severe shortages of leucovorin, used to treat colorectal cancer, prompted the American Society of Clinical Oncology (ASCO) to issue a clinical alert.9 The alert suggested that levofolinate be substituted.9, There is evidence that levofolinate, in combination with irinotecan and fluorouracil, is effective in patients with metastatic colorectal cancer.9 However, it is unclear whether this agent is as effective as leucovorin in treating colorectal cancer; therefore, this strategy is risky.9 In addition, levofolinate is FDA-approved for use only as a rescue drug after high-dose methotrexate in patients with osteosarcoma.9 It is also much more expensive than leucovorin.9, Epinephrine is often used as a replacement for norepinephrine bitartrate injection, a blood pressure medication that is often in short supply.8 However, epinephrine has physiological effects that differ from those of norepinephrine bitartrate and is therefore not always an ideal replacement.8, Medication errors can occur more frequently as a result of drug shortages. With the exception of color additives and ingredients that are prohibited or restricted by FDA regulations, you may use any ingredient in your cosmetic, as long as it does not cause the product to be adulterated in any way. [1] The Act prohibited, under penalty of seizure of goods, the interstate transport of food which had been "adulterated," with that term referring to the addition of fillers of reduced "quality or strength," coloring to conceal "damage or inferiority," formulation with additives "injurious to health," or the use of "filthy, decomposed, or putrid" substances. The Food Safety Modernization Act (FSMA) was signed into law by President Barack Obama on January 4, 2011. Pub. FDA consumer consultants are appointed in each field district to maintain communications with consumers and ensure that FDA considers their needs and problems. Kaiser J. An agency of the Department of Health, and Human Services which is responsible for ensuring compliance with the amended federal Food, Drug and Cosmetic Act. WebA few companies that hire no experience drivers: WEL Companies; Nussbaum Transportation Services, Inc. Jobs in the Great Outdoors: Conservation Crews & Leaders Environmental & Outdoor Education Jobs + Internships. If the brewing facility fails the FDA inspection they will not only get fined but a stricter re-inspection will be required at a cost of over $200 per hour payable by the inspected brewer. (y). For purposes of this subsection, other than paragraph (1)(A)(i), the term petition means a request described in paragraph (1)(A)(i). (1) and (2) as subpars. [13], As part of the U.S. Public Health Service reorganizations of 19661973, FDA became part of the Public Health Service (PHS) within the Department of Health, Education, and Welfare in 1968. Subsec. The goals of the initiative are to focus on the greatest risks to public health in manufacturing procedures, to ensure that process and product quality standards do not impede innovation, and to apply a consistent approach to these issues across FDA. 510. L. 115271, 3041(b)(3), substituted safety or new effectiveness information for safety information. FDA begins administering Sanitation Programs for milk, shellfish, food service, and interstate travel facilities, and for preventing poisoning and accidents. The purposes referred to in this subparagraph with respect to a postapproval study or postapproval clinical trial are the following: Establishment of requirement after approval of covered application, Notification; timetables; periodic reports, Safety labeling changes requested by Secretary, New safety or new effectiveness information, Following notification pursuant to subparagraph (A), the, Petitions and civil actions regarding approval of certain applications, The information described in subparagraph (B) shall be conveyed via either, at the discretion of the, For purposes of judicial review related to the approval of an, Annual report on delays in approvals per petitions, Postmarket drug safety information for patients and providers, ensuring that the information provided on the Internet Web site is comprehensive and includes, when available and appropriate, Certain drugs containing single enantiomers, For purposes of subsections (c)(3)(E)(ii) and (j)(5)(F)(ii), if an, includes full reports of new clinical investigations (other than, No approval in certain therapeutic categories, Deadline for determination on certain petitions, Date of approval in the case of recommended controls under the CSA, For purposes of this section, with respect to an, Contrast agents intended for use with applicable medical imaging devices, In reviewing a supplement submitted under this subsection, the agency center charged with the premarket review of. No person shall introduce or deliver for introduction into interstate commerce any new drug, unless an approval of an application filed pursuant to subsection (b) or (j) is effective with respect to such drug. Other contaminants: Unwanted substances from a number of sources may adulterate a product. (n)(2). (A) which read as follows: The term bioavailability means the rate and extent to which the active ingredient or therapeutic ingredient is absorbed from a drug and becomes available at the site of drug action.. 811(j)]. L. 98417, 102(a)(2), (b)(2), 103(b), designated existing provisions of subsec. (h). L. 114255, 3075(a)(2), as amended by Pub. The committee recommends a substantial expansion of FDA staff and facilities, a new headquarters building, and more use of educational and informational programs. Keep in mind, however, that its your responsibility to manufacture products in an environment that will not cause them to become adulterated. Preventive controls include steps that a food facility would take to prevent or significantly minimize the likelihood of problems occurring. Consumer Bill of Rights is proclaimed by President John F. Kennedy in a message to Congress. Within one year of enactment, the law directs the FDA to inspect at least 600 foreign facilities and double those inspections every year for the next five years. In 1942, like many other pharmacologists, Oldham was looking for a synthetic cure for malaria. [36] Every 2 years in even numbered years, every registered facility needs to renew its registration between October 1 and December 31. (j) as (k). For example, a "treatment IND" was issued for the first HIV drug, AZT, in 1985, and approval was granted just two years later in 1987. Congress appropriates $5,000 to the Bureau of Chemistry to study chemical preservatives and colors and their effects on digestion and health. Pub. L. 108173, 1101(b)(2)(B)(ii)(III), added cl. [32], Now, the FDA has planned to make available to the general public and to Congress significant progress they have made towards implementing the FSMA. Packaging: The composition of its container may make the contents "injurious to health. (u)(4). Subsec. 1994 Chosen as the namesake for Frances Kelsey Secondary School which opened in 1995. L. 11085, 921, added par. 3943, provided that: Pub. For example, they must be safe for consumers under labeled or customary conditions of use, and they must be properly labeled. [43] Under current law, alcoholic beverages, such as beer, wine, cider and spirits, are exempt from the FDA's normal oversight of food products. L. 116290, 2(g)(2), substituted clauses (ii) through (vi) of subsection (b)(1)(A) for clauses (B) through (F) of subsection (b)(1). In the hours following the Three Mile Island nuclear emergency of March 28, 1979, FDA contracted with firms in Missouri, Michigan, and New Jersey to prepare and package enough doses of potassium iodide to protect those threatened with thyroid cancer if exposed to radiation. The cost for the first five years is projected to be $1.4 billion and is not yet fully funded.[35]. Any color additives they contain must be approved for the intended use, and some must be from batches certified in FDAs own labs. For purposes of this section, the term patent means a patent issued by the United States Patent and Trademark Office. Pub. The FDA must develop and implement strategies to leverage and enhance the food safety and defense capacities of State and local agencies. As a reviewer for the U.S. Food and Drug Administration (FDA), she refused to authorize thalidomide for market because she had concerns about the lack of evidence regarding the drug's safety. (1) substituted under subsection (k) or to comply with the notice requirements of section 360(k)(2) of this title for under subsection (j) or to comply with the notice requirements of section 360(j)(2) of this title. WebA landmark bill introduced by Rep. Sean Patrick Maloney at the 116th U.S. Congress aims to amend the 1938 Federal Food, Drug and Cosmetic Act such that cosmetics with packaging or labeling using the term natural will be considered as misbranded if they do not meet certain standards. (IV). December: The federal Humane Cosmetics Act, legislation to prohibit cosmetics animal testing and the sale of animal-tested cosmetics, is (n). Before sharing sensitive information, make sure you're on a federal government site. Pub. These reforms had the effect of increasing the time required to bring a drug to market. Jensen V, Kimzey L, Goldberger MJ. ASHP = American Society of Health-System Pharmacists; GPO = group-purchasing organization. (6) relating to the failure of the application to contain the patent information prescribed by subsec. This information is intended to help you get started. One component of the plan is to address training of foreign governments and food producers on U.S. food safety requirements. The measure would eliminate a federal mandate in the 1938 Food, Drug, and Cosmetic Act requiring animal testing for new drugs. Manufacturers are required to conduct post-market surveillance on permanently implanted devices whose failure might cause serious harm or death, and to establish methods for tracing and locating patients depending on such devices. Subsec. (m). ", Microbial contamination: Cosmetics are not required to be sterile, but microbial contamination can pose a health hazard, making a product adulterated. L. 114255, div. L. 108173, 1101(b)(2)(B)(ii)(IV), substituted as provided in clause (i); or for on the date of such court decision.. If the applicant only made a certification described in clause (i) or (ii) of subsection (b)(2)(A) or in both such clauses, the approval may be made effective immediately. Subsec. With acceptance of premarket notification 510(k) k033391 in January 2004, the FDA granted Dr. Ronald Sherman permission to produce and market medical maggots for use in humans or other animals as a prescription medical device. The management of drug shortages in hospitals and health systems is particularly complex because these facilities routinely treat patients with acute or emergent conditions, deliver a significant number of medically necessary or single-source products, and use high-cost new drug technologies.2 In response to drug shortages, health systems must act rapidly to identify and obtain the drug, or the alternative product, to avoid disruptions in patient care and to provide uninterrupted, therapeutically equivalent, safe drug therapy, preferably at comparable costs.2,3 A drug shortage can also affect established procedures regarding drug procurement, therapeutic decision-making, and other institutional practices.9, Although it is often not possible to predict when a drug shortage will occur, strategies for dealing with shortages should be defined in advance.2 In 2001, the ASHP began providing guidelines for managing drug shortages that, ideally, have the potential to minimize such challenges.24 Some highlights of the recommendations issued by the ASHP are summarized in the following section.2, When a back order or other notice is received by a health systems drug-purchasing agent, there is often lead time before actual stock depletion.2 Therefore, the person responsible for procuring drug supplies needs to be aware of fluctuations in the health systems supply chain that might indicate a potential shortage; for example, a specific strength is difficult to obtain, only a partial order is filled, or most manufacturers have no stock.2 Drug-purchasing agents who are not pharmacists need to work with the pharmacy staff.2, The suspected drug shortage should be verified with the distributor or manufacturer, and, whenever possible, the cause should be determined.2 This information will help to determine when the drug shortage will have an impact and how long it will last, since these factors vary according to the cause of the shortage and where the problem occurred in the supply chain.2 For example, a lack of raw materials may affect all manufacturers that produce the drug, whereas manufacturing problems will likely affect only the supply from a single manufacturer.2 A projected date for resumed product availability should be requested from manufacturers or distributors in order to guide management strategies and to determine the ability to endure the shortage.2, Once a shortage is confirmed, the inventory on hand needs to be counted and an estimate of the time period it will cover should be made.2 This count should include all available inventory of the drug within the health care facility, including pharmacy stock, inpatient units, ambulatory care clinics, automated medication storage and distribution devices, floor stock, resuscitation carts, and prepared trays.2 Based on available quantities and historical usage, the pharmacy should estimate how long a shortage can be endured.2 Usage data can be obtained from purchasing agent records, distributors, the pharmacy department, billing, and/or automated medication storage and dispensing devices.2 After conservation measures, both current and reduced use rates should be considered in calculations of how long the available inventory of the drug and possible alternative products will last.2 Inventory data and the estimate of the shortages duration will allow a threat analysis to be conducted to determine the potential consequences of the shortage to the health care facility.2, Whenever possible, collaborative arrangements within the health care system or with other regional institutions should be established.2 Large health systems can often survive drug shortages by shifting drug inventory among its sites.18 Information regarding possible alternative therapies should also be shared among facilities.2, An important task in managing drug shortages is to identify alternative therapies that can substitute for the unavailable drug product.2 Decisions regarding alternative agents should be made in collaboration with medical, nursing, and pharmacy representatives and should be approved by the appropriate medical committees.2 Once a decision is made, the therapeutic alternative should also be inventoried to ensure an adequate supply.2 Pharmacists may also need to establish or alter procedures for bar coding; look-alike, sound-alike medications; distribution paths; contract compliance; effects on automation; and final product preparation.2 The health care facility should also be prepared in case a shortage of the best alternative agent subsequently develops.2, Criteria for patient prioritization during a drug shortage should be developed by a multidisciplinary team involving pharmacy, medical, and nursing staff.2,3 All patients whose treatment depends on the unavailable drug product and alternative therapies should be identified.2,3 Judicious use of the product in short supply helps to ensure that treatment will be available to patients who cannot be treated with an alternative agent.3,4 Drug prescribing and utilization trend data may also be useful in developing criteria for prioritization.2 Once criteria are established to determine which patients will receive the drug in short supply, good communication is essential to ensure that adequate supplies will be available to complete entire courses of therapy.2, National organizations, such as the CDC or professional medical societies, may be sources of guidance.2 Health facility risk managers or the ethics staff may also be consulted for help with patient prioritization when drug supplies are severely limited.15 For example, during the influenza vaccine shortage of 20042005, many health care facilities did not have a sufficient supply to follow recommended CDC guidelines, so they had to develop guidelines to further prioritize which patient groups would receive the vaccine.2, Inventory management can be a challenge during a drug shortage.

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