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Interchangeability of various combination vaccines

PRACTICAL ISSUES IN THE USE OF  COMBINATION   VACCINES Interchangeability It is unrealistic to expect that the same vaccine will always be available for each child at the time of each vaccination, given bulk vaccine purchasing through competitive bidding. The situation is further complicated by the fact that 25% of children see at least 2 different healthcare providers for vaccination during the first 2 years of life and that children remain in publicly funded healthcare plans for 9 months, on average.  41  Different practitioners are likely to stock different  combination   vaccines , and it will not be feasible to stock all brands of each type of licensed monovalent or  combination  vaccine. When multiple  combination   vaccines  are available from several different manufacturers, practitioners will question whether the  vaccines  can be used interchangeably. This question is complex to answer even for monocomponent  vaccines ; getting definitive answers for multicomponent  v