For some vaccines, parents and physicians in private offices have a choice of products (eg, hepatitis B vaccine) produced by different manufacturers. Occasionally, choice extends from the private marketplace to the public side of vaccine provision; some states allow health care providers choice of manufacturer for the federal Vaccines for Children program (VFC)-purchased or other government-financed vaccines, whereas other states do not. Because all vaccines licensed for use in the United States have passed Food and Drug Administration tests of safety and efficacy, the choice of vaccine brand made by parents, physicians, or government purchasers is based on a variety of other factors, including price, availability, combinations with other vaccines, minor variations in immunogenicity, and personal relationships with manufacturer representatives. Absent from this decision process has been any assessment of variation in the pain associated with the injection of one vaccine product for a specific antigen(s) relative to another.
Freed GL. Criteria for Choosing a Specific Vaccine. Arch Pediatr Adolesc Med. 2004;158(4):311. doi:10.1001/archpedi.158.4.311