Update on 2D-Bar Coded Vaccines

September 2016 - Vol.13 No. 9 - Page #30

Because 2D bar codes comprise more information than linear bar codes in a smaller footprint—while linear bar codes currently contain product identification information only—more than half of US hospitals employ 2D bar codes in some capacity.1 When used for vaccines, 2D barcodes can include the vaccine product identification information, the lot number, and the expiration date. Thus, 2D bar codes facilitate the accurate tracking of product identifiers and help health care providers capture correct, complete data regarding vaccine inventory and administration.

In recent years, The Centers for Disease Control and Prevention (CDC) has explored the potential of 2D bar codes to streamline immunization practices. The National Childhood Vaccine Injury Act requires documentation of vaccine product identification and vaccine lot number, and the American Academy of Pediatrics recommends documenting vaccine expiration date. However, in many health systems, this information is either handwritten or typed into an electronic medical record (EMR) and/or immunization information system (IIS), and it is not uncommon for the information entered to be inaccurate or missing within the IIS and Vaccine Adverse Event Reporting System reports. Implementing the use of 2D bar codes on vaccines allows for automatic, rapid, and accurate capture of these data via a handheld scanner, which can then populate these fields in an EMR and/or an IIS.

In 2013, the Drug Supply Chain Security Act was introduced, which requires all manufacturers to place 2D bar codes on all vaccine units of sale within the next few years (see SIDEBAR for 2D-Bar Coded Vaccines Currently Available in the US.) Scanning these 2D-bar codes will allow pharmacists to add all necessary information into inventory records. An increasing number of health systems are investing in scanning technology and 2D bar code-compatible EMR systems.

2D-Bar Coded Vaccine Pilot Studies

The CDC recently initiated two vaccine bar code pilot projects to investigate the effect of 2D bar codes on the completeness and accuracy of vaccination data collected during vaccine administration (more information on these studies is available at www.cdc.gov/vaccines/programs/iis/2d-vaccine-barcodes/about.html). Vaccine manufacturers, health information systems vendors, and pharmacies participated. The findings of the pilot demonstrated that 2D bar code scanning was associated with improved accuracy and completeness of lot number and expiration date in vaccine administration records. In addition, health care providers reported positive user experiences with 2D bar code scanning; as a result, many are seeking out this new approach.

Adopting 2D Bar Codes

Pharmacies can use 2D-bar coded products to improve the data quality of immunization records. The CDC provides educational materials for pharmacists and other health care providers to assist with adopting 2D bar codes, including information describing the benefits of 2D technology, staff training documents and videos, frequently asked questions, and a troubleshooting guide (available at www.cdc.gov/vaccines/programs/iis/2d-vaccine-barcodes/providers.html).

In addition, pharmacists can promote the following activities regarding the adoption of 2D bar codes:

  • Request that pharmacy information system vendors continue to integrate scanning functions into their systems
  • Obtain 2D bar code scanners and train staff on their use
  • Develop a 2D bar code scanning protocol, which should include:
    • Staff training
    • Regular testing to ensure that scanners are working properly (eg, scan 2D bar codes into a word processing document to validate output)
    • Support scanner configuration, troubleshooting, and continuing
      education as needed
  • Encourage scanning of 2D bar codes on vaccines and promote consistency of use among pharmacists

The information presented here is from Adopting 2D Barcodes: Information for Pharmacies, available on the CDC Web site at www.cdc.gov/vaccines/programs/iis/2d-vaccine-barcodes/downloads/brief-pharmacist.pdf, and About Two-Dimensional (2D) Vaccine Barcodes, also available at the CDC Web site, at www.cdc.gov/vaccines/programs/iis/2d-vaccine-barcodes/about.html.


  1. State of Pharmacy Automation Survey. Pharm Purch Prod. 2015;12(8):46.

Jennifer Karpinski is a senior editor at Pharmacy Purchasing & Products magazine, and can be reached at jkarpinski@ridgewoodmedia.com.

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