Needle Shortage Survey

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Please fill out the short survey below and tell us if your site has been experiencing needle shortages. The Philadelphia Immunization Program is working to better understand the need throughout the city and identify ways to address it.

If you have any questions, please contact vaccines@phila.gov.

1. VFC/VFAAR Pin #

2. Site name

3. Site address

4. Contact Name *

5. Contact Title *

6. Contact Email address *

7. Contact Phone #

8. Which needles are you currently having trouble accessing (Select all that apply): *

25 gauge 1 inch Needle tips for prefilled syringes

25 gauge 5/8 inch Needle tips for prefilled syringes

25 gauge 1 1/2 inch Needle tips for prefilled syringes

25 gauge 1 inch 1mL Syringes

25 gauge 5/8 inch 1mL Syringes

25 gauge 1 ½ inch 1mL Syringes

25 gauge 1 inch 3 mL Syringes

25 gauge 5/8 inch 3 mL Syringes

25 gauge 1 ½ inch 3 mL Syringes

Other:

Required

9. How long do you estimate your current supply of needles will last? *

≥ 1 month

3- 4 weeks

1 –2 weeks

≤ 1 week

Supply is already depleted

10. How many needles do you typically use in a week? *

11. Select the statement that best matches the current situation at your site: *

We placed have an order for needles and it is on its way

We placed have an order for needles but it is delayed

We tried to place an order but were told that there is no stock available

None of the above

Other:

12. Are there additional details about the challenges that your practice is having accessing these supplies that we should be aware of?

Submit

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