March 14, 2002

Nationwide Shortages of Vaccine Cause of Concern for Missourians

As a smaller operation the Scotland County Health Department has not been hit hard, at least not yet, by a shortage of child vaccines.

"Right now we are okay, but when we have to reorder we may see the impact of the shortage in the state," said Scotland County Director Margaret Curry. "We have an ample supply of the highest used vaccines as long as we follow the state usage guidelines. For instance we have been directed to only administer tetanus shots in case of an accident or other direct need as opposed to the routine vaccinations."

The Scotland County Health Department performs a number of vaccines for area children during normal office hours Monday and Tuesday from 12:00 - 2:30 p.m. and Friday from 8:00 a.m. to 4:00 p.m. as well as during the Well Child Clinic held the third Thursday of each month.

During the month of February the health department performed approximately 60 vaccines. Because of the manageable numbers the department has not reported any immediate shortages. However the department is still aware of the issue.

"The United States is experiencing severe shortages of a number of childhood vaccines. As a result, many of Missouri's children may not get the immunizations they need to protect them from dangerous diseases," said Vic Tomlinson, chief, Section of Vaccine-Preventable and Tuberculosis Disease Elimination, Missouri Department of Health and Senior Services (DHSS).

"The real concern we have is that children who are turned away won't come back or won't be reached when vaccine supplies are available," said Dr. Walter Orenstein, director of the National Immunization Program at the Centers for Disease Control and Prevention (CDC). "We are quite worried we might see the return of some outbreaks."

"All parents and health care providers should make sure that children get their immunizations as soon as possible," said Tomlinson. "Parents should stay in contact with their health care providers to make sure they know when these vaccines are available for their children."

Three vaccines are especially difficult to obtain in this state. They are varicella vaccine, which protects against chickenpox; pneumococcal conjugate vaccine, which protects young children against some kinds of pneumonia and other severe infections; and tetanus/diphtheria vaccine.

Routine doses of tetanus/ diphtheria have been deferred for more than a year.

Missouri requirements for daycare attendance changed to include varicella (chickenpox) vaccine in July 2001. "Now we must advise daycare operators to defer requiring the vaccine until adequate supplies are available," said Tomlinson.

The vaccine shortage has been building for at least two years. Few manufacturers are producing vaccine, and in some instances they are having problems obtaining approval from the Food and Drug Administration (FDA).

On February 11, a federal panel discussed how vaccine supplies could be increased. While the members did not recommend a specific plan, suggestions included creating vaccine stockpiles and giving drug companies financial incentives to continue researching and developing vaccines.

Some states are experiencing significant shortages of vaccine that prevent diphtheria, tetanus, and pertussis.

"In Missouri, we continue to encourage health care providers to give infants their first three doses of tetanus/diphtheria/ pertussis vaccine on time, during the first six months of life, as well as booster doses at one year and 4-6 years. Our neighbors in Arkansas, Illinois, and Iowa are all experiencing significant outbreaks of pertussis, or whooping cough, which is most serious in children under one year old," said Tomlinson. "The pertussis vaccine usually only lasts until early adolescence, so most of us are susceptible to the disease and could catch it and pass it on to very young children. The only way to protect them is to immunize them on time."

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