Shortage forces cutback in infant vaccine
WASHINGTON (Reuters) -- Health officials asked doctors to further reduce the number of vaccine doses given to protect infants against meningitis and deadly blood infections, in order to stretch out a short supply.
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The Centers for Disease Control and Prevention reluctantly recommended this week that doctors cut back their doses to two per child until supplies of the vaccine, Prevnar, are sufficient to return to the full schedule of four.
"CDC estimates this action will help conserve more than 1 million doses by July 2004, making widespread or prolonged disruptions less likely," the CDC said in a statement.
Wyeth is the sole manufacturer of Prevnar, a vaccine that protects against several different strains of pneumococcal bacteria. The company has had problems with supplies of the vaccine for two years and last month the CDC reduced the recommended number of doses to three.
"It's worsened just in the last three weeks," Dr. Steve Cochi, acting director for the CDC's National Immunization Program, said in a telephone interview.
"Our levels of concern have increased. If we can manage with a limited supply ... we might be able to see our way through this temporary shortage with a two-dose schedule and still protect most, if not all, children."
Normally children should get their first shot of Prevnar at 2 months, another at 4 months, the third at 6 months, and the last between 12 and 15 months.
"This recommendation suspends the third and fourth doses usually administered at 6 months and between 12 and 15 months for healthy children," the CDC said.
"Children with certain health conditions, such as sickle cell anemia or immune system disorders, are at increased risk of severe disease and should continue to receive the full, routine, four-dose series."
Cochi said even with the dose schedule halved, 90 percent of children should be protected against the worst infections. Four doses boosts the protective level to 97 percent.
The CDC lacks a national surveillance program to see what effects the shortage might be having, but it monitors six sites around the country for an indication. Health experts say a better nationwide monitoring system is urgently needed.
The shortage was caused by production problems, Cochi said.
"The major problem that they have is their filling line. The vaccine is made (but they) can't get it into vials."
Before a vaccine was available, pneumococcal infections caused more than 700 cases of meningitis, 13,000 blood infections and about 5 million ear infections in U.S. children, and killed around 200 a year, the CDC said.
Federal health officials said the infections have become less common among adults and children in the United States since the Food and Drug Administration approved use of the Prevnar vaccine in 2000 for infants.
Health officials had expected the prevalence of pneumococcal disease to drop in young children, but it also fell in adults, especially seniors.
The findings, presented by CDC researchers at conference in Atlanta, indicate young children may have been a reservoir for pneumococcal bacteria.
"We're vaccinating children, and the children in turn are not passing the bacteria on to adults and other children," said the CDC's Cynthia Whitney, who helped conduct two separate studies on the prevalence of invasive pneumococcal disease.
The number of cases of the disease in adults aged 50 and older fell 25 percent to 29 per 100,000 in 2002 from 41 cases per 100,000 reported in 1998-1999, according to a CDC analysis of data from one state and seven cities.
Copyright 2004
Reuters. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
