During a hepatitis A emergency, there's a nationwide shortage of vaccine

Story highlights

  • A national shortage of Hepatitis A vaccine is hindering efforts to combat outbreaks
  • CDC is working with state and local agencies to prioritize at-risk populations

(CNN)The battle against hepatitis A outbreaks across the US is being stymied by a national shortage of the vaccine needed to combat it.

"Current supply is not sufficient to support demand for vaccine," the US Centers for Disease Control and Prevention said in a written statement.
    Southeast Michigan has seen 495 cases of hepatitis A and 19 deaths, mostly in Macomb and Wayne counties and in Detroit. The outbreak began in August 2016, and after a drop off during the winter, has been climbing since February of this year, said Michigan Department of Health and Human Services spokesperson Angela Minicuci.
      "We have a limited supply of vaccine," Minicuci said, "so we are prioritizing delivery to high-risk populations."
      In California an outbreak of the virus has sickened at least 644 people and claimed 21 lives, mostly in the cities of San Diego, Santa Cruz and Los Angeles, according to the CDC.
      Persons infected with the virus there have also spread it to Arizona, Utah and Colorado, said Dr. Wilma Wooten, public health director at San Diego's Health and Human Services Agency.
        To manage the current shortage, the CDC said, staff have been working closely with public health officials to target vaccinations toward at-risk populations, as well as coordinating with vaccine manufacturers "to monitor and manage public and private vaccine orders to make the best use of supplies ... during this period of unexpected increased demand."

        An unexpected demand

        "It's unprecedented what we are seeing out of California and other parts of the country," GlaxoSmithKline spokeswoman Robin Gaitens said. "The shortage is simply an issue of supply and demand."
        Outbreaks of hepatitis A are normally small; rates have declined 95% since the vaccine became available in 1995. GlaxoSmithKline and Merck are the only companies approved by the Food and Drug Administration to sell a Hepatitis A adult or pediatric vaccine in the US.
        A San Diego nurse gives a Hepatitis A vaccine to a Homeless person in downtown San Diego.
        "We typically provide 1.2 million adult doses each year to the US market, and the demand this year has vastly surpassed the supply on hand," Gaitens said. She stressed there is no shortage of the pediatric version, which is given in a two-dose series about six months apart. Nor is there a shortage of their combination hepatitis A/B vaccine.
        The current outbreaks of hepatitis A, virus genotype IB, is normally not found in the US; it's more common in the Mediterranean, Turkey and South Africa. However, the current vaccine is effective against all strains of the virus.
        In an emailed statement, Merck said it has been taking steps to increase the manufacturing capacity of both their adult and pediatric versions of their vaccine due to "unexpected demand in markets."
        "At the end of October, we began shipping single-dose vials (in packages of 10 vials) for adults, which previously had been on backorder," the statement said. "We anticipate the availability of adult and pediatric pre-filled syringes of the vaccine in the first quarter of 2018."
        GlaxoSmithKline also began shipping backordered single-dose syringes at the end of October, Gaitens said, adding that the company is working closely with the CDC and California officials on "how to distribute and to ensure the vaccines are actually going to where there is the greatest need."