Wednesday, May 29, 2002

National immunization shortage

How it might affect your school-age child

Most of us by now have heard something about immunizations of one sort or another being in short supply. It may have been during flu season when Influenza vaccine was being shipped in batches, or if you have recently tried to get a Tetanus booster and found that it was in short supply.

The United States is currently experiencing shortages in several vaccines that are required for infants, children and college students to attend schools, daycare, and other facilities and programs in Georgia. These vaccines are DTaP (Diphtheria, Tetanus, Acellular Pertussis), Varicella (Chicken pox vaccine), MMR (Measles/Mumps/Rubella), and Td (Tetanus). These shortages could last from a few months to a year, depending on a variety of circumstances.

In some cases shortages have been due to some drug companies moving out of the "vaccine-producing business." In other instances we have one company that makes more than one vaccine, but they are only able to manufacture one type at a time.

To make certain that enough vaccine is available for those at highest risk of developing disease the Georgia Immunization program is following the interim guidelines as recommended by the Advisory Committee on Immunization Practices (ACIP). These recommendations require that some vaccines be deferred (delayed) until sufficient vaccine is available, given later than normal, or given only under certain circumstances.

This in no way implies that because some shots will be deferred parents do not have to take their children to their healthcare provider to receive an accurate and up-to-date certificate of immunization. It does mean that some of the vaccines your child would normally receive will not be given. Those that are due but "deferred" because of the shortage will be documented on your child's updated certificate. Your child's name should then be entered into a system at that provider's office whereby you can be notified when those vaccines become available, so that you can make an appointment for your child to receive them.

The recommendations of the ACIP are as follows:

Defer (do not give) the 4th and 5th dose of DTaP regardless of age until further notice. This means that if your child has not already had the 4th dose of DTaP, or the 5th dose (if the 4th dose was given before age 4) then that dose will not be given until the shortage has abated.

Give Varicella between 18 months and 24 months of age (instead of 12months). Continue to give varicella if not yet immunized or there is no history of the child having chickenpox at school entry, or by entry into the 6th grade. This recommendation merely pushes the time that a child would normally receive Varicella from 12 months of age to 18 to 24 months of age.

Defer the second dose of MMR until the shortage abates.

College students, as well as elementary and secondary school students are affected by this recommendation. This will be noted on your immunization certificate as "deferred due to national shortage" by your provider.

In the case of college students, your physician's office or the health department can provide you with a letter of deferment. In Georgia, the Board of Regents has been made aware of the current immunization situation.

Td (Tetanus) vaccine is to be given only in certain situations. These are Tetanus booster shots. Your health care provider will know what circumstances warrant the administration of Td vaccine despite the shortage.

The number of doses of Prevnar to be given has been reduced to 2, unless the child falls into a high-risk category. Again, your health care provider will be able to determine if your child falls into the "high-risk" category.

We in public health realize that for most parents, the immunization schedule can be hard to follow. Now a new wrinkle has been added.

We also recognize that this will cause some inconvenience to parents who, instead of being able to complete their child's shots in one office visit, will most likely have to return more than once. This will also place an added responsibility on providers who must keep track of all deferred vaccines and recall patients when those vaccines become available. We can only hope that these shortages will not last long.

The ultimate goal of immunization is maintaining the health and well being of our children and community. Keeping this goal in mind, parents, doctors, health departments, daycare facilities, and schools will be able to work together to maintain our stronghold against vaccine-preventable diseases. Please contact the Fayette County Health Department at 770-461-1178, ext. 5416, or your health care provider if you have questions about immunizations.