New research that shines light on an ongoing national shortage of the vaccine that prevents meningitis and pneumonia in children has left some local doctors scrambling to provide even a minimum number of shots to those at risk. "We have had shortages at different times of almost all of our vaccines," says Maura Frank, M.D., acting division chief of ambulatory pediatrics at New York Presbyterian Hospital Weill Cornell Center. Currently, Dr. Frank says, the city is facing a shortage of the Prevnar vaccine. The federal Centers for Disease Control and Prevention and the American Academy of Pediatrics recommended Prevnar for children under age 2, in mid-2000, after its approval by the Food and Drug Administration (FDA) that year. The Prevnar shortage began in 2001, and may continue through 2003, due to high demand and manufacturing problems. Administered as a series of four shots, Prevnar is known to confer protection against disease caused by the seven strains of Streptococcus pneumonia. They include bacterial meningitis, blood infections and pneumonia. The bacteria also cause millions of ear infections, or otitis media, each year, and an FDA panel recently recommended that Prevnar be approved to prevent ear infections caused by pneumococcal bacteria. University of Michigan in Ann Arbor researchers recently revealed that 75 percent of 405 doctors’ offices in 12 states — including New York — reported problems with consistently getting enough of the Prevnar vaccine. More than half of doctors’ offices polled said they had run out of the vaccine completely at least once, according to the study, published in a recent issue of the Journal of the American Medical Association. What’s more, many of the doctors’ offices said they had borrowed Prevnar from public stocks reserved for poor and uninsured children in order to vaccinate privately insured children, or vice versa, as their stock ran out.
What’s a parent to do? "If parents have been to a physician who did not have a vaccine that their child was recommended to receive, they need to stay vigilant regarding the future availability of that vaccine so that when a supply becomes available, their child can receive it," says study author Gary Freed, M.D., M.P.H., the Percy and Mary Murphy professor of pediatrics and child health delivery in the University of Michigan department of pediatrics and communicable diseases. As for Prevnar, he says, "Doctors still strongly believe that once the supply is available, all children should receive this vaccine. However, physicians may not have a system in place to call back parents of children who did not get the vaccine." Dr. Freed’s advice to New York City parents? Stay on top of it and call around to other offices if need be.
Why the shortage? "There is only one company that makes it [Wyeth] and the demand was greater than the manufacturer expected," Dr. Freed explains. Manufacturers also had some production difficulties, he adds. In September, 2001, the shortage led the CDC to alter its recommended vaccination schedule, prioritizing the vaccine supply to ensure infants got at least two of the four recommended doses and, therefore, some protection against disease, Dr. Freed says. Of the city’s Prevnar shortage, Dr. Frank of New York Presbyterian says, "Eventually we will get them, you just may have to wait. One possibility is calling a different doctor because sometimes one doctor may not have it and another will." Some doctors recommend giving two or three shots as opposed to four, and while "it’s not optimal because clearly the vaccine is made for four doses in a time of shortage, I’d rather give a lot of kids two vaccines than have kids go unvaccinated," Dr. Frank says. Still, "having two is better than none," she says, adding, "before 2001, kids didn’t get any at all." The most important thing for parents, Dr. Frank says, is to know all of the vaccines their child needs and to make sure he or she receives them. For more information on vaccination, call the CDC Vaccine Information Hotline at (800) 232-2522 (English), or (800) 232-0233 (Spanish). ——————————————————
To find out what vaccinations your child should be receiving, go to the website of the American Academy of Pediatrics (www.app.gov), and click on: AAP ISSUES 2003 IMMUNIZATION SCHEDULE.