http://www.denverpost.com/Stories/0,1002,53%257E263527,00.html

 

Shortages of vaccines for kids posing health risks

By Allison Sherry
Denver Post Medical Writer

Sunday, December 09, 2001 - Vaccines protecting children from whooping cough, tetanus, pneumococcal illnesses - and in some cases chickenpox - are in such chronic short supply nationwide that federal health officials have changed national guidelines, and some doctors worry that fewer vaccines could mean widespread illness.

TO LEARN MORE For more information about vaccine schedules, call the Colorado Department of Public Health and Environmentat 303-692-2000, or 1-800-886-7689 outside of Denver.

Federal authorities think the latter might already be happening. Figures indicate that in 2000, almost 8,000 people were diagnosed with pertussis, also known as whooping cough, the highest number since 1967.

On Friday, doctors from a handful of states, including Colorado, and federal health officials opted to abandon old vaccine requirements to ensure the waning supply goes to babies.

Doctors will withhold two diphtheria/tetanus and pertussis boosters for 15-month-olds and 5-year-olds to save the vaccine for infants. Some clinics have virtually none left.

The pneumococcal vaccine, a four-dose inoculation that protects babies against some strains of pneumonia and bacterial meningitis, is also being saved and stockpiled for infants. Doctors are withholding the last two, and maybe three, shots for 6- and 12-month-olds.

Justine Coan's 16-month-old daughter, Maggie, was turned down for her third pneumococcal vaccine last week. Coan has been told to come back when her pediatrician, Dr. Larry Wolk, gets more. "I realized here in Colorado we feel the effects of what is going on globally," said Coan, who lives in Englewood. "As a stay-at-home mom, it hadn't affected me, yet."

If the shortages continue, Wolk said, pediatricians may opt to inoculate only subsets of kids, instead of everyone. "I do have concerns about that," Wolk said. "Immunization schedules are set up scientifically to provide long-term immunity.

"If it falls through the cracks, then children may be protected through most of their childhood, but maybe in adolescence we'll start seeing those diseases crop up again."

In the past few months, roughly 70 percent of some vaccine requests have been put on waiting lists, according to the federal Centers for Disease Control and Prevention.

Reasons behind vaccine shortages are many. About two years ago, the CDC asked pharmaceutical companies to stop producing vaccines with mercury. Even though an investigation couldn't unearth a link between mercury and autism, attention-deficit disorder or speech delays in children, CDC officials decided to require manufacturers to find a way to leave it out of the production process.

"Because we had to make these changes, it slowed things down," said Douglas Petkus of Wyeth-Ayerst Laboratories, which makes the pneumococcal vaccine.

Pharmaceutical companies see little financial incentive in vaccine production. It can be expensive, and profits are small. When faced with choices, companies would often rather produce a new, expensive drug than a vaccine.

Several required vaccines are made by a single company. In the case of the pneumococcal vaccine, also called Prevnar, Wyeth officials hadn't prepared for its high demand when they rolled out the first doses a little less than two years ago. Many states have lumped the vaccine onto the list of required shots for children, including Colorado.

The law here takes effect next summer.

If shortages continue, though, the state may suspend that requirement, said Dr. Lisa Miller, the acting chief medical officer for the state health department.

The high cost of the vaccine, which runs about $200 for a complete round, may also force state health officials to rethink the rule.

Most major health plans will cover Prevnar, but for Medicaid children and the uninsured, federal money will have to cover it, said Rebecca Jordan, program manager of the immunization program for the state. And with a crimped post-Sept. 11 budget, Jordan hopes Colorado gets enough money to get to everyone.

"We're still waiting to receive written notification of what our vaccine award would be," Jordan said. "Since Sept. 11, many things at the federal level have changed."

That change is frustrating for doctors such as Wolk, a pediatrician who runs Rocky Mountain Youth, a string of pediatric clinics around the state. Wolk has a giant refrigerator full of pneumococcal vaccine that the state purchased awhile ago. Because the state paid for it, he can't give it to kids served by private insurance.

Wolk is also on his last 10 doses of chickenpox vaccine.

Federal health officials acknowledged last week that the private sector could be harder hit, because of long-standing federal contracts with pharmaceutical companies.

"It makes it difficult to be consistent," he said. "Kids right now are somewhat protected, but not fully protected."

 

 

 

ALL INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR LEGAL ADVICE.  THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.