June 12
By Maggie Fox, Health and Science Correspondent
WASHINGTON (Reuters) - A vaccine shortage that has prevented infants and
toddlers across America from getting regular shots will not ease until next
year, U.S. officials said on Wednesday, but they have seen no evidence of
any outbreaks of disease.
The Food and Drug Administration and the Centers for Disease Control and
Prevention both said they were seeking ways to encourage more companies to
make vaccines.
"We want to send a signal here that we want to be as creative as possible
in dealing with these processes," Lester Crawford, deputy commissioner at
the FDA, told a Senate hearing.
Crawford said FDA would try to help companies in any way to become
vaccine manufacturers. "We can provide consultations with them and meet with
them at their behest," he told the hearing of the Senate Committee on
Governmental Affairs.
"What we need to do is find a way to facilitate other companies to come
and get their vaccine licensed," agreed Dr. Walter Orenstein, director of
the CDC's National Immunization Program.
The vaccine shortage has hit hospitals and clinics across the country,
forcing schools to relax requirements for children to start classes and
leaving children unprotected.
The CDC says there are shortages of the vaccines against diphtheria,
tetanus and pertussis (DTaP) vaccine, measles, mumps and rubella,
chickenpox, pneumococcus, and the diphtheria-tetanus vaccine.
"We ... have not seen, as yet, outbreaks of disease relating to these
shortages but we certainly remain very concerned," Orenstein said.
MONTHS TO RAMP UP MANUFACTURING
The shortage is expected to last until next year because it takes months
for makers to ramp up manufacturing.
Only four pharmaceutical companies now make the vaccines recommended for
routine childhood use -- Merck and Co. Inc., GlaxoSmithKline Plc, Wyeth and
Aventis-Pasteur. In the 1960s, 30 companies made vaccines.
Immunization wiped out smallpox 25 years ago and is on the verge of
wiping out polio. It has saved millions of lives, according to the American
Academy of Pediatrics.
Orenstein said there is 40 percent less tetanus vaccine available this
year compared to last. "There clearly is an increase in vulnerability to
disease when children remain unvaccinated," he said.
Price is one factor. Regulators, doctors and drug companies agree there
is not much profit incentive to make vaccines.
"However, the issue of vaccine prices cannot fully explain the shortages
we are seeing today," Orenstein said. "We are having more problems with the
higher-priced vaccines than the lower-priced vaccines."
For instance, Wyeth's pneumococcal vaccine, Prevnar, costs $40 to $50 per
dose, yet is in short supply.
Wayne Pisano, executive vice president of Aventis Pasteur North America,
agreed that price was only one factor. His company, for instance, was taken
by surprise when Wyeth decided suddenly to stop making tetanus vaccine.
It took 11 months to catch up.
And the government's decision that it would be safer to remove a
mercury-based preservative, thimerosol, from vaccines meant a complex
reformulating process. This then had to be approved, and the vaccine had to
be re-packaged into smaller units, cutting output by 25 percent, Pisano
said.
Companies also complain that a government program limiting their
liability for side-effects from vaccines needs to be strengthened.
Orenstein said the National Vaccine Advisory Committee and the General
Accounting Office were both looking into the situation and would report on
five areas: economic incentives, streamlining the regulatory process,
getting the government involved in supplying vaccines, better stockpiles and
reduced liability for vaccine makers.
"We didn't have stockpiles for many of the vaccines in shortage today,"
he noted.
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