Shortages of vaccines put children at risk
Robert Pear - New York Times
Tuesday, September 17, 2002
 

Washington --- States have begun rationing vaccines for children, including those for measles, rubella and chickenpox, and have reduced immunization requirements because of shortages, federal investigators said Monday. They also warned of future shortages.

''Our vaccine supply will continue to be vulnerable,'' said Janet Heinrich, director of public health issues at the General Accounting Office, the investigative and auditing arm of Congress, which examined the problem at the request of six senators and two representatives.

Although several policy changes could ease the problem, Heinrich said, none promise a quick solution.

In the last year, the General Accounting Office said, children were endangered by shortages of five vaccines that protect against eight diseases: diphtheria, tetanus, whooping cough, measles, mumps, rubella, chickenpox and pneumococcal disease, which can cause meningitis and pneumonia.

The GAO said many factors had contributed to the shortages. Some manufacturers experienced production problems. Some had difficulty complying with federal standards. One halted production of some vaccines. Demand for a new vaccine exceeded expectations. And companies had to reformulate some vaccines to remove a preservative said to contain unsafe amounts of mercury.

The supply is easily disrupted, the GAO said, because ''five of the eight recommended childhood vaccines have only one manufacturer each.'' Drug companies are not required to inform the government if they intend to stop making a vaccine, though one company recently promised to do so.

Manufacturers need a year or more to produce some vaccines, so the industry cannot immediately increase output if the supply runs short. Production requires the use of viruses and bacteria, which do not always grow or respond on demand.

In addition, vaccine manufacturers said the threat of lawsuits and huge liabilities had prompted some companies to consider withdrawing from the market.

Sen. Jack Reed (D-R.I.) said, ''It's clear from this report that we have a system that cannot guarantee a stable supply of vaccines and is inadequate to handle a potential outbreak of any of a number of routine childhood diseases.''

Reed is scheduled to preside over a hearing on the issue today by the Senate Committee on Health, Education, Labor and Pensions.

The accounting office said that the federal government had the authority and the money to stockpile childhood vaccines, but had reserves for only two of the eight standard vaccines. Federal health officials do not have a strategy for creating such stockpiles and do not know how much vaccine to set aside or where to store it, the report said.

The Atlanta-based Centers for Disease Control and Prevention said it could take four or five years to build stockpiles for all the recommended childhood vaccines.