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Kids' Vaccine in Short Supply

Meningitis, pneumonia drug limited to most vulnerable, say officials

TUESDAY, Sept. 18, 2001 (HealthDayNews) -- Barely 18 months after it was introduced, a popular vaccine that protects against bacterial meningitis and pneumonia already is in short supply, forcing doctors and clinics to limit doses to babies who need the most protection.

Amid delays in delivery of the vaccine, known by the brand name Prevnar, federal medical officials last week recommended that doctors give priority to children under 2 and older children who are at greater risk due to other illnesses.

In Northern California, an official with the Kaiser Permanente Health Plan said the shortage shouldn't create major problems because it will only affect older children who face the lowest risk of disease. "But if the shortage becomes more extreme, then younger children would be under-vaccinated," said Dr. Steven Black, co-director of the health plan's Vaccine Study Center.

The problems with delivery of the vaccine -- known as a pneumococcal conjugate vaccine -- came well before the Sept. 11 terrorist attacks. While an estimated 2 million doses will be needed each month for the rest of 2001, medical officials estimate that only 1.7 million will be available.

In February 2000, Prevnar joined the list of six vaccines that are commonly given to children in the United States. "It's one of the more successful new vaccines ever in terms of the number of children using it," Black said.

Prevnar protects against the bacterium Streptococcus pneumoniae. The germ can cause meningitis, an inflammation of the membranes surrounding the brain and spinal cord, pneumonia and a blood infection known as bacteremia.

Black said, "It's highly effective in a trial we did here. It was 97 percent effective in preventing blood poisoning or meningitis and more than 80 percent in preventing pneumonia."

The vaccine's protection against meningitis is especially important, Black said. "Of children who get that, about 10 percent die. More than half end up with a lifelong disability like blindness, deafness and paralysis."

The vaccine also protects against some kinds of ear infections, although that protection is limited.

Wyeth Lederle Vaccines, manufacturer of Prevnar, has had trouble meeting the "phenomenal" demand for the vaccine, said spokeswoman Natalie deVane. As of August, the company had received more orders this year than in the 11 months last year when the vaccine was available.

"There have been short periods of time over the last several months when we've been unable to fulfill orders immediately after they've been placed. People have had to wait from time to time to get the vaccine," deVane said.

The federal Centers for Disease Control and Prevention (CDC) says the company now expects a full supply of the vaccine for the remainder of the year, but delays may prevent doses from getting where they belong.

In its recommendation last week, the CDC asked doctors not to give the vaccine to children older than 2 unless they are at high risk due to chronic illness or diseases like AIDS and sickle-cell anemia. Previously, older children were getting the vaccine if they hadn't been vaccinated earlier.

Children typically get the vaccine in four doses at 2, 4 and 6 months and then once after their first birthdays. The CDC is recommending that doctors delay the final booster shot until the shortage is over and postpone other shots if they are in very short supply.

It's not clear if the vaccine's protection is lifelong, but it may be, Black said. The vaccine works by priming the immune system to create antibodies when the bacteria attack. Essentially, people who have been vaccinated will develop stronger immunity each time they're exposed, he said.

What To Do

If you have a young child, follow your doctor's recommendations about Prevnar.

For more information about Prevnar and appropriate doses, visit this Web site designed by its manufacturer.

To learn more about the Prevnar shortage, read this CDC report. To learn when your child should be vaccinated, check this CDC fact sheet. You'll need free Adobe Acrobat software to read it.

SOURCES: Interviews with Steven Black, M.D., co-director, Vaccine Study Center, Kaiser Permanente Health Plan, Oakland, Calif., and Natalie deVane, spokeswoman, Wyeth Lederle Vaccines, Radnor, Pa.
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