Moves Urged to Boost Childhood Vaccine Supply

Experts say more money and public education needed

TUESDAY, Dec. 16, 2003 (HealthDayNews) -- Shortages of childhood vaccines will continue unless more companies make the shots, and more money is spent developing and distributing them.

Americans also must be educated on the safety of vaccinations -- a step that should stabilize demand, a new study says.

A panel of experts says that disruption to the supply is "likely to continue to occur," and that action needs to be taken for both the long and short terms.

Like this year's flu shot, several routine childhood vaccines have been in short supply in the last few years.

Routine immunizations can protect children from hepatitis B, polio, measles, and other dangerous childhood diseases. But beginning in late 2000, unexpected and unprecedented shortages of eight of the 11 vaccines for childhood infectious diseases occurred in the United States, leaving many children dangerously behind on their immunizations.

The National Vaccine Advisory Committee has issued a list of recommendations to maintain the supply. Its report appears in the Dec. 17 issue of the Journal of the American Medical Association.

"Vaccines are a tremendous commodity for the prevention of childhood disease," says Dr. Georges Peter, chair of the advisory committee, director of the division of pediatric infectious diseases at Rhode Island Hospital, and a professor of pediatrics at Brown University Medical School.

With regular vaccination schedules now common in childhood, he says, "we have made a major change in the once common occurrence of infectious diseases."

However, shortages threaten to sabotage that progress. To avoid that, the committee, which was chartered in 1988 and reports to the U.S. Department of Health and Human Services, looked at why the shortages occurred and what can be done to strengthen the vaccine supply.

Among the factors leading to the shortages, the committee says, are the high cost to develop, manufacture, and distribute the vaccines, the relatively small number of vaccine manufacturers, and the lack of ongoing investment in some manufacturing facilities. To complicate matters, one year a maker discontinued making a vaccine, leaving the others scrambling to make up for the shortage.

Among the solutions recommended to prevent or minimize future problems are to increase funds for vaccine stockpiles, strengthen the National Vaccine Injury Compensation Program (a no-fault system that compensates for injuries that may have been caused by a childhood vaccine), and launch a national campaign to educate the public about the importance of vaccinations.

Such a campaign would encourage more parents to have their children vaccinated, and give vaccine makers a stable demand, the report says.

"We are going to continue to monitor the situation," Peter says. The vaccine stockpile program, already partially under way, is probably the best short-term solution, he says.

Partial vaccine stockpiles now exist for measles, mumps, chicken pox, some polio vaccines, and diphtheria and tetanus.

The new report is termed "very helpful" by another pediatric infectious disease expert, Dr. Carol J. Baker, who is a member of the Committee on Infectious Diseases for the American Academy of Pediatrics.

"It describes the shortage problem that most everyone in medicine and a large part of the public were aware of [when it occurred]," she says. "It also gives proposals to improve the situation."

Another study, appearing in the January issue of the American Journal of Preventive Medicine, suggests that the education campaign is overdue. Parents are showing increasing concern about vaccine safety, a survey of 743 doctors has found. The parents worry about side effects such as reaction to the shot, pain from the injection, and long-term complications.

Four of five doctors from the 743 surveyed in 2000 reported at least one instance of a parent refusing to have a child vaccinated. More than two-thirds of the doctors said parents showed more concern than they have in the past, according to the researchers from the University of Michigan and the Centers for Disease Control and Prevention.

Parents should expect to obtain vaccine information in statement form at every childhood vaccination, experts say, and should ask their doctor for a complete explanation of risks and benefits if they have questions.

More information

For immunization information, visit the American Academy of Pediatrics or the Centers for Disease Control and Prevention.

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