Notice to Readers Diphtheria-Tetanus-Pertussis Vaccine
Shortage
On February 12, 1985, the American Academy of Pediatrics hosted
a
meeting to discuss ways of dealing with the current shortage of
diphtheria-tetanus-pertussis (DTP) vaccine. The meeting was
attended
by representatives of the American Medical Association; American
Academy of Family Practice; the vaccine manufacturer; state,
county,
and city health officials; the U.S. Department of Defense; and the
U.S. Department of Health and Human Services.
Available information indicates that, overall, state health
departments have approximately 2.3 months' supply of DTP vaccine on
hand, but this vaccine is not uniformly distributed, with 18 states
having supplies on hand of 1 month or less. Because of close
inventory monitoring and prudent use of DTP reserves held by the
manufacturer, vaccine has remained available in the public sector
to
date.
A survey conducted by eight different state health departments
of
583 physicians indicated approximately one-third had had
difficulties
in obtaining DTP vaccine, and approximately one-half were following
the current recommendations to defer the DTP doses for 18-month-old
and 4- to 6-year-old children. In four states, where inventory
estimates were made, physicians' current inventories ranged from
1.9
to 2.9 months' supply.
Lederle Laboratories reported the release for distribution of
one
DTP vaccine lot on February 12. This lot, about 35,000 vials
(525,000
doses), has been divided among the company's five regional
distribution centers located in Los Angeles, California; Atlanta,
Georgia; Chicago, Illinois; Philadelphia, Pennsylvania; and Dallas,
Texas. This vaccine is being distributed to health-care providers
now.
Because currently available supplies of DTP vaccine are
limited,
the manufacturer is carefully coordinating the distribution of
vaccine
to both public and private health-care providers. Following
extensive
discussions, the group reached the following conclusions and
recommendations:
Current information indicates that adequate supplies of
DTP
vaccine should become available in mid- or late 1985.
Until adequate supplies become available, it is important
to
continue the currently recommended practice of deferring
the
DTP vaccine doses for 18-month-old and 4- to 6-year-old
children to assure that the initial three-dose
immunization
schedule for infants is met.
Practitioners should not administer partial doses of DTP
vaccine in an effort to make the vaccine go further, since
the degree of protection afforded by such partial doses is
not certain.
Diphtheria-tetanus vaccine should not be substituted in
the
routine DTP vaccine schedule for 18-month-old and 4- to
6-year-old children.
It is important for practitioners to establish recall
systems
to ensure that children whose doses are deferred are
recalled
for the DTP vaccine they need once supplies become
available.
Because some children will have their 18-month or
"preschool
dose" of DTP vaccine deferred this spring and summer, it
may
be necessary for day-care centers or school systems to
allow
provisional enrollment of such children until they can
receive the needed doses.
As soon as adequate supplies become available, the Academy
of
Pediatrics and the U.S. Public Health Service will notify
physicians so they can again resume the full DTP
immunization
schedule and recall those who need additional doses.
Reported by U.S. Public Health Service Interagency Group to Monitor
Vaccine Development, Production, and Usage.
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