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Vaccine shortage to alter requirements


State: Note from doctor, promise to comply will suffice

A shortage of the tetanus-diphtheria vaccine has prompted the state to advise public high schools to allow students who have not received their booster shots.

State law requires high school students to have an additional dose of the vaccine if 10 years have lapsed since their last shot.

But schools should not turn away students as long as they have a note from a doctor and promise to get the vaccine as soon as the shortage is over, according to a letter to school districts from John Lumpkin, director of the Illinois Department of Public Health, and Glenn "Max" McGee, state superintendent of schools.

Freshmen will still be required to meet other state mandates, including Hepatitis B shots, a physical exam and a dental exam.

The high school student in question could be either a freshman or a sophomore, said Colette Roland, coordinator of nursing services for the Plainfield School District. If students get a booster when they are ready to go into kindergarten, she said, they might be either 4 or 5 at that point. So the state requirement for the adult booster wouldn't kick in until they are 14 or 15.

Generally, Roland said, they suggest incoming freshmen get the tetanus-diptheria shot the same time they get their required physicals. And since most of their students come from feeder schools in the unit district, she said, it's relatively easy to check when a student received the first booster and needs the second one.

But that still means sending out hundreds of notifications to parents of incoming freshmen and sophomores to make sure the medical records are up to date, Roland said. And that takes time and a lot of paperwork.

"We kill a lot of trees," she said. "It's terrible."

Roland said a few more trees died when they, and other school districts, sent notices to parents informing them of the vaccine shortage. Chris Ward, Lockport Township High School superintendent, hoped that parents and guardians don't use the shortage as a reason not to get the shots.

"What we don't want is people who will make that decision without consulting a health care provider," he said. Hence the required note from the health care provider asking the school to waive the 10-year booster requirement until more vaccine is available.

Likely, there is not a broad exemption instead of the note system because vaccine is available at some doctor's offices and clinics. But James Clark, Joliet Township High School superintendent, hoped there would be enough at the Will County Health Department's clinic, where many of their low-income families go to get physicals and immunizations.

They have some, said Will County Health Department spokesman Vic Reato, but not a lot. So they will do as the Illinois Department of Public Health suggests and save the tetanus-diptheria vaccine for those who need it most: those having a recent wound requiring a the vaccine, and those traveling internationally.

Luckily, the area administrators say, we aren't in an area where there is an extremely great need for tetanus-diptheria vaccine, and only a handful of students are kept out every year for not having the booster at the required time.

Other than making sure their children stay healthy, Roland said parents have another reason for making sure their high school-age children have their health records up to date.

"By the end of summer," she said chuckling, "they are ready to have their kids back in school. They want them out of the house."

The nationwide shortage came about earlier this year when Wyeth-Lederle Laboratories halted production of the vaccine.

Aventis Pasteur, the lone remaining producer, has been working to produce enough of the vaccine, which takes 11 months to make.

The shortage only involves the adult version of the tetanus vaccine, not the one administered to infants and young children.


-- Martin Thompson (, June 02, 2001


Western Pa. hospitals ration tetanus shots

Associated Press

PITTSBURGH -- Some hospitals, clinics and doctors' offices in western Pennsylvania are trying to limit tetanus shots because of a potential shortage.

Health care providers are trying to limit use of the vaccine to trauma cases in some instances because manufacturing delays may hurt supplies.

According to new guidelines issued last week by the Centers for Disease Control and Prevention in Atlanta, people who haven't had a booster shot in the last decade are being told to wait until next year to get the vaccine.

''If someone walks in with a cut and they had a tetanus shot two years ago, they wouldn't get the shot,'' said Bob Henderson, a spokesman at UPMC Passavant in McCandless. ''But we're giving the shots to everyone who needs them.''

At western Pennsylvania's largest hospitals, officials say they have supplies of the vaccine but want to make sure they avoid any serious shortage in the future.

''We've been able to stay on top of it, but we're telling our doctors about the national shortage just in case,'' said Noreen Tompkins, a pharmacist at Allegheny General Hospital in Pittsburgh.

Allegheny County health officials said there is an ample supply of the vaccine available but they want to make sure to avoid a shortage in the future by limiting use of the shots now.

The vaccine works for several years but, in the past, patients were sometimes given a new shot when they couldn't remember when their last one was. Now, health officials are trying harder to determine when the patient last had a shot or a booster.

''We're not giving the vaccines to people who don't need it,'' said Guillermo Cole of the Allegheny County Health Department. ''We're making a very determined effort to find out when they received their last shot.''

-- Martin Thompson (, June 02, 2001.

Tetanus Vaccine Shortage

Vaccine Should Be Available for Summer Injuries But Not for Booster Shots

By Robin Eisner

May 28 Accidents happen. But a tetanus vaccine shortage should make people a bit more cautious sliding onto home plate or digging in their garden this summer. STORY HIGHLIGHTS The Pervasive Microbe: Tetanus When Was Your Last Tetanus Booster Shot? Tetanus Rare in U.S. Because of Vaccinations

Although public health officials say anyone who has a serious injury should be able to get a shot at their local hospital, some doctors' offices throughout the country may not have the vaccine available in response to emergency situations. Tetanus is a disease due to toxins present in the Clostridium tetani bacterium that cause painful spasms of the muscles and a locking of the jaw, preventing the victim from opening his or her mouth or swallowing. Death ensues when the toxin affects someone's ability to breathe.

The Pervasive Microbe: Tetanus

The microbe is found everywhere, but it is most common in dust, soil and manure. Rusty nail punctures, gardening cuts or sports scrapes covered with dirt create environments in which the bacteria flourish.

People with such injuries who have not been vaccinated within five years to 10 years, depending on how serious the wound is, will need a shot to protect them from the tetanus toxins, experts say.

"Injured people should seek medical attention as soon as possible," says Robert Snyder, public health adviser for the National Immunization Program at the Centers for Disease Control in Atlanta.

Experts say if you or a loved one is badly hurt you probably should contact your family physician first.

When Was Your Last Tetanus Booster Shot?

"Your family doctor could tell you when you received your last booster shot and if a shot is necessary what health care facility in the area would have it available if your doctor didn't" says Dr. Ross Black, a family practitioner in Cuyahoga Falls, Ohio, and member of the board of the American Academy of Family Physicians.

The shortage has come about because Wyeth-Lederle, St. Davids, Pa., announced it would stop manufacturing tetanus vaccine January for financial reasons, leaving only one company, Aventis Pasteur, of Swiftwater, Pa., to produce it.

Aventis and the Centers for Disease Control are working together to keep supplies available throughout the United States, they say. The company is rationing the number of doses hospitals and physicians can get, says Len Lavenda, Aventis Pasteur spokesman.

"We are keeping a reserve in case of hurricanes, floods or catastrophes," says Len Lavenda, "and we can overnight ship supplies to places that need it if they call us."

To keep supply available, the CDC is recommending that doctors not give booster shots to adolescents or adults until next year.

And doctors are following the recommendations. "We have stopped giving booster shots to our adult patients," says Dr. Charles Colodny, a family practitioner in the Libertyville Medical Group, which is located in a suburb of Chicago.

Likewise, the St. Lucie County school district has exempted seventh graders from getting the tetanus vaccine shot this fall.

Tetanus Rare in U.S. Because of Vaccinations

Tetanus, which is not spread by human-to-human contact, is rare in the United States, killing only around 100 people a year.

The low number, however, is due to the success of America's tetanus vaccination programs, which start in infancy. The disease is significant outside the United States where there are more than 300,000 cases annually.

The vaccine provides protection against the devastating effects of the bacterial toxin, but booster shots are necessary. Children usually get shots at two, four, six and 15 months; at 4 to 6 years of age; and at adolescence. Under normal supply conditions, boosters are recommended every ten years, thereafter.

With the tetanus vaccine shortage coming on the heels of flu vaccine scarcity last fall, doctors are concerned the country may be suffering a vaccine manufacturing problem.

"We need to understand why manufacturers are having problems with or getting out of vaccine production," says Black. "Is it they are not making enough money? Is it liability concerns? These issues need to be addressed because vaccines are so important in the prevention and treatment of disease."

-- Martin Thompson (, June 02, 2001.

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