Nationwide vaccine shortage hits home

By Emily Richmond (contact)

Friday, April 26, 2002 | 10:57 a.m.

Las Vegas Valley health officials said this week that they have run out of shots of a new drug that protects children against meningitis and pneumonia as well as ear and blood infections, and supplies are low for other children's vaccines.

It is the result of a critical nationwide shortage of children's immunizations, they say.

Medical professionals have "very real fears" that the vaccine shortage could mean a resurgence of potentially fatal childhood illnesses, Peggy Hensley, coordinator of the Clark County Health District's immunization program, said.

In addition to running out of the new drug, Prevnar, the Health District is almost out of the MMR vaccine against mumps, measles and rubella, along with DTaP, which protects against diphtheria and whooping cough.

"Every time we have to tell a parent to come back later because we've run out of doses, we wonder if we've lost them for good," Hensley said. "Because of the shortages today, are we going to see diseases in a few years that we haven't seen in 50 or 60 years?"

For more than a decade Nevada state health officials have fought to improve Nevada's immunization track record through outreach, educational programs and partnerships with public and private agencies. A national health survery ranked Nevada 34th in the nation for vaccinations, with nearly 78 percent of newborns receiving initial doses. That's up from 35 percent in 1991, according to the survey.

The Health District vaccinates about 15,000 children each year with doses of MMR, DTaP and polio vaccines, all required by the Clark County School District for enrollment. So far for 2002, health officials are vaccinating about 150 fewer children each month than last year, Hensley said.

The federal Centers for Disease Control and Prevention in Atlanta has been monitoring shortage of vaccines for nearly all of the major childhood diseases. The shortages have worsened in the past six months as the sole manufacturer has experienced production problems.

CDC officials have been rationing what doses are available, giving top priority to public health clinics for treating the most vulnerable patients. Since most of the vaccines are given in a series of doses, health professionals have been instructed to use their supplies for the youngest patients who have not yet had their first dose, and delay the second and third doses for older children.

Bob Salcido, immunization program manager for the Nevada State Health Division, said each month he contacts CDC officials with a tally of births from the previous 30 days. Based on the number of newborns, CDC officials calculate what Nevada's share of the vaccines will be for that month, Salcido said.

American drug companies have little incentive to get into the business of manufacturing vaccines, Salcido said. Developing a new drug and getting it approved by the Food and Drug Administration is a lengthy and costly process. FDA regulations also control how much a company can charge for a vaccine, which cuts into profits, Salcido said.

The only American company that manufactures the MMR vaccine cut back on its production schedule, citing problems, which set off the shortage, according to the CDC. Other companies that used to make the vaccines got out of the business because of small profit margins.

"We need to come up with a way to encourage companies to get into the vaccine business, either by shortening the FDA approval time or offering other incentives," Salcido said. "At the same time, we need to balance that against safety concerns."

Prevnar has been in short supply since December. The CDC has instructed health professionals to give the Prevnar inoculations only to infants and toddlers, who are at the highest risk. Healthy children older than 2 must wait until the supplies are replenished.

Gail Mattson, a lifelong resident of Las Vegas, said Tuesday she has been trying since August to get her now year-old son his first dose of Prevnar.

"It's frustrating because we're always being told how important the shots are and not to put them off," said Mattson, who unsuccessfully tried again Wednesday. "I feel like I'm not doing enough to protect my son."

The county's health clinic offers low-cost vaccinations to qualified families through the federally funded Vaccine for Children program. When supplies allow, paying customers can also bring their children to the clinic for vaccinations.

The supplies for the federal program and the general public are kept separate. As of Tuesday both inventories for Prevnar had been exhausted, Hensley said.

State health officials ordered 320 doses of Prevnar for Clark County last week, but there's no way of knowing when the shipment will arrive, Hensley said.

Dr. Kenneth Misch, a Las Vegas pediatrician, said the vaccine shortages have caused chaos for many of the families he treats. Some vaccines involve a series of as many as five shots requiring repeat visits, he said. Once the schedule is interrupted, it becomes difficult for parents to keep track of which shot is due, Misch said.

"It's hard enough to get parents into the office to get their kids immunized," he said. "Then when they show up and we tell them we've run out and they have to come back, it's downright embarrassing."

Misch had been directing families to the health clinic for their shots of Prevnar since December, when his own supplies dried up. Now that the Health District is also out of doses, Misch said he doesn't know where to send his at-risk patients.

"Nevada was already behind the rest of the country when it comes to immunizing our kids. Now we're going to be even deeper in the hole," Misch said.

Sen. Harry Reid, D-Nev., is concerned about the vaccine shortage and anticipating a federal report into the crisis due this summer, a spokesman for the senator said this morning.