Hernán Rozemberg The Arizona Republic
A shortage
of tetanus vaccine shots has worsened, leaving many hospitals
and clinics across the country with only a week-to-week supply.
Though no
Arizona medical center has yet run out of the tetanus vaccine,
the shortage has many doctors biting their nails as they await
the next small shipment.
In mid-January,
Wyeth-Ayerst, one of the nation's two tetanus manufacturers, announced
that it was stopping production of both child and adult versions
of the vaccine.
"It caught
us all by surprise," said Len Lavenda, spokesman with Aventis
Pasteur, the Pennsylvania-based company now responsible for developing
the vaccine for the entire country. "We never thought they
were making a permanent exit from the market."
It is estimated
the shortage could continue for up to 18 months. Lavenda said
it will take at least until the end of the year before supply
meets demand for the adult brand - more commonly known as "10-year
booster shots."
Until then,
orders are being "rationed," meaning, for example, that
a hospital asking for 1,000 doses will get only 100 doses.
It also will
take several months before the children's version, a series of
five shots given between birth and age 5, is no longer on back
order, said Lavenda, who pointed out that it takes nearly a year
to grow the bacteria to make the vaccine.
The Centers
for Disease Control and Prevention in Atlanta, the U.S. government's
health monitor, doesn't see a need to panic. But "spot shortages"
may be worse in parts of the country that are further down on
the waiting list, spokeswoman Barbara Reynolds said.
Lavenda also
sees no need to worry. If hospitals or doctors run out, all they
need to do is ask for help - an emergency supply is always kept
handy, he said.
Even so, Arizona
health officials would like to prevent such a scenario. They're
calling for temporary changes until the shortage ends.
"When
you have to be putting new orders in every week and you're used
to a regular three-month supply, it makes everyone nervous,"
said Kathy Frederickson, who runs Arizona's Immunization Program.
The program is the vaccine distributor for nearly 800 public hospitals
and clinics across the state.
Frederickson's
office dispatched a memo to all medical centers in the state saying
they may keep only up to one month's reserve of the children's
version. They also must list how many shots were given the previous
month and their current stock or they won't be given more.
The memo also
asks that the last shot kids get before entering kindergarten
be delayed until they're 5 to 6 years old - many children get
this shot when they're 4.
The 10-year
boosters are required to attend school, but due to the shortage,
school nurses are being told to let students in even if they haven't
had them.
"We're
being told to use it only for students with injuries," Mesa
High School nurse Marilyn Brown said.
Medical workers
are nervous but aren't sounding the alarm - at least not yet.
"It's
a big change in practice for us," said Marcia Dern, a Phoenix
Children's Hospital nurse who serves many low-income, uninsured
children that depend on free shots. "Normally, if I have
a 4-year-old in the office, I don't have to think about not giving
a tetanus shot."
Gary Baker,
pharmacy director for the privately run Scottsdale Healthcare
hospitals, has nightmares of having to turn people away.
"We haven't
run bone-dry yet, but we've often been down to our last vial,"
he said. "It'll be a really big deal when a patient shows
up and cannot be served."
According
to the Centers for Disease Control, tetanus is a potentially fatal
disease that stiffens the body's muscles and produces spasms,
usually starting with the jaw area. The bacterium that causes
tetanus usually comes from the soil and enters through a wound.
Elderly people
are most vulnerable, primarily because they haven't had tetanus
shots in many years. During the 1990s, a larger number of younger
people became infected, mostly through the use of drug needles.
The number
of cases has dramatically dropped. While as many as 600 people
in the United States died of tetanus in the late 1940s, an all-time
low of 33 deaths was reported in 1999.
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