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Pneumococcal Vaccine in Short Supply

Prevnar Shortage Prompts Change in Vaccination Recommendations

By Jennifer Warner
WebMD Health News

Reviewed by Brunilda Nazario, MD

March 2, 2004 -- A shortage of the pneumococcal vaccine Prevnar will mean many children will have to wait for their third and fourth doses of the vaccine.

Today the CDC recommended that all health care providers temporarily suspend regular use of both the third and fourth booster doses of Prevnar until supplies return to normal. Children at high risk of severe disease, such as those with impaired immune systems or sickle cell anemia, should continue to receive the full, routine, four-dose series.

The pneumococcal vaccine is normally recommended for all children in a four-dose schedule: one dose at 2 months, at 4 months, at 6 months, and a final dose between 12 and 15 months. This current recommendation suspends the third and fourth dose for healthy children.

"CDC is concerned anytime children are not able to receive all of the recommended doses of a recommended vaccine," says Steve Cochi, MD, acting director for the CDC's National Immunization Program, in a news release. "Delaying the third and fourth doses of this important vaccine is not ideal; however, it is important to take steps to assure all children receive some protection with at least two doses of vaccines."

Vaccine Shortage Prompts Change in Schedule

The pneumococcal vaccine helps prevent serious diseases, such as meningitis and blood infections. Children under 2 years of age are at highest risk for these diseases.

In November 2003, the CDC learned from the sole manufacturer of the vaccine in the U.S., Wyeth Vaccines, that production constraints could cause delays in the shipment of the vaccine in early 2004.

On Feb. 12, the CDC recommended that health care providers temporarily suspend the fourth dose of the vaccine in order to conserve the vaccine. Since that recommendation, production of the vaccine has been much less than had been expected, and shipments have been further delayed.

CDC officials say widespread shortages of Prevnar may now continue beyond the summer and prompted today's action to suspend third and fourth doses of the vaccine to healthy children.

"Four doses of PCV7 provide the best protection, but children who have received three doses should also have a very high level of protection," says Cochi. "Children who have had two doses should also have some protection, but the exact level is unknown."

Officials say health care providers should keep track of children who miss their third or fourth dose of Prevnar. These children should receive the missed doses on their first visit after supplies return to normal.

The CDC made the recommendation in consultation with the American Academy of Family Physicians, the American Academy of Pediatrics, and the Advisory Committee on Immunization Practices.

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