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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:

  1. Current information indicates that adequate supplies of DTP vaccine should become available in mid- or late 1985.

  2. 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.

  3. 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.

  4. Diphtheria-tetanus vaccine should not be substituted in the routine DTP vaccine schedule for 18-month-old and 4- to 6-year-old children.

  5. 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.

  6. 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.

  7. 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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