June 27, 2001
Vaccine Shortage Affects Normal Distribution in Oregon
Portland, OR (SafetyAlerts) - As a nationwide
shortage of tetanus-diphtheria (Td) vaccine continues, the vaccine's sole manufacturer has
announced it will no longer ship to private physicians, according to public health
officials at the Oregon Department of Human Services.
"The means the vaccine will only be available
through hospitals and county health departments," says Mel Kohn, M.D., Oregon State
epidemiologist at the Health Division. "It will only be given to people who have
tetanus-prone wounds, or those who will be traveling to a country where the risk of
diphtheria is high."
The Health Division is notifying
health providers throughout Oregon of this change and informing physicians that they
will need to write a referral for any high-risk patients that go to a hospital or health
department for Td vaccination.
"This is a difficult problem and we need the
cooperation of everyone involved," Kohn says. "We must make sure that maximum
disease prevention is achieved with the limited vaccine available. We will continue to
keep health providers and the public informed of developments."
The vaccine shortage resulted when one of the two
manufacturers discontinued production. Aventis Pasteur, the remaining manufacturer, has
increased its production to try to meet national needs. More information on the Td vaccine
shortage and usage guidelines is available on the Web at:
Tetanus-diphtheria (Td) for foreign travel:
Td should be administered to persons traveling to countries where the risk for diphtheria
is high. Travelers to certain countries may be at substantial risk for exposure to
toxigenic strains of C. diphtheriae, especially with prolonged travel, extensive contact
with children, or exposure to poor hygiene. High-risk countries include the following:
Africa Algeria, Egypt, and
sub-Saharan Africa (Angola, Benin, Burkina Faso, Burundi, Cameroon, Cape Verde, Central
African Republic, Chad, Comoros, Congo, Cote d'Ivoire and the Democratic Republic of
Americas Brazil, Dominican Republic,
Ecuador and Haiti.
Bangladesh, Cambodia, China, India, Indonesia, Iran, Iraq, Laos, Mongolia, Myanmar, Nepal,
Pakistan, Philippines, Syria, Thailand, Turkey, Vietnam and Yemen.
Europe - Albania and all countries of the
former Soviet Union (Armenia, Azerbaijan, Belarus, Estonia, Georgia, Kazakhstan, Kyrgyz
Republic, Latvia, Lithuania, Moldova, Tajikistan, Turkmenistan, Ukraine and Uzbekistan).1,2,3
1 Immunization Practices Advisory
Committee. Diphtheria, tetanus, and pertussis: recommendations for vaccine use and other
preventive measuresrecommendations of the Immunization Practices Advisory Committee.
MMWR 1991;40 (no. RR-10)
2 CDC. Shortage of tetanus and diphtheria
toxoids. MMWR 2000;49:1029-30
3 CDC. Deferral of Routine Booster Doses of
Tetanus and Diphtheria Toxoids for Adolescents and Adults. MMWR 2001;50:418,427
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