The United

States is currently experiencing shortages in several vaccines that are

required for infants, children and college students to attend schools,

daycare, and other facilities and programs in Georgia. These vaccines

are DTaP (Diphtheria, Tetanus, Acellular Pertussis), Varicella (Chicken

pox vaccine), MMR (Measles/Mumps/Rubella), and Td (Tetanus). These shortages

could last from a few months to a year, depending on a variety of circumstances.

In some cases

shortages have been due to some drug companies moving out of the "vaccine-producing

business." In other instances we have one company that makes more

than one vaccine, but they are only able to manufacture one type at a

time.

To make certain

that enough vaccine is available for those at highest risk of developing

disease the Georgia Immunization program is following the interim guidelines

as recommended by the Advisory Committee on Immunization Practices (ACIP).

These recommendations require that some vaccines be deferred (delayed)

until sufficient vaccine is available, given later than normal, or given

only under certain circumstances.

This in no

way implies that because some shots will be deferred parents do not have

to take their children to their healthcare provider to receive an accurate

and up-to-date certificate of immunization. It does mean that some of

the vaccines your child would normally receive will not be given. Those

that are due but "deferred" because of the shortage will be

documented on your child's updated certificate. Your child's name should

then be entered into a system at that provider's office whereby you can

be notified when those vaccines become available, so that you can make

an appointment for your child to receive them.

The recommendations

of the ACIP are as follows:

Defer (do

not give) the 4th and 5th dose of DTaP regardless of age until further

notice. This means that if your child has not already had the 4th dose

of DTaP, or the 5th dose (if the 4th dose was given before age 4) then

that dose will not be given until the shortage has abated.

Give Varicella

between 18 months and 24 months of age (instead of 12months). Continue

to give varicella if not yet immunized or there is no history of the child

having chickenpox at school entry, or by entry into the 6th grade. This

recommendation merely pushes the time that a child would normally receive

Varicella from 12 months of age to 18 to 24 months of age.

Defer the

second dose of MMR until the shortage abates.

College students,

as well as elementary and secondary school students are affected by this

recommendation. This will be noted on your immunization certificate as

"deferred due to national shortage" by your provider.

In the case

of college students, your physician's office or the health department

can provide you with a letter of deferment. In Georgia, the Board of Regents

has been made aware of the current immunization situation.

Td (Tetanus)

vaccine is to be given only in certain situations. These are Tetanus booster

shots. Your health care provider will know what circumstances warrant

the administration of Td vaccine despite the shortage.

The number

of doses of Prevnar to be given has been reduced to 2, unless the child

falls into a high-risk category. Again, your health care provider will

be able to determine if your child falls into the "high-risk"

category.

We in public

health realize that for most parents, the immunization schedule can be

hard to follow. Now a new wrinkle has been added.

We also recognize

that this will cause some inconvenience to parents who, instead of being

able to complete their child's shots in one office visit, will most likely

have to return more than once. This will also place an added responsibility

on providers who must keep track of all deferred vaccines and recall patients

when those vaccines become available. We can only hope that these shortages

will not last long.

The ultimate

goal of immunization is maintaining the health and well being of our children

and community. Keeping this goal in mind, parents, doctors, health departments,

daycare facilities, and schools will be able to work together to maintain

our stronghold against vaccine-preventable diseases. Please contact the

Fayette County Health Department at 770-461-1178, ext. 5416, or your health

care provider if you have questions about immunizations.

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