State: Hey kids, no tetanus shots . . . for now

A national shortage of tetanus vaccine has led to its rationing, which means that rising seventh-graders in Florida won't have to get their required booster shots this year, to conserve supplies for emergencies.

The tetanus vaccine has been scarce for months, but the U.S. Centers of Disease Control recently warned that the shortage has become severe, and the squeeze is not expected to ease for 12 to 18 months.

In response, the Florida Department of Health began notifying county health departments and pediatricians last week that the tetanus booster won't be mandated this year. The students usually get those shots in the spring.

Instead, seventh-graders will get a temporary medical exemption good for one year. Other states are taking similar measures.

"As soon as the vaccine becomes available, we're going to recall all of them to get the shot," said Al Sulkes, manager of the Vaccines for Children program in the bureau of immunization, state Department of Health.

Florida requires all rising seventh-graders to be vaccinated against tetanus and diphtheria, which are usually combined in one shot. They also need shots for measles, mumps and rubella (known as the MMR vaccine) and hepatitis B.

The other shots are still required, and Sulkes acknowledged "it's a hassle for the parents. It would be a lot simpler if we could do it in our normal routine this spring."

But many physicians just can't get the vaccine, and health departments are empty or low, he said. Tampa Bay area emergency room physicians say they still have the vaccine they need.

It is commonly given after someone suffers a bad cut or puncture wound or other injury. Tetanus is caused by a common bacteria and can cause muscle seizures or paralysis. Thus its nickname, lockjaw.

Thanks to aggressive immunization programs, tetanus is rare in the United States.

"There's been a lot of drug shortages in the marketplace, and it just gets real scary to our people who want to take good care of patients to know that gosh, this therapeutic tool may not be available," said Mike McGee, director of pharmacy for St. Joseph's-Baptist Health Care in Tampa.

The shortage began in January, when one of the nation's two main suppliers of tetanus vaccines, Wyeth Lederle, announced it no longer would make it. Spokeswoman Natalie deVane said it was a business decision, made "after a review of our product portfolio and a complete evaluation."

The other major producer, Aventis Pasteur, immediately began increasing production at its Swiftwater, Pa., plant, but the vaccine takes 11 months to make, spokesman Len Lavenda said.

"We're coming into the springtime; this is when we tend to have the greatest demand," Lavenda said. "People are spending more time outdoors; they have many injuries that require emergency treatment, we need to be sure there is a sufficient supply to meet those critical needs."

Lavenda said the tight supply is unrelated to the big price increase Aventis instituted last year, which has seen the cost of a 10-dose vial rise from $14.50 in 1999 to $62.21 in 2001. Children typically get five doses of the tetanus and diphtheria vaccine between birth and age 6. Most states also require a booster shot for students of middle-school age, and a booster shot is recommended every 10 years after.

Experts said the health effect of withholding the vaccine from seventh-graders for a year should be minimal. These students would have had their last booster less than 10 years ago. If they're injured, they can get a booster at the hospital.

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Lucy Morgan

From the Times state desk