State suffers
vaccine shortage

Immunization shots for childhood
diseases are in limited supply

By Helen Altonn

An unprecedented national vaccine shortage is being felt here in three areas: varicella (chickenpox); measles, mumps and rubella (MMR); and diphtheria, tetanus and pertussis (whooping cough) (DTaP).

Judy Strait-Jones, Hawaii Immunization Program project director, said program manager Malama Markowitz reported difficulty as of late last month in providing vaccines for those diseases. But the Health Department has been able to supply vaccines to doctors in most other cases, Strait-Jones said.

She said Markowitz reported that the program has not had too many vaccine requests from doctors that at least a portion could not be filled.

"We're not really in a crisis mode at this point," Strait-Jones said. "It'll only get better," she said, as more vaccines are manufactured.

Nationally, shots to protect children against eight of 11 vaccine-preventable infections have been in short supply off and on since last summer. Some shortages are expected to continue for six months.

Hawaii is part of the Vaccines for Children Program, funded by the federal Centers for Disease Control and Prevention to provide vaccines to eligible children.

Calling the shortage "unprecedented," Dr. Walter Orenstein, director of the CDC's National Immunization Program, told the Washington Post, "I have never seen anything like the supply problems with this many vaccines in the 24 years I've worked in immunization."

A number of factors combined to create the shortages, the federal agency said, including companies leaving the market, manufacturing or production problems and insufficient stockpiles.

Strait-Jones said several strategies are being used to make sure children who need the shots will get them, especially those at high risk for the diseases.

She said Hawaii's program follows recommendations by the federal Advisory Committee on Immunization Practices, which has made temporary changes in some cases.

The Health Department has provided free reminder-recall postcards to Hawaii doctors for parents to list contact information so they can be called when vaccine is available, she said.

All students entering seventh grade are required to have shots by July 1 to protect against hepatitis B, measles, mumps and rubella and varicella or chickenpox.

New immunization requirements also will go into effect for children in child care or preschool 19 months of age and older and for first-time students.

Varicella has been added to vaccination requirements for younger children.

The national advisory committee has made varicella a priority for limited supplies of vaccine because of dramatic declines in cases and hospitalizations in areas with chickenpox vaccination programs.

So long as the varicella vaccine shortage continues, doctors are asked to delay vaccinating infants until they are 18 months old or upon their two-year visit.

They are asked to use the call-back system if varicella vaccine is delayed.

Strait-Jones said physician-to-physician contacts also are encouraged during the vaccine dilemma. "Very often, one physician will be short of a particular vaccine while another physician will have a supply that they are willing to share. We have seen a lot of this."

Children unable to get vaccinations required for school can take an entry card or note from their doctor showing they are working on getting shots, Strait-Jones said.

"We saw the shortage looming. That is why we established the postcards. We have got to be flexible and helpful."

The Health Department has been working with doctors and schools in a public education campaign, Vax to School, to get the message out about new vaccination requirements.

Parents who do not have a doctor for their child should call Ask Aloha United Way, 275-2000, for a clinic near them. Neighbor island residents may call toll-free 877-275-6569.

For more information, call the Hawaii Immunization program, 586-8323, or from the neighbor islands toll-free, 800-933-4832, or visit

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