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9/21/2001

Shortage Leads CDC to Advise Delay in Pneumococcal Immunization of Certain Children

Cheryl A. Thompson

A shortage stemming from problems in manufacturing Prevnar, Wyeth Lederle Vaccines’ seven-valent pneumococcal conjugate vaccine, has led the Centers for Disease Control and Prevention (CDC) to ask health care providers to delay administering the product to healthy children older than 2 years of age who are not at high risk of pneumococcal infection.

Until the supply of Prevnar improves, CDC has designated two levels of priority for vaccination.

Health care providers should focus their efforts on vaccinating all infants less than 12 months of age and children 1–5 years old with at least one of the following risk factors:

  • Sickle cell disease or another sickle cell hemoglobinopathy,  
  • Lack of a functioning spleen,  
  • Human immunodeficiency virus infection,  
  • Chronic disease, including chronic cardiac and pulmonary disease (excluding asthma, unless therapy includes a high-dose corticosteroid regimen), diabetes mellitus, and cerebrospinal fluid leak, or  
  • An immunocompromising condition, including malignancy, chronic renal failure, nephrotic syndrome, receipt of radiation therapy or immunosuppressive cancer chemotherapy such as a long-term corticosteroid regimen, and receipt of a solid organ transplant.

Health care providers who have sufficient doses of the vaccine to cover the high-priority patients may also administer it to healthy children 1–2 years old.

According to CDC, infants should receive the vaccine at 2, 4, and 6 months of age. The fourth dose, to be administered when the child is 12–15 months old, may be deferred during the shortage.

CDC recommended that health care providers record the names of children whose pneumococcal vaccination has been deferred. The federal agency said the shortage will last through December 2001, perhaps longer.