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1/4/2002

CDC Advises Deferring Some Pediatric DTaP Vaccinations

Kate Traynor

The Centers for Disease Control and Prevention (CDC), in an effort to reserve enough diphtheria and tetanus toxoids and acellular pertussis vaccine adsorbed (DTaP) for young infants, has asked health care providers to defer administering doses of the vaccine to older children.

In a notice published in the Jan. 4 MMWR, CDC’s Advisory Committee on Immunization Practices (ACIP) asked health care providers who lack sufficient DTaP stocks and cannot maintain all of their young patients on the five-dose childhood immunization schedule to defer the fourth DTaP dose.

If deferring the fourth dose—usually given at 15 to 18 months of age—does not free up enough DTaP for infants to receive their first three doses on schedule, ACIP recommends deferring the fifth dose, which is normally given between ages 4 and 5 years.

In areas where the shortage of DTaP is "severe," ACIP said local public health authorities could recommend communitywide deferral of the fourth dose and possibly the fifth.

The report noted that children who will be travelling to countries where the risk for diphtheria is high should be vaccinated on schedule.

ACIP attributed the current shortage of DTaP to the withdrawal from the market, two years ago, of preparations made by Wyeth Lederle of Pearl River, New York, and Baxter Hyland Immuno Vaccines of Baltimore. Aventis Pasteur of Swiftwater, Penn., and GlaxoSmithKline of Philadelphia are the only remaining U.S. manufacturers of DTaP.

According to ACIP, DTaP is likely to remain in short supply until at least the middle of this year. ACIP reminded practitioners to "recall" patients and administer the missed DTaP doses when the vaccine shortage ends.