Health Groups Recommend Temporary Suspension Of Pediatric Pneumococcal Conjugate Vaccine Dose

Three major health groups today jointly recommended that healthcare providers temporarily suspend routine use of the fourth dose of the pneumococcal conjugate vaccine (PCV7). The Centers for Disease Control and Prevention (CDC) Advisory Committee for Immunization Practices (ACIP), the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP) made the recommendation to conserve vaccine and minimize the likelihood of shortages caused by production and supply problems at Wyeth Vaccines, the only supplier of the vaccine in the United States.

“We are taking this action to ensure that every child can be protected against pneumococcal disease despite the limited supply,” said Dr. Steve Cochi, acting director for the CDC National Immunization Program.

The recommendation calls for the temporary suspension of the fourth dose of PCV7, a booster dose given at 12 to 15 months of age. Healthcare providers should move to a three-dose series of one dose at two months, one dose at four months, and one dose at six months. Providers should continue to administer the fourth dose to children at increased risk of severe disease. Children whose booster dose is deferred should receive PCV7 on their first visit after supplies return to normal. This recommendation is not expected to have any adverse health consequences for children.

CDC estimates this action will help conserve more than 1 million doses by July 2004, making widespread or prolonged disruptions less likely.

In November, 2003, CDC learned from the manufacturer that production constraints could cause delays in shipment of the vaccine in early 2004. Since then, CDC has worked closely with the manufacturer to continually assess the situation and manage the allocation of limited supplies of PCV7 to ensure a balanced inventory across states and immunization programs.

The manufacturer has advised CDC that production problems have not been resolved and supplies are likely to be limited through mid-summer or later.

The vaccine can help prevent serious pneumococcal disease such as meningitis and blood infections. Invasive pnuemococcal disease is responsible for about 200 deaths each year among children under five years of age. It is the leading cause of bacterial meningitis in the United States. Children under two years of age are at highest risk. Before a vaccine was available, each year pneumococcal infection caused more than 700 cases of meningitis, 13,000 blood infections and about 5 million ear infections.

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