Shortage of MMR vaccine leads to stockpile raiding

By Julie Appleby and Anita Manning, USA TODAY

The vaccine that protects children against measles, mumps and rubella is in such short supply that federal health officials have tapped into a dwindling stockpile, yet some hospitals and doctors are still finding it difficult to get.

The MMR vaccine, as it is known, joins a growing list of scarce drugs, with shortfalls caused by production problems, fewer drugmakers and pharmaceutical companies electing to stop making some products.

The situation is so bad that eight of the 11 recommended childhood vaccines are in short supply, including tetanus, diphtheria and a pneumococcal vaccine used to prevent bacterial meningitis.

Some doctors are having to put off scheduled vaccinations, leading parents to fear they won't be able to get their children signed up for school.

Production problems that began last summer are responsible for the MMR vaccine shortfall, says a spokesman for Merck, the sole maker of the shot.

"We are experiencing some temporary shortages," says spokesman Chris Loder, who says production is "returning to normal levels."

Another Merck vaccine, one that prevents chicken pox, is also on back order. Because there are no stockpiles of chickenpox vaccine, health officials will meet next week to consider whether to change chickenpox vaccination recommendations in an effort to conserve the remaining supply. The shortage comes as chickenpox "season" peaks, from mid-February through spring.

Even though Merck is producing some MMR vaccine, supply has not kept up with demand in a nation that uses 1.8 million doses a month.

In October and November, the average delivery of the MMR vaccine fell 61% below national demand, according to the Centers for Disease Control, which asked Merck to supplement production by taking 700,000 doses from a stockpile of 3.1 million doses.

Those doses were delivered in January, but the CDC says it has asked to dip into the supplies again.

"We are concerned," says Walter Orenstein, director of the National Immunization Program at CDC, pointing to an outbreak in 1989-91 that led to 55,000 measles cases, 11,000 hospitalizations and 123 deaths.

Doctors and parents fear the shortage could mean children miss a dose of the vaccine, which is given at ages 12 months to 15 months, with a booster shot shortly before the child starts school.

Adults, too, might find it difficult to find the vaccine.

Merck is currently not producing individual vaccines against measles, mumps or rubella.

Some parents might be asked to bring children to doctors for extra visits to make up missed shots, says Bruce Gellin of Vanderbilt University.

The danger is that more children will miss critical immunizations."

There's a real possibility you will widen the cracks people fall through," he says.

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-- Martin Thompson (mthom1927@aol.com), February 20, 2002