Tetanus shortage a pain for patients

Manufacturing change creates problem

LORRINE THOMPSON THE OLYMPIAN

THURSTON COUNTY -- When nurse Lisa Sprague cut her foot on some metal at her Olympia home this month, she was stunned at how long and far she searched for a tetanus shot.

Turned away from her doctor's office and the Thurston County Health Department, Sprague finally got a vaccine at one of the out-of-county hospitals where she works.

"It pays to know somebody," she said.

The search was Sprague's introduction to the shortage of tetanus vaccines that is squeezing doctors and health departments across the country.

Caused by a manufacturing change, the shortage has been frustrating health workers for more than a year.

The lack of supply means doctors often run out of the vaccines, and health departments and hospitals ration the vaccines, using priority lists for who should receive them.

"It continues to be a problem," said Thurston County Health Officer Dr. Diana Yu.

The county health department does not know from month to month how many vaccines it will receive for distribution to local doctors, she said.

The department performs few vaccinations, with local doctors giving 90 percent of vaccines to patients, Yu said.

Last month, the health department warned Thurston County doctors that they would not receive all the vaccines they need.

"We gave them 80 percent of what they ordered," Yu said.

"We'll be lucky if we can fill 50 percent of the orders this month."

It's important to note that people who need tetanus vaccines -- those with injuries who haven't had a booster shot in the past five years -- will be able to get them, she said.

In some cases, however, people will not be able to get the shots from their doctors and may need to visit an emergency or urgent care clinic.

It's not a popular choice among some patients.

Though Sprague felt her cut might have required a couple of stitches, she decided against waiting hours in an emergency room and instead used butterfly bandages to close her wound -- after cleaning it thoroughly.

It did not occur to her, however, that she wouldn't be able to get a tetanus vaccine from her doctor.

"It's kind of scary," Sprague said.

"The next time something happens, am I going to have to go to Canada for treatment?"

Shortage until July

The shortage began in 2000, when a major pharmaceutical company stopped producing tetanus vaccines, according to the Atlanta-based Centers for Disease Control and Prevention.

Only one other company now makes the vaccine, and it takes months to build supplies up.

The shortage is expected to end in July or August this year, the report said.

Those who are a priority for receiving tetanus vaccines include:

-Infants and children, who receive the vaccine in a series of DTaP shots that also include diphtheria and pertussis vaccines.

The first three shots are most critical, but children are scheduled for a series of five in their first years.

-Adolescents and adults with puncture wounds who have not had tetanus booster shots during the past five years.

-Travelers to countries where the risk for diphtheria is high. The vaccines for tetanus and diphtheria are generally combined.

-Anyone who has not received three doses of tetanus vaccine in their lives.

-Pregnant women who have not received tetanus vaccines in the past 10 years.

Health officials ask that people wanting a 10-year tetanus booster wait until the shortage is over.

"I know it's very disappointing to the physicians, but it's just as disappointing to us," Yu said.

However, Yu said the shortage does not mean the vaccines aren't available.

"The supply is low, but the people who need it are getting it."

Lorrine Thompson covers Thurston County and health for The Olympian. She can be reached at 360-754-5431.

A tetanus primer

Tetanus is a noncontagious disease caused by bacteria that enter the body through cuts in the skin, particularly deep puncture wounds. The bacteria live everywhere, but are often found in soil, dust and manure.

Symptoms of tetanus poisoning -- also called lockjaw -- include headaches, irritability, spasms of the jaw muscles, neck, arms, legs and stomach. About 50 people a year in the United States get tetanus, with 30 percent dying from the disease. Tetanus vaccines are given in a series to babies and children, then in 10-year boosters to adults. However, someone with a puncture wound who hasn't had a vaccine in more than five years should get a booster shot.

For more information, visit the state Department of Health Web site at www.doh.wa.gov, or call the state immunization program at 360-236-3569.

The Olympian Copyright 2002

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