Bases face shortage of Hib vaccine
August 8, 2008
A shortage of the Hib vaccine in the United States means some kids at military bases in the Pacific — including infants — won’t get their Hib shots on time.
Some bases are out of doses for Haemophilus influenzae type b, or Hib, a vaccine that helps protect infants and young children from bacteria that can cause pneumonia, meningitis and other serious infections.
A December recall by the manufacturer, Merck & Co., because of potential contamination of some lots has made the injection scarce and forced some hospitals to ration the vaccine.
Merck suspended production of its two Hib-containing vaccines, projecting it won’t be able to distribute the products again until sometime this fall.
Military hospitals in the Pacific reported that no shots were administered using vaccine from the lots subject to the voluntary recall.
But all the hospitals say they have been affected by the shortage.
At Misawa Air Base in northern Japan, the immunization clinic has no Hib vaccine available, and some children are two months past due for the shot, according to Lt. Col. James Sperl, 35th Medical Group deputy commander.
"We project by the end of the 4th quarter of 2008 Misawa will have approximately 250 children awaiting this vaccine," Sperl said Monday in an e-mail response.
Sperl stressed that parents should still keep their children’s routine medical checkups and make sure they receive other vaccines as scheduled.
Military health care providers at Misawa "feel assured there is no reason for heightened concern," Sperl stated, adding that no adverse outcomes are anticipated due to the delay.
"I’m concerned it’s not available," said Air Force spouse Erica Onder of Misawa. Onder said her 5-month-old son, Ryley, was not able to get an Hib shot at 4 months. "The technician assured me that because he had the first batch, he’s OK."
According to the National Network for Immunization Information, children should get the Hib vaccine at 2 months, 4 months, and sometimes 6 months, depending on the brand, with a booster shot between 12 and 15 months.
Other parents of young children at Misawa were not aware of the vaccine shortage. Air Force spouse Darlene Herrera said she expected to hear something when she took her almost 1-year-old daughter Maricia for her next checkup.
She’ll likely go armed with questions for her provider. "What does it mean?" she said of the shortage. "Do they just wait for the vaccine to come in? What if it’s too late?"
Sperl said that when more vaccines are received, the medical group will call families, starting with the longest overdue first.
U.S. Naval Hospital Okinawa at Camp Lester administered its last dose of the vaccine in May, according to Lt. Cmdr. Michael E. Epperly, head of the hospital’s pediatric department.
Sixty-three children are on the waiting list for the immunization, he said.
The hospital, he added, contracted with a new supply company and expects to receive shipments by the end of this month.
The immunization clinic at Yokota Air Base near Tokyo has been ordering the Hib vaccine directly from Sanofi Pasteur — the only other manufacturer of the drug — but because of the shortage, the company is limiting facilities to 10 five-dose packages per month, hospital officials said.
Yokota has enough vaccine to ensure infants receive their first immunizations, officials said. For older children, the clinic is following the Advisory Committee on Immunization Practices’ recommendation that the vaccine be deferred for children 12 to 15 months until further notice, officials said.
Army bases in South Korea also have limited supplies of the vaccine.
Lt. Col. Paula Doulaveris, 18th Medical Command pharmacy consultant, said the U.S. Army Medical Materiel Agency determines the allocation each facility gets based on size. 18th MEDCOM receives 80 doses a month, which are distributed among all the Army facilities in South Korea. Most of them are used in Yongsan, which Doulaveris said sees most of the infants in the military community.
With that, she said, the immunization clinics have been able to deliver all of the initial Hib immunizations on time, though they are not giving the 12- to 15-month booster shots to healthy children. High-risk children — such as those with asplenia, sickle cell disease, HIV, or other immune syndromes, or those who are Alaskan or Native American — are receiving their booster shots.
She said she doesn’t know when 18th MEDCOM will be able to resume the booster shots.
"Right now we’re getting [Sanofi Pasteur’s] product," she said. "But everyone is trying to get their product."
Doulaveris said 18th MEDCOM uses about 60 of its allocated dosages every month. She said she wouldn’t describe the remaining doses as a surplus, but a "comfortable cushion."
"We wouldn’t sit on a surplus," she said. "If we had a surplus, we would canvass other [Department of Defense] sites to see who needed it."
With limited supplies of the Hib vaccine from Sanofi Pasteur, U.S. Naval Hospital Yokosuka in Japan is immunizing 2-, 4- and 12-month-olds, according to Lt. Cmdr. Gloria Garner, who heads up the hospital’s pharmacy department.
The hospital expects a shipment next week, she said.
"As replenishments arrive, patients are called to be vaccinated."
Lt. Col. Peter H. Kim, 51st Medical Group chief of medical staff at Osan Air Base, said the vaccine has not been administered there since December and there is no word on when they’ll start getting new shipments.
"The process to make a safe and effective vaccine takes time, and it takes more time to build up enough of them to meet an ongoing shortage," he said.
Stars and Stripes reporters Natasha Lee and Charlie Reed contributed to this story.