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Notice to Readers: Resumption of Routine Schedule for Diphtheria
and Tetanus Toxoids and Acellular Pertussis Vaccine and for Measles,
Mumps, and Rubella Vaccine
Please note:
The
text of this report has been corrected and does not correspond to the official
electronic PDF version. An erratum has been published; to view the erratum,
please click here.
Supplies of diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine and measles, mumps, and rubella
(MMR) vaccine in the United States have become sufficient to permit the resumption of the routine schedule for DTaP and MMR
use as recommended by the Advisory Committee on Immunization Practices (ACIP)
(1--3). However, health-care providers should be advised that, for the next 2 months, supply might not be adequate for the initiation of ambitious recall or
special initiative programs. With increases in national inventory, more comprehensive recall programs can be established. Child
care and school attendance provisions requiring children to receive a DTaP booster and a second dose of MMR vaccine at age
4--6 years can be reinstituted.
DTaP Vaccine
Three DTaP vaccines are distributed currently in the United States:
Tripedia® (Aventis Pasteur, Swiftwater,
Pennsylvania), Infanrix™ (GlaxoSmithKline, Philadelphia, Pennsylvania), and
DAPTACEL™ (Aventis Pasteur, Toronto, Ontario). The
Food and Drug Administration (FDA) approved DAPTACEL™ for use in the United States on May 14, 2002
(4).
During the DTaP vaccine shortage beginning in 2000
(5), ACIP recommended that health-care providers vaccinate
infants with the initial 3 DTaP doses, if they did not have sufficient supply of DTaP to vaccinate all children in their
practice. ACIP also recommended deferral of the fourth and fifth DTaP doses if supplies were still inadequate
(6). Supplies are now adequate to resume the full 5-dose schedule for DTaP vaccine
(1,3).
MMR Vaccine
A temporary shortage of MMR vaccine in the United States resulted from a voluntary interruption of
manufacturing operations of Merck & Co., Inc., the only manufacturer of this vaccine in the United States
(7). During the vaccine shortage, ACIP recommended deferral of the second dose of MMR vaccine at age 4--6 years if health-care providers were unable
to obtain sufficient amounts of vaccine. The first dose at age 12--15 months was not to be delayed because of the severity
of measles in young children (7). Supplies are now adequate to resume the second dose of MMR vaccine
(2,3).
Vaccine Supply
Health-care providers should review the vaccination status of their patients and administer DTaP and MMR vaccines,
as appropriate. For at least the next 2 months, providers should order DTaP and MMR vaccine in amounts sufficient for a
<30-day supply to ensure that current supplies can meet requests. Recall or special initiative programs can be instituted
when DTaP and MMR vaccine supply improves further but should be deferred during this transition period. However, if
children who need these vaccines seek medical care for other reasons, they should be administered vaccine provided
no contraindications exist. Furthermore, vaccine should be offered to children who need vaccination and whose
parents requested vaccination. CDC will continue to monitor DTaP and MMR vaccine supply and, if necessary, allocate
vaccine. Updates regarding vaccine supply and shortages can be found at http://www.cdc.gov/nip/.
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of pages found at these sites. URL addresses listed in MMWR were current as of
the date of publication.
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