In Midst of Pediatric Hepatitis B Vaccine Shortage, CDC Urges Docs to Not Hoard Doses

Supplies of pediatric hepatitis B vaccines are expected to remain tight through the summer, but CDC officials said in a May 5 status update letter (2-page Word file; About Downloading) that supplies will be sufficient through the end of the year, "if providers continue to order vaccine judiciously."

Merck and GlaxoSmithKline, or GSK, have been experiencing hepatitis B vaccine supply issues since February. The CDC responded by releasing doses of each manufacturer's monovalent pediatric hepatitis B vaccine from its vaccine stockpiles.

The agency said Merck expects supplies of Recombivax HB, the manufacturer's pediatric hepatitis B vaccine, to be limited through the remainder of 2009, while GSK plans to ship additional supplies of its Pediatric Engerix-B vaccine in the fall.

Providers should continue to administer pediatric hepatitis B vaccine according to the recommended vaccination schedule, (1-page PDF file; About PDFs) said Jeanne Santoli, M.D., M.P.H., acting chief of the Vaccine Supply and Assurance Branch of the Immunization Services Division in the CDC's National Center for Immunization and Respiratory Diseases.

"We are most likely to be successful in maintaining the ability to provide three doses of hepatitis B vaccine to all infants and toddlers on schedule if immunization providers continue routine ordering practices," Santoli said in the letter. "Placing larger-than-normal orders to build a stock of vaccine is discouraged."

Santoli said changes in purchase patterns based on concerns about supply can worsen a shortage.

"Vaccine shortages are frustrating for everyone, but it is important for family physicians to cooperate with the CDC and local health departments and adhere to recommendations regarding ordering and stocking vaccine in order to protect the health of the entire public," said Doug Campos-Outcalt, M.D., M.P.A., the AAFP's liaison to the CDC's Advisory Committee on Immunization Practices and associate head of the department of family and community medicine at the University of Arizona College of Medicine, Phoenix.