Physicians rationing vaccine for meningitis

7/28/2006

A national shortage of meningitis vaccine has local doctors rationing doses to make sure enough is on hand for incoming college freshmen, one of the most at-risk groups for the disease.

Doctors and health officials blamed broadened vaccination recommendations from the federal Centers for Disease Control and a new version of the vaccine - manufactured by Sanofi Pasteur of Swiftwater, Pa., and licensed last year - as the causes for the national shortage.

Meningococcal meningitis - which is estimated by the National Meningitis Association to infect about 2,500 Americans annually - causes spinal and brain tissue inflammation and can be fatal. Symptoms include headache, fever, and a stiff neck.

"Typically, when a new vaccine is approved, in the first few years it's kind of challenging to link up supply with demand," said Lola Russell, a CDC spokesman.

Toledo-area clinics said there should be enough of the new vaccine, called Menactra, to go around if it's distributed only to college students, although some reported have waiting lists.

Immunization is normally recommended for children ages 11-12, students entering high school who have not previously been vaccinated, incoming college freshmen, or others in high-risk groups.

According to the CDC, college students are at higher risk because of close living quarters in dorms, sometimes suspect hygiene habits, and other lifestyle factors.

Because of the potential for a shortage identified as early as May, the CDC recommended the vaccine not be distributed to younger children this year.

"We're only inoculating kids who are going off to college," said Dr. Francis Rogalski, a Toledo pediatrician who said he expects to have enough to meet demand.

He added that some high-risk high school students, such as those traveling abroad or attending a summer camp, could also be vaccinated.

Fallen Timbers Family Physicians in Maumee is limiting distribution of vaccine to college students. Despite a waiting list, a representative said the clinic should have enough to go around.

Dr. Glenn Egelman, director and physician-in-chief at Bowling Green State University's student health services, said he's heard of private physicians having trouble obtaining enough of the vaccine.

He called the shortage "100 percent predictable" and said BGSU stocked up in advance by buying 100 doses. He noted the manufacturer is limiting orders to 20 per month.

Karen Gallo-Willard, head pharmacist at the University of Toledo's student medical center, said there hasn't been a major demand yet since students haven't returned from summer vacation and "it probably isn't on the radar yet." She said UT has 40 doses, but would like to have twice that by mid-August when students return.

Although UT and BGSU do not require meningitis vaccinations, some colleges require incoming freshmen be inoculated as a prerequisite to living on campus - almost exclusively because state laws require it.

In Massachusetts, for example, legislation requires all new and transfer college students living in a college residence hall to be immunized against meningococcal disease at least two weeks prior to their enrollment on campus.

Beginning with the fall 2006 semester, all incoming freshmen at any public or private university in Louisiana must be vaccinated against meningitis in order to enroll.

The law was imposed in large part because of the health risks associated with the aftermath of Hurricane Katrina.

Ohio law does not require vaccination for college students, either to enroll or live in on-campus housing, but students are legally obligated to disclose to a university whether they have been vaccinated, said Kristopher Weiss, spokesman for the Ohio Department of Health.

Michigan law directs colleges to provide educational information on meningitis to students, but does not require vaccination status disclosure, according to the National Meningitis Association.

Contact Eric Lund at:

elund@theblade.com

or 419-724-6050.