GPs warned tetanus vaccine stocks dangerously low

Supplies of a vaccine against a life-threatening disease are dangerously low, the Irish College of General Practitioners (ICGP) has warned. The company supplying tetanus vaccine here says it is out of stock and will have no fresh deliveries until next week.

The warning came in a letter to doctors from ICGP chairman Dr Richard Brennan. It said that while some doctors and health board regions still had supplies, GPs in the South Western Area Health Board were reporting problems getting the vaccine.

"The health boards' and hospitals' supplies are fairly well intact at the moment," Dr Brennan said yesterday. "We have talked to the Department of Health and Children about this and they are looking" for alternative supplies.

If supplies are not available, doctors should send patients to hospital for vaccination. They are also being told by the ICGP to give notice to the Department in writing that the patient "is being put at risk due to unavailability of this potentially life-saving vaccine" and to write to their medical insurers.

Only one company supplies the tetanus vaccine here, Aventis Pasteur MSD, following the withdrawal from the market earlier this year of a second major supplier.

The company supplied its last doses of pure tetanus vaccine and a two-in-one version last Monday, according to its business manager, Ms Mary Morgan.

"This is the first time I have never had a dose in stock but I am getting some in next week," she said yesterday. "However, when it comes in we will have to ration it."

Supplies for the next few months will be "sporadic" because of a worldwide shortfall caused when the supplier Medeva left the market without warning, she said. The company could only provide intermittent stocks as it tried to cope with the shortfall, she said.

Supplies of the five-in-one and two-in-one versions for infants are not in jeopardy but adult versions were in short supply worldwide. Her company was the sole supplier in the Republic and UK and most other European countries, she said.

Infants are automatically vaccinated against tetanus or "lockjaw", a disease caused by a bacterium readily found in most soils. Children also regularly receive booster vaccines; adults receive it if they have had serious cuts or puncture wounds.

"The general feeling here is if children have taken their three primary vaccinations plus their school boosters, that should by and large give them sufficient cover unless they receive an at-risk cut," Dr Brennan said. These include injuries received on farms, around livestock and horses; or deep cuts or abrasions caused by soils or road surfaces. Mortality occurs in a quarter to a half of all cases even with the best care possible.

The Republic typically needed 170,000 to 180,000 vaccine doses a year, Dr Brennan said but is expected to receive no more than 80,000 to 90,000 doses over the next year. "We want people to be aware that they must be prudent with their supplies," he said.

A spokesman at the Department acknowledged the shortage: "The Eastern Regional Health Authority which acts as the central purchasing agency for vaccines on behalf of all health boards, is working in conjunction with the existing supplier to ensure there is sufficient product to meet essential needs," he said. "The ERHA is endeavouring to secure further supplies of tetanus vaccine as a matter of urgency."