Td Vaccine No Longer Being Shipped to Offices.

ATLANTA -- The nation's only manufacturer of tetanus-diphtheria (Td) vaccine has temporarily halted shipments to physicians' offices in order to maintain sufficient supplies for critical needs during the shortage.

That announcement came from Phil Hosbach, executive director of public business and immunization policy at AventisPasteur, Swiftwater, Pa., at a meeting of the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices.

Physicians should refer high-priority patients to local hospitals, emergency rooms, or public health clinics that have adequate supplies, he said.

In the interim, neither DT (used in children up to age 7) nor DtaP vaccine should be used as a substitute for Td in people aged 7 or older. Tetanus immune globulin or antimicrobial therapy should not be substituted for Td vaccine in any patient.

The recommendations for wound management haven't changed: Patients with severe or contaminated wounds should receive Td if more than 5 years have passed since their last dose, as should those with dean and minor wounds who have not received tetanus-containing vaccine in the past 10 years.

In early June, the CDC issued a statement prioritizing the use of Td vaccine for wound management, travel to diphtheria-endemic countries, people who have received fewer than three doses of vaccine containing tetanus and diphtheria toxoids (primary series), and pregnant women who have not been vaccinated within the preceding 10 years. They advised that routine adult and adolescent boosters be delayed until 2002 (MMWR 50[20]:418, 427, 2001).

Some state health departments were not complying with that ...