The following was sent to me by my pharmacy.
I understand that this change has already occured in the USA. I didn't think
diphtheria was a problem in this country apart from the odd case
report.
Any comments
Ray McGlone
A&E Lancaster
The Introduction of Adsorbed
Diphtheria and Tetanus
Vaccine for Adults and Adolescents as a replacement
for
Adsorbed Tetanus.
Vaccine on Hospital Contracts.
On the advice of the Joint Committee on Vaccination
and Immunisation (JCVI) the Department of Health is changing the current policy
for tetanus immunisation in adult life. To counter the declining immunity to
diphtheria seen in adults Adsorbed Tetanus vaccine is to be discontinued once
current stocks are exhausted. In its place Adsorbed Diphtheria and Tetanus
Vaccine for Adults and Adolescents will be used in the future.,
As you are aware Adult Diphtheria and Tetanus
vaccine is not a new vaccine. It is otherwise known as low dose diphtheria and
tetanus vaccine (Td) and is used in the Childhood Vaccination Programme for the
adolescent tetanus and diphtheria booster.
Under normal circumstances this letter would
not have been issued in advance of clinical guidance from the Department.
This guidance will be issued shortly but due to the status of the current stocks
of single Tetanus vaccines early notification to hospitals has been deemed
necessary.
The NHS Purchasing and Supply Agency have been
working with the current hospital contract manufacturer of Adsorbed Tetanus
Vaccine to phase out production of this vaccine and to make available supplies
of Adsorbed Diphtheria and Tetanus Vaccine for Adults and Adolescents. Aventis
Pasteur MSD have available stocks of Adsorbed Diphtheria and Tetanus Vaccine for
Adults and Adolescents as a pre-filled syringe presentation and contract terms
for NHS hospital supply in England have been agreed and will be circulated by
NHS Purchasing and Supply shortly.
Supplies of Adsorbed Tetanus Vaccine are still
available although stocks held in wholesalers are very limited. Users are
advised to continue to use their own existing stocks. The limited supplies which
both Aventis Pastear MSD and Evans Vaccines have of Adsorbed Tetanus are set
aside for GP supplies. Indeed Evans Vaccines do not supply Adsorbed Tetanus
Vaccines to hospitals under contract and Aventis Pasteur MSD stocks are
insufficient to maintain the hospital supply.
As indicated above clinical advice will be issued
shortly and advice given to NHS Purchasing and Supply Agency indicates that the
vaccine change can be safely undertaken. Indeed the advice given in the British
National Formulary recommends the use of Adsorbed Diphtheria and Tetanus Vaccine
for -Adults and Adolescents during adult life where diphtheria cover is also
required in addition to a tetanus booster. This is the background to, on a
population basis, the JCVI advice underpinning this change
over.
Yours sincerely
Alan Russell Technical Pharmacist NHS
Purchasing and Supply Agency.
RM NWR Critical Shortage cascade
07/05/02