Shortages may affect vaccinations

By Alice Keesing
Advertiser Health Writer

State health officials are crossing their fingers as they wait to find out whether there will be enough vaccines available as they prepare to enforce a new immunization rule for seventh-grade students.

	Mandatory vaccinations
	Immunizations required for entry into kindergarten or students transferring into a Hawai'i school
•	Diphtheria, tetanus, pertussis
•	Polio
•	Hepatitis B
•	Measles, mumps, rubella
•	Chickenpox*
	Immunizations required for 7th-grade attendance
•	Hepatitis B
•	Measles, mumps, rubella
•	Chickenpox*
	* A documented history of chickenpox may be substituted for the vaccine requirement.

However, implementing the new rule could become a challenge, said Paul Effler, interim chief for the Department of Health's communicable diseases division, because of nationwide shortages of many vaccines, including those for measles, tetanus, whooping cough and diphtheria.

It's a national concern and Hawai'i, like other states, is waiting to see whether drug manufacturers will deliver as promised, said Malama Markowitz, who manages the Health Department's immunization program.

The department is awaiting national recommendations on how to proceed if vaccine shortages affect parents' ability to meet the July deadline.

About 99 percent of Hawai'i children are vaccinated by the time they enter school and experts aren't sure how many of the 15,000 seventh-graders will need shots as a result of the new rule. Some vaccinations, such as varicella for chickenpox, only recently became available, so there are children who did not receive it before entering school, Effler said.

The new rule is an opportunity to get children immunized who may have been missed at an earlier age, Effler said. "We want to make sure that any kids that either historically didn't get the vaccines because they weren't required when they were born or entered school ... or kids coming into the system that we have a sure-fire way to make sure that they're all caught up," Effler said.

Hawai'i's schools have had occasional, small outbreaks of measles, rubella and whooping cough.

"The levels of these diseases in our society have been knocked down by the vaccination campaign to the point where people don't really perceive the threat or the harm they can cause," Effler said. "But getting acute hepatitis B or A or varicella (chickenpox) as an adult or teenager can be really quite catastrophic and that's we're trying to prevent."

While doctors in some states have had to turn patients away because of low vaccine supplies, Hawai'i officials say they have managed the shortages by prioritizing who gets shots and when.

"Right now Hawai'i is in fairly good standing," Markowitz said. "We don't have a major problem right now, but if the vaccine shortages and delays go on, we will."

If parents are unable to get the shots for their children, they are given a three-month extension if they provide a signed statement from a doctor that the child has a physical exam scheduled or has begun the vaccination series and is waiting for the next dose. There also are medical and religious exemptions.

"There is leeway. We don't want to keep kids out of school," Markowitz said.

For more information, call the Hawai'i immunization program at 586-8323.

Reach Alice Keesing at akeesing@honoluluadvertiser.com or 525-8014.