The state has ordered doctors to indefinitely postpone giving booster doses of a routine childhood vaccine, as part of a rationing program started after one drug company recalled all of its vaccine.
The order from the Department of Public Health, issued last week, is designed to ensure that there is enough vaccine to provide infants with a basic level of protection against Haemophilus influenzae Type B, a potentially lethal bacterial infection known more commonly by its medical shorthand, Hib.
"We don't want some children in parts of the country not to get the primary series" of Hib vaccinations, said Dr. Alfred DeMaria, the state's director of communicable disease control.
Depending on how long the shortage persists, physicians might be forced to defer booster shots for as many as 80,000 Bay State children during the next year, health authorities estimated yesterday. But disease specialists in Massachusetts said they are confident they will have enough vaccine for children to receive their initial rounds of shots.
That is because Massachusetts, which has an expansive government program to vaccinate children against once-common diseases, buys its shots from the company unaffected by the recall, Sanofi Pasteur.
The other firm that supplies Hib vaccine in the United States,
A Merck spokesman said yesterday that the company had no further update on when it will be able to resume production.
As recently as 1987, nearly 150 Massachusetts children a year were stricken with Hib, a disease that can cause pneumonia; infections of the blood, bones, joints, and heart- and throat-swelling so severe that it interferes with breathing. Children up to age 3 are most susceptible, said Dr. Sean Palfrey, past president of the Massachusetts branch of the American Academy of Pediatrics.
Widespread use of a vaccine against the disease started in the 1980s, with an enhanced version appearing in the 1990s, DeMaria said. The shots have stopped Hib in its tracks: Last year, there was not a single case of the condition reported in Massachusetts.
"So it would be a big deal if we couldn't vaccinate them at 2, 4 or 6 months," the ages at which the first three doses are typically given, said Palfrey, a pediatrician at the Boston University School of Medicine. "It is less of a big deal if we don't have enough vaccine for the 12- to 15-month vaccination, because the kids have some immunity already. However, boosting their immunity is still a good thing."
Children with impaired immune systems, sickle cell disease, and other conditions that make them especially vulnerable to Hib should continue receiving the booster even in the face of the shortage, the state stressed in its order to physicians.
The Department of Public Health also urged doctors to be vigilant for any signs that the disease is making a comeback in Massachusetts.
DeMaria said that parents who encounter difficulty enrolling their children in day care or school because they haven't received their full course of Hib vaccination should ask for a waiver pending resumption of the booster shots. It is important, too, that doctors make a note in children's medical records explaining why a booster wasn't given between 12 months and 15 months.
Stephen Smith can be reached at stsmith@globe.com.
