Wanted: A Shot At Protection

Shortages of Recommended Meningitis Vaccine Leave Some New College Students, Families Searching for Supplies

Even as new college students are being barraged with offers mini-refrigerators, laptop computers and other items, freshmen may have to scramble to find a vaccine that could save their lives.

Some doctors and clinics and a major Washington university have depleted their supplies of Menactra, a vaccine that helps protect against potentially deadly or disabling bacterial meningitis.

"I run out all the time," said Alan Rosenthal, owner of Potomac Prompt Medical Care clinic in Rockville. "There's such a huge demand for it, and nobody can get it" easily.

Bacterial meningitis is a swift-acting infection of fluid surrounding the brain and spinal cord. While the disease is rare -- there were 1,361 cases of meningococcal disease in the United States in 2004, according to the Centers for Disease Control and Prevention (CDC) -- it kills one out of 10 people who get it and leaves others deaf, brain-damaged or with tissue death that requires the amputation of limbs.

Because dormitory living fosters spread of the disease, through coughing, kissing and other exchanges of throat and respiratory secretions, the vaccine is recommended for all entering freshmen, and some states and colleges make vaccination mandatory unless the student or a parent signs a waiver. The CDC also recommends the vaccine for students entering high school.

"Meningococcal disease is less communicable than the common cold," said Nancy Rosenstein, chief of the CDC's meningitis branch. "You really do have to be directly coughed on. . . . It's close contact." Reza Didehvar, a family physician and owner of Old Dominion Urgent Care Center in McLean, said he has been able to get only three doses of Menomune, the Sanofi Pasteur vaccine that was largely replaced by Menactra last year. "That was only after begging them and calling different people," he said. "I've ordered 20 shots" of Menactra for late August or September delivery, "but when I'm going to get it, God knows."

Rosenthal, who was still awaiting his August shipment last week, met recently with a Sanofi Pasteur representative. "The first question out of my mouth was, 'Why can't I get Menactra?' " he said. "I bet she gets that question all day long."

Donna Cary, a spokesman for the drug maker, said the vaccine is recommended for about 10 million Americans: 2 million college freshmen, 4 million high school freshman and 4 million 11- to 12-year-olds. She said the company is hoping to produce 6 million doses this year and 7 million next year.

"We're making as much vaccine as we can," she said. The current shortages are "all being driven by an August back-to-school rush. It's not an ideal situation. We'd like people to be able to get their vaccine from their private physician," she added, but those who cannot should understand that "there is vaccine out there. We're shipping vaccine every day. [Parents] might need to look for it a little bit."

That could require persistence -- and a willingness to pay $100 to $150 for those who use a source outside their insurance network. Frustrated parents have been "overjoyed" to find the vaccine, said Susan Cruz, a nurse at the SmarTravel clinic in Alexandria, which laid in a large supply of Menactra. "The colleges are requiring it, but the people couldn't find it."

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As a result of the shortage, the CDC has asked medical offices to delay immunizing 11- and 12-year-olds.

CDC epidemiologist Tom Clark says ninth-graders are considered a priority "because it's a time when adolescent behaviors are changing" and there is temptation to share cigarettes and drinking glasses. But the "biggest worry" right now, he says, is college freshmen entering dorms; they are about five times more likely than others in their age group to develop meningococcal disease.