Human tetanus immunoglobulin shortage - recommending tet vax

[Guest guest]

From Department of Health in UK (letter)

Here they are recommending diphtheria, tetanus and polio vax even if not

indicated in someone not previously vaccinated.

Not even in their protocols.

Tetanus immunglobulin is given if the person is not up to date with

vaccines if there is an injury that is a risk.

No proof any of this works.

Sheri

Gateway Reference: 8539

Room 510Wellington House 133-155 Waterloo Road London SE1 8UG Tel: 020 7972

4377 Fax: 020 7972 3989

24 July 2007

Dear Colleague

Human Tetanus Immunoglobulin

The availability of Human tetanus immunoglobulin (TIG) for prophylaxis is

currently extremely limited in the UK. Supplies may not be restored until

the end of August 2007. Bio Products Laboratory (BPL) is holding a small

amount of intramuscular TIG for emergency treatment of established tetanus

only. It can be ordered direct from the company.

Hospitals should prioritise, where possible, their existing supplies of TIG

for treatment of established tetanus. The Department of Health recommends

the use of combined tetanus, low dose diphtheria and polio vaccine

(Revaxis), (or the equivalent age appropriate vaccine for young children)

for use in other cases. This should be administered where TIG would

normally have been indicated, although this may not generate a response

quickly enough to prevent tetanus at the shorter end of the incubation

period. It may be prudent for clinicians to have a lower threshold for

antimicrobial treatment/prophylaxis of tetanus prone wounds according to

local protocols. Records of patients for whom TIG would have normally been

recommended should indicate clearly if they do not receive it, as they may

be at increased risk of re-attending with tetanus at a later stage, to

ensure early diagnosis.

Supplies of Revaxis for this use should be obtained direct from Sanofi

Pasteur, or you should place orders direct with hospital branches of AAH,

Unichem and Mawdsley as part of your hospital contract.

If preferred, hospitals can import TIG on the basis of a Clinical Emergency

after the approval by the MHRA. You would need to notify the MHRA and

follow the instructions given for Import of Unlicensed Medicines given on

the MHRA website www.mhra.gov.uk/home/idcplg?Idc

Service=SS_GET_PAGE & nodeId=161. There are several importers with the

necessary Import Licenses, who can import this product on your behalf.

Clinical Emergency cases are not subject to the same timelines which apply

to other unlicensed imports and these are processed more rapidly than other

cases.

Information on procurement by Public bodies is contained in the

Introduction to the EU Procurement Rules on the Office for Government

Commerce website.

www.ogc.gov.uk/index.asp?id=1004559

A copy of this letter and a short Q & A will be available at

www.immunisation.nhs.uk.

Yours sincerely signature

Professor D M SALISBURY CB FRCP FRCPCH FFPH Director of Immunisation

--------------------------------------------------------

Sheri Nakken, R.N., MA, Hahnemannian Homeopath

Vaccination Information & Choice Network, Nevada City CA & Wales UK

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