tdap vaccine cost :: Article CreatorCDC Tells Physicians To Conserve Tetanus Shots, Warns Of Upcoming Shortage
The CDC is urging healthcare professionals to conserve their supply of the Td vaccine, a type of tetanus shot, in advance of an upcoming shortage. Doctors should administer the Tdap vaccine instead of the Td vaccine when possible to protect against tetanus. Experts say the widely available Tdap vaccine is the preferred tetanus shot since it also protects against whooping cough. If you've ever been to the emergency room to treat a serious wound, you probably received a tetanus shot.
As the most commonly administered vaccine in the ER, tetanus shots are used to protect against tetanus, an infection caused by Clostridium tetani bacteria. However, health officials say a common type of tetanus vaccine may soon be in short supply.
The Centers for Disease Control and Prevention (CDC) is advising healthcare professionals to preserve the Td vaccine, also known as TdVax, which protects against tetanus and diphtheria infections.
The new guidance follows a recent announcement from the vaccine's manufacturer, MassBiologics, that it would discontinue production of the shot. Grifols, the sole supplier of TdVax, anticipates running out of the vaccine by June 2024, the CDC shared with its vaccine advisory panel on Wednesday.
The CDC reports that Sanofi, the only other manufacturer of a Td vaccine licensed and approved for use in the United States, is ramping up its supply of the shot.
"Temporary ordering controls are in place in the public and private sectors to help manage the gap in supply," a spokesperson for the CDC told Healthline. The Tdap vaccine is available for use without supply constraints at this time, the spokesperson said.
The CDC recommends doctors administer the Tdap vaccine instead of Td. The Tdap vaccine also offers protection against pertussis or whooping cough.
In most cases, Tdap and Td shots are used interchangeably among older children and adults. Younger children under 7 receive the DTap vaccine. There's a small number of people with contraindications to pertussis-containing vaccines who should continue to receive the Td shot.
"Based on the rarity of developing a contraindication to pertussis-containing vaccines, the temporarily constrained supply of Td vaccine is not anticipated to prevent providers from utilizing Td vaccine for these children in the VFC program," the CDC told its vaccine panel.
Dr. William Schaffner, a professor of infectious diseases at Vanderbilt University Medical Center in Nashville, told Healthline that one reason for the shortage of the Td shot is there's no longer a market for it. The Tdap vaccine, he said, is the preferred tetanus vaccine.
"I'm a little concerned about the language in talking about shortage because there is no shortage in Tdap," Schaffner said. "From a public health point of view, there's no real concern because there's plenty of Tdap, [we] just have to persuade the small number of providers that are still using Td to use Tdap instead."
Indeed, the CDC confirmed for Healthline that based on available data, most people who received a tetanus shot in the past 10 years received the Tdap vaccine.
Tdap is the preferred tetanus shot because it contains [acellular] pertussis, which provides protection against whooping cough.
"That's an immunization where the protection begins to wane fairly substantially," he said. "That's why it's preferred to be used in these circumstances because you'll also get protection against whooping cough, and we want to reduce that as much as possible."
While infants are most at risk for severe illness and death from whooping cough, this disease can impact individuals of all ages, Schaffner said, regardless of whether they are unvaccinated or have waning immunity.
"It's a historical disease," he said. "That's why we immunize widely. That's why we vaccinate children as early as possible, starting at 2 months, and why it is recommended that everyone who has contact with a newborn should be up to date with their Tdap immunizations because adults and older siblings and other children can bring the bacteria Bordetella pertussis to the infant."
Dr. Monica Gandhi, MPH, professor of medicine at the University of California, San Francisco, echoed the Tdap vaccine's protective benefits against whooping cough but noted it may not be as cost-effective for healthcare professionals compared to the Td vaccine.
While the cost of the Tdap vaccine is slightly higher, both vaccines are typically covered by insurance.
"The discontinuation of the vaccine that protects for both tetanus and diphtheria called Td is disappointing because it means that clinics will now have to stock the more expensive Tdap vaccine," Gandhi told Healthline.
"I suspect that this will not cut down on vaccination rates, but will mean that the more expensive vaccine formulation for three different pathogens will be stocked by clinics," she said.
Tetanus is a bacterial infection affecting the nervous system and muscles, particularly the neck and jaw. But with the help of vaccines, tetanus has essentially been eradicated.
The CDC recommends tetanus shots for all individuals after the childhood vaccine series every 10 years since these vaccinations do not provide lifelong immunity.
There are three types of tetanus shots used in the U.S. To protect against tetanus and other infectious diseases, but only pertussis-containing vaccines protect against whooping cough:
DTap vaccines: diphtheria, tetanus, and pertussis Tdap: tetanus, diphtheria, and pertussis Td vaccines: tetanus and diphtheria Infants and children under 7 receive DTap shots whereas older children and adults receive Tdap and Td.
The CDC confirmed the Tdap vaccine is an acceptable alternative to the Td vaccine, including when a tetanus booster is indicated for wound management.
Common side effects of a tetanus shot include soreness, redness, or swelling at the injection site. Some individuals may experience a rash.
In rare cases, tetanus shots containing pertussis may cause a severe allergic reaction, such as anaphylaxis or encephalopathy. People with a contraindication to receiving pertussis-containing vaccines should continue to receive the Td vaccine only, the CDC told Healthline.
Each tetanus shot works with different effectiveness, Schaffner explained, but all are effective at protecting against tetanus.
Schaffner, who spoke with Healthline during a two-day meeting with the CDC's Advisory Committee on Immunization Practices, said tetanus shots have been "brilliantly successful" at eliminating tetanus and diphtheria in the U.S.
"Vaccines have the capacity to eliminate diseases almost completely," he said. "With tetanus, it's extraordinary because the bacteria that causes tetanus hasn't disappeared — it's in the soil all around us, it's environmentally constant. So what we've done is protected our entire population should they encounter this bacteria," Schaffner said.
The CDC has issued new guidance for healthcare professionals about administering the tetanus shot in advance of an upcoming shortage.
The federal agency says doctors should use the Tdap vaccine instead of the Td vaccine, reserving the latter for high risk patients allergic to pertussis only.
Tetanus shots are recommended every 10 years to protect against serious bacterial infection and whooping cough.
If you can't remember the last time you had a tetanus shot, it may be time to call your doctor.
CDC Braces For Shortage After Tetanus Shot Discontinued, Issues New Guidance
The Centers for Disease Control and Prevention is urging doctors to conserve shots of a kind of tetanus vaccine, as the agency braces for a potential shortage of those shots this year.
Doctors should switch from using the so-called Td vaccine – the immunization that protects against both tetanus and diphtheria infections – to giving the broader Tdap vaccine instead whenever possible, the CDC now says. In addition to tetanus and diphtheria, the Tdap vaccine also offers protection against pertussis, the infection also known as "whooping cough."
This year's shortage risk stems from a decision by nonprofit vaccinemaker MassBiologics to discontinue production of its Td vaccine, branded as TdVax.
Supplies of the shot will likely run low as soon as this summer from the shot's distributor Grifols, the CDC told a panel of its vaccine advisers Wednesday.
"It's available through June, through sometime in June, but it won't be available beyond that," said Jeanne Santoli of the CDC's Immunization Services Division.
Why did MassBiologics stop making TdVax?
Use of the Td vaccine has declined in recent decades, as more doctors have switched to stocking the newer but often pricier Tdap vaccines now on the market.
Sarah Wiley, a spokesperson for MassBiologics, said the "similar vaccines have led to a reduction in demand" for TdVax
Wiley said the decision to stop making the shots was unrelated to a previous disruption to TdVax supply through last year, after the company faced scrutiny from the Food and Drug Administration over some lots they had manufactured.
The shots are often given as a booster dose every 10 years, though doctors are recommended to give them earlier when treating severe or dirty wounds and burns that can let tetanus bacteria into the body.
Grifols had marketed TdVax as an alternative for doctors treating patients with wounds "when Tdap isn't necessary," saying the shot "delivers what your patients need, and nothing they don't."
Sanofi also historically made a version of the vaccine that had a higher dose to protect against diphtheria, alongside tetanus. The vaccine maker stopped making so-called DT shot in 2020 and used up its supply by the end of 2022, the CDC says.
What alternatives are available for tetanus shots?
Not everyone can get the Tdap vaccine as their booster shot for tetanus instead. The CDC says some people face a "very rare" risk of developing a type of brain damage called encephalopathy from the pertussis component of Tdap vaccines.
People who have developed encephalopathy after getting vaccinated are recommended to avoid future pertussis shots, and have no other option to get a tetanus booster.
"The limited supply of Td vaccine needs to be preserved for those with a contraindication to receiving pertussis-containing vaccines," the agency says in its guidance.
Sanofi says it will ramp up its supply of Tenivac, the last remaining Td vaccine available to U.S. Patients. However, the CDC says this will likely not be enough to avoid a "constrained" market for the tetanus and diphtheria-only shots.
A Sanofi spokesperson confirmed it was "taking steps to augment its available U.S. Supply" of Td vaccine, but declined to offer specific supply figures. Ordering limits are being levied in both public and private sector orders to manage the supply gap, the CDC said.
"A supplier is discontinuing production of tetanus/diphtheria vaccine. Because of this, there may be more healthcare providers ordering Tenivac," the Sanofi spokesperson said.
What is tetanus?
Widely found in the soil, tetanus is caused by the bacteria Clostridium tetani. The bacteria's spores can be difficult to kill with heat and disinfectants.
One of the first signs of tetanus infection is often its "lockjaw" symptoms, as the muscles spasm and tighten painfully from the bacteria's toxins attacking the brain and nervous system. Survivors can take months to recover from the infections.
Cases from tetanus have fallen to only a few dozen each year, thanks in part to vaccines driving down the once-high rates of the often-deadly infections in the early 20th century.
Preliminary CDC data tallies just 15 cases in 2023 and 28 in 2022 reported from the infection.
The CDC estimates 92.7% of kindergarteners nationwide were vaccinated with one of the tetanus vaccines for the 2022 to 2023 school year. Among adults, around 64.2% in 2022 said they had gotten their Td or Tdap shots.
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Alexander Tin
Alexander Tin is a digital reporter for CBS News based in the Washington, D.C. Bureau. He covers the Biden administration's public health agencies, including the federal response to infectious disease outbreaks like COVID-19.
CDC Anticipates Shortage Of Certain Tetanus Vaccines In 2024
The CDC is anticipating a shortage of Td vaccines — which protect against tetanus and diphtheria — as the maker of one shot has discontinued production.
As a result, the CDC has updated guidance for providers and is recommending that they switch to administering Tdap vaccines, which protect against pertussis in addition to tetanus and diphtheria, whenever possible.
MassBiologics discontinued production of its TdVax shot, and while Sanofi also manufactures a Td vaccine and is working to boost supplies, the CDC anticipates the U.S. Could see a shortage of the vaccines later this year.
Because not everyone can receive the Tdap vaccine, "the limited supply of Td vaccine needs to be preserved for those with a contraindication to receiving pertussis-containing vaccines," the CDC said in its guidance.
A spokesperson for MassBiologics told CBS News the company stopped making TdVax as "similar vaccines have led to a reduction in demand."
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