Some local doctors and hospitals are feeling the pinch from a shortage in tetanus vaccinations that's not expected to end anytime soon.

The Centers for Disease Control and Prevention announced May 25 that health care providers should delay giving routine tetanus booster shots to adults and teens for the rest of the year. The decision was due to a nationwide shortage of products containing tetanus toxoid, including the tetanus vaccine and the tetanus diphtheria vaccine.

Tetanus, or lockjaw, is a bacterial infection caused by germs that enter the body through a wound. Symptoms include headache, spasms of the jaw, neck, arm, leg and stomach muscles and painful convulsions. The disease is sometimes fatal.

It takes 11 months to produce the tetanus vaccine, and with only one major manufacturer making the vaccine, supply hasn't kept up with demand, said Ron Barnes, manager of pharmacy services at UPMC Horizon. He said there used to be three manufacturers.

"We expect the shortage won't get any better," Barnes said, noting that tornado, flood and hurricane seasons are upon us and if an emergency strikes in a certain area of the country, all the available vaccine will be shipped there.

While wounded patients who really need tetanus shots haven't been denied, adult booster vaccinations have been suspended and the less critically wounded have been placed on waiting lists at many places.

"We've asked emergency room doctors to choose their patients carefully," Barnes said.

Dr. Frank Farone, medical director for the occupational and environmental medicine department at UPMC Horizon, said his department just received a bottle of the vaccine this week.

"They said to take care of it, because they don't know when the next shipment is coming in," Farone said. "We're parceling out small amounts and distributing it as evenly as we can."

Farone said that while no one has been denied a shot in his department, those with tetanus-prone wounds, such as deep puncture wounds caused by rusty metal, have first priority.

The department has also established a list of people with less serious wounds, such as superficial cuts or abrasions, who probably should have a tetanus shot because they are due for a booster. Doctors advise patients receive a tetanus booster every 10 years.

"If they're due for a vaccination, we put them on the list," he said.

Farone said the people on the list will be contacted when more vaccine becomes available.

Lorrie Speir, director of clinical services for Primary Health Network, said the network is following CDC and state Department of Health guidelines, which include giving the shot only to those who need it, such as pregnant women, people traveling to a country where risk of diphtheria is high or people with tetanus-prone wounds.

Ms. Speir said she used to be able to get as many bottles of the vaccine as she needed. Now she gets only two bottles a month to serve the 17 sites the network covers.

The tetanus shortage has not yet hit full force at Sharon Regional Health System or United Community Hospital in Pine Township, officials say.

"So far we've been very fortunate and we have been able to meet the needs of our community," said Kathy Lehman, UCH spokeswoman. "If the supply becomes limited, we have established criteria for meeting the needs of critical patients."

Mrs. Lehman said the hospital has had to use the criteria only once and was able to get vaccines the next day for non-critical patients.

Joyce Yager, director of pharmacy services at Sharon Regional, said the hospital has not had any problems so far with a vaccine shortage.

"We have everything we need to meet our needs at this time ... at this point we're doing just fine, and hopefully we stay that way," Ms. Yager said.

Dr. Sergio Segarra, director of the emergency department at Sharon Regional, also said the hospital has not experienced the effects of the shortage.

"We've been very fortunate here ... we have not experienced any significant shortage," he said. "We're not restricting the use of the tetanus immunization on any patients."

Segarra said a patient usually receives a tetanus shot for a deep, penetrating wound if the patient has not had a tetanus booster in five years. For more superficial abrasions, the patient receives a shot if it has been more than 10 years since the last booster.

Anything in between is a judgment call, he said.

"Everyone who has come in and needed a tetanus shot has gotten a tetanus shot," Segarra said.