What allergy sufferers should do: Health,
As the global shortage of lifesaving allergy jabs worsens...
BRITA IN’ Stop school nurse last night accused health chiefs of downplaying the EpiPen crisis as it was revealed an international shortage of the jabs could halt child vaccination programmes due to begin this month.
The news will add to the worry and frustration for the UK’s estimated 250,000 allergy sufferers who rely on the adrenaline autoinjectors to halt life-threatening reactions to foods, insect stings and bites, and medicines.
If this condition, anaphylactic shock, is not swiftly treated, there can be dire consequences, as proved by the tragic death of 15-year-old Natasha Ednan Laperouse, who suffered a fatal reaction to a Pret A Manger baguette.
The first indications of the glo- bal EpiPen shortage came in April when Mylan, a US-based firm that makes the pre-loaded syringes, warned of supply problems. The two other brands of shots available in the UK, Jext and Emerade, are now also hard to find.
In an effort to provide a temporary fix, the Medicines and Healthcare Products Regulatory Agency issued guidance at the end of September that the use-by date of adult-use EpiPens, which have a 12-month shelf-life, can be extended by four months. The extension does not apply to EpiPen Junior versions.
There are no official figures on how many EpiPens remain in the UK – but many pharmacies report that they do not have any left.
Now it has emerged that the shortage may throw various national vaccination schemes into chaos, including the childhood jabs for MMR, HPV and meningitis, and for seasonal flu.
Sharon White, CEO of The School and Public Health Nurses Association, said: ‘You can’t give vaccines of any type unless you have an anaphylaxis pack containing adrenaline jabs, because of the risk of a severe allergic reaction to ingredients used in vaccines. At the moment there’s no information to be had from anyone and everyone in officialdom just wants to play down the crisis.’
Pharmacist Sid Dajani in Eastleigh, Hampshire, says he has no adrenaline auto-injectors at all. ‘I haven’t seen an EpiPen for two months and we ran out of Jext auto-injectors a month ago.’ As of last week he was no longer offering flu vaccines.
Parenting forums and Twitter are awash with concerned parents and allergy sufferers saying they cannot get their prescribed auto-injectors, despite calling multiple pharmacies on a daily basis.
THE EXPERTS’ ADVICE…
Do not dispose of expired devices before receiving a new one. Remember, the four- month extension on expiry dates is advice from UK charity the Anaphylaxis Campaign.
Keep trying. Anyone who doesn’t have an auto-injector and can’t get one should call all the pharmacies in their area until they find one that still has stock. Getting one may involve travelling. Be quick – due to high demand, pharmacists won’t reserve auto-injectors.
One auto- injector is enough for most people, though those with more severe problems who carry two doses should continue to do so. Take extra care to avoid allergens. Dr Pamela Ewan, consult- ant allergist at Addenbrooke’s Hospital in Cambridge, says: ‘Most allergic reactions can be treated with antihistamines.’
Small studies show that EpiPens can remain potent for years. Researchers in California found EpiPens that were 50 months out of date contained at least 90 per cent of the stated amount of the adrenaline. The drug does not become toxic.
Ask your child’s school to go nutfree. Dr Adrian Morris, an allergy doctor at the Surrey Allergy Clinic, says: ‘ Otherwise, make sure your school knows about your child’s triggers and takes steps to minimise any contact during the school day.’
Schools may have a stock of EpiPens as they can buy them without prescription. If you can’t get one, write to your child’s teacher to see if there is one on site.
If your child has severe allergies, and you cannot get an auto-injector then you could be justified in keeping them away from school. Dr Morris said: ‘Children may have to be kept at home and out of harm’s way.’
In extreme cases, Dr Morris suggests asking your doctor for ampoules of adrenaline and syringes. ‘ The GP may need to prescribe the ageappropriate amounts and instruct the parent how to inject this into the child in a situation of anaphylaxis.’
Never try to make your own EpiPen, as some people are advocating online, says Dr Morris. ‘They can fail and it’s really not a safe and reliable option.’
If you’re travelling by air, the Anaphylaxis Campaign advises: ‘Stick to plain foods without sauces and dressings and take safe, non-perishable snacks with you. If you don’t know what’s in the food, don’t eat it.’ Some airlines have removed peanut snacks from flights, but you should carry wipes to clean surfaces on the aircraft to minimise the risk of skin contact with traces on seat-back trays and armrests.
In an emergency – whether or not you have an auto-injector – call 999 or go to your nearest accident & emergency department, says Dr Ewan.