Doctors watch 3 who got ill after vaccine

Only 1 of the cases seems likely to be tied to smallpox inoculation

By LAURA MECKLER
Associated Press

WASHINGTON -- Officials are investigating medical problems in three health care workers who became ill after receiving the smallpox vaccine, though only one appears to have had a reaction to the inoculation.

It is the first report of injuries associated with the month-old civilian vaccination program. The three people, whom officials would not identify, live in Florida and are doing well.

As of last week, 7,354 people had been vaccinated in 38 states and in Los Angeles and New York, which are running separate programs.

Based on data collected in the 1960s, before routine smallpox vaccinations ended in the United States, as many as 50 people out of every 1 million being vaccinated for the first time suffer life-threatening complications, and one or two die.

The Centers for Disease Control and Prevention requires that states look for serious reactions to the vaccine. Health problems that do not have any obvious relation to the vaccination also are being reported.

"Our surveillance system is very good. It's working," Dr. Eric Mast, a CDC immunization expert, said Thursday.

The first case reported Thursday involves a 39-year-old nurse who appears to have generalized vaccinia. The smallpox vaccine is made with a live virus called vaccinia, which can escape the inoculation site and cause infection. Generalized vaccinia can occur if someone touches the spot of the vaccination and then another part of the body.

The nurse in this case reported pain, malaise and headache nine days after receiving the vaccine. The next day, she developed a rash on her chest that spread onto her back and included scattered pustules.

She was treated with antihistamines and within a few days, the rash began fading.

The second case involves a 60-year-old man who already had symptoms of heart disease before being inoculated. He had chest pains while playing tennis four days after getting the vaccine, was diagnosed with a blocked coronary artery and had angioplasty. The smallpox vaccine has never been associated with heart problems such as angina.

The third case, reported by Florida authorities but not the CDC, involves a vaccine recipient whose gallbladder was removed because of inflammation. Gallbladder problems also are not associated with the vaccine.

CDC officials plan a survey of 10,000 people vaccinated to measure less severe reactions to the vaccine.