WASHINGTON, Feb 06, 2003 (United Press International via COMTEX) -- Despite two soldiers developing serious reactions after receiving the smallpox vaccine, there have been no side effects among nearly 700 civilian healthcare workers who have been vaccinated, federal health officials said Thursday.

"No significant adverse events have been reported so far," Julie Gerberding, director of the Centers for Disease and Control and Prevention said during a teleconference from Atlanta. The CDC convened the teleconference to announce a new system for monitoring and responding to adverse events experienced by those receiving the vaccine.

Last week, the Department of Defense said one soldier developed a blistering skin-rash due to the vaccine and a second soldier came down with encephalitis or brain-swelling after receiving the vaccine. Encephalitis is not a known side effect of the smallpox medication, however.

Gerberding said the agency expects to see side effects in the civilian population as more people receive the vaccine.

"I want you to be prepared for that, and we will tell you about it as soon as we have information that we can make available publicly," she said.

So far, more than 3,600 military healthcare workers have been vaccinated and "multiple tens of thousands" of soldiers and related forces have received the vaccination, according to the Department of Defense Web site. Some 3 percent of military personnel vaccinated have developed side effects that required sick leave but most reactions have been minor.

President Bush's smallpox vaccination policy called for vaccinating 500,000 military personnel and more than 10 million civilian healthcare workers.

Although the first phase of vaccinations was to include 450,000 civilians, Gerberding downplayed that number during the teleconference, saying the CDC did not have a specific number of people it planned to vaccinate. Ensuring the country is prepared to respond to a smallpox attack will not require vaccinating 450,000 workers, she said. The number was based on vaccination plans from individuals states and in some cases state governments might have overestimated the number of workers who would actually be vaccinated.

Gerberding also said the civilian vaccination program has been slowed by concerns among some healthcare workers about compensation issues for medical bills and lost wages if they are incapacitated due to the vaccine. More than 80 hospitals have decided not to participate and several unions representing healthcare workers have said they will not advise their members to receive the vaccine.

Gerberding said the Department of Health and Human Services is working on a plan to address the compensation issues and is very close to finalizing it.

"I do expect we will be hearing something very soon," she said, adding, "I am confident about our ability to address these issues."

Charles Pena, senior defense policy analyst with the Cato Institute, a Washington think tank, told United Press International the public health community, including "certain elements in the CDC," has delayed the implementation of the smallpox vaccination policy because they disagree with it.

"The public health community has been highly resistant" and this might be due largely to their failure to view smallpox as a national security issue but rather to look at it in terms of a public health problem, Pena said.

The CDC should be doing more to encourage hospitals and public health workers to get vaccinated, Pena said.

"The CDC could be more proactive there and say to hospitals or unions ... 'Your job is to find a way to make this process happen and allow the individual workers to make the decision him or herself,'" he said.

The agency's system for tracking side effects, called the Smallpox Vaccine Adverse Events Monitoring and Response System, will collect information about reactions to the vaccine requiring hospitalizations or outpatient care. This in turn will be used to coordinate distribution of vaccinia immune globulin and the antibiotic cidofivir, which can help alleviate serious complications due to the vaccine. It also will be used to detect pre-existing conditions that may heighten the risk of reactions to the vaccine.

So far, 16 states or counties have begun vaccinations, including Colorado, Connecticut, Georgia, Iowa, Kentucky, Los Angeles County, New Hampshire, New Jersey, New York, North Carolina, Pennsylvania, South Dakota, Tennessee, Vermont, Virginia and Wyoming.

Forty counties or states have requested the vaccine and the CDC has shipped out 204,600 doses.