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Smallpox vaccines start with secrecy, publicity
Maura Lerner, Star Tribune
 
Published Feb. 13, 2003

The tiny vial of smallpox vaccine arrived under armed guard at a St. Paul conference room Wednesday morning.

And as a state trooper stood watch, Dr. Harry Hull, the state epidemiologist, sat down, rolled up his sleeve and smiled gamely for the cameras as he became the first civilian in Minnesota to be vaccinated under the federal smallpox prevention program.

"I couldn't even feel it," Hull said afterward.

It wasn't pain, but security that seemed to be uppermost in everyone's mind as the vaccine program got off to its start in Minnesota.

State officials were so concerned about security that they refused to say where most of the first volunteers were getting the vaccine Wednesday.

Instead, they created a special clinic just for five volunteers who were willing to "go public" and get their vaccinations in front of a roomful of journalists.

They kept even that location secret, telling journalists to meet in front of a smoked glass door in a tunnel at St. Paul's Town Square to be escorted to the vaccination site. That turned out to be a room in the emergency operations center of the state Department of Public Safety building.

Why all the secrecy?

"We want to make sure that the vaccine is safe," said Kris Ehresmann, the Health Department's immunization section chief and one of the coordinators of the smallpox vaccine program. She noted that the vaccine isn't available to the public, and that "with all that's going on," someone might try to disrupt the plan to vaccinate health workers. She also said the Health Department wants to protect the privacy of those who volunteer for the vaccine.

So Wednesday morning, they turned a conference room, ever so briefly, into a clinic for five people. "This is a made-for-TV event," acknowledged Kevin Smith, spokesman for the Public Safety Department.

The vaccine was real, however, even if the event was staged. Dr. Gregory Poland, a smallpox researcher at the Mayo Clinic in Rochester, was tapped to administer the vaccine to four physicians and a nurse.

Each vaccination took a few seconds. Poland would unwrap the distinctive two-pronged needle and dip it in the vial of smallpox vaccine, which contains 100 doses. Then he would prick the skin on the upper arm 15 times and cover the spot with two special bandages, a teflon-coated gauze pad and a semipermeable membrane. The site must be kept covered for about two weeks to prevent spread of the virus used to make the vaccine, a smallpox cousin called vaccinia. It can cause potentially serious side effects.

Some of the volunteers hadn't had a smallpox vaccine since they were kids.

But this was Hull's fourth time, and he didn't flinch. His last time was in 1975, he said, when he went to Bangladesh to fight smallpox. The disease was last seen in 1977 and in 1980 was declared eradicated worldwide.

Now, Hull would head the state's response if smallpox was released in a terrorist attack.

Although the vaccine plan has divided many in the health-care community because of its potentially serious effects, Dr. Ralph Morris, a Bemidji physician who got the vaccine Wednesday, said he had no second thoughts. "I look at this as my obligation as a public health physician," said Morris, 55, who works for the Health Department. "It's also a way for me to personally step up to the plate to fight terrorism."

Throughout the country, however, dozens of hospitals have opted out of the program, saying it's too risky to vaccinate health workers now.

But Dr. Dean Tsukayama, an infectious disease specialist at Hennepin County Medical Center in Minneapolis, said after getting his vaccine Wednesday, "It wasn't a difficult decision. If I didn't think it was safe, I wouldn't do it. But I understand that there's uncertainty associated with this."

-- Maura Lerner is at mlerner@startribune.com.

 

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ALL INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR LEGAL ADVICE.  THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.