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Smallpox efforts are off to a bumpy start

Initial steps are taken in the national vaccine plan, but concerns about liability and other issues still exist.

By Victoria Stagg Elliott, AMNews staff. Feb. 24, 2003. Additional information

Health departments in Connecticut, Nebraska, Vermont and Los Angeles County were among the first to receive shipments of the smallpox vaccine Jan. 22. Vaccines will be given on a voluntary basis to health care workers, who would be the likely first responders in the event of a smallpox attack. These volunteers are the first civilian Americans in decades to be vaccinated against the disease.

"It was a very odd sensation of something going on in your body," said Richard Garibaldi, MD, chair of the department of medicine at the University of Connecticut, Farmington. He was one of the first doctors in his state to be vaccinated so that he could in turn vaccinate health care workers at his hospital. "After I was vaccinated, I had low-grade temperature, body aches and a mild headache. It's as though you're in the early stage of a flu, although I've since gotten better."

Nationally, a half-million first responders are expected to receive the shot during the initial wave of the plan, which will continue to be implemented in the coming months.

The effort, however, is not without controversy. Unresolved issues regarding liability and vaccine injury compensation have emerged as stumbling blocks to large numbers of first responders stepping forward.

In the first two weeks, fewer than 700 inoculations had been given, according to press reports. Several public health agencies and unions representing large numbers of health care workers, as well as major hospitals and health facilities, have either asked to delay the program or opted against participating at this time.

"Adequate protections are not yet in place," said Sandra Feldman, president of American Federation of Teachers/AFT Healthcare, a union representing 63,000 health care workers. "The program should not be implemented until education, training, thorough medical screening, compensation for dealing with adverse reactions and other necessary measures are in place."

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Copyright 2003 American Medical Association. All rights reserved.