LAUDERHILL (AP) -- Ethel Edwards
was among the first to offer her assistance with testing when the AIDS
scare broke in the early 1980s. She was on the front lines when public
health officials had to respond to Hurricane Andrew's devastation in 1992.
And when volunteers were sought to lead Florida's smallpox vaccination
response, Edwards did what the vast majority of health workers around the
nation are refusing to do -- step forward, without hesitation, and receive
the shots.
Edwards, a divorced mother of three adult children, was among the
earliest recipients of the smallpox vaccine when Florida's inoculation
operation began Monday. She said the choice, while voluntary, was an easy
one based on the training and education health workers were provided with.
"I have to take care of me and I have to educate me to do this job,"
said Edwards, who is an assistant nursing director for the Broward County
Department of Health. "If I'm going to provide the service to the
community, I have to go through it first."
Edwards was one of 503 county health workers in Florida to receive the
inoculation on Monday. In all, the state hopes to vaccinate as many as
433,000 health care workers, police and emergency response personnel in
the first two phases of Florida's three-stage smallpox plan.
No timetable for completion of the first two phases is set, state
health spokesman Rob Hayes said. Stage I should end by April 1, but Stage
II's start date has not been scheduled. Stage III, for citizens, would not
begin until at least 2004 and only if the federal government deems it
necessary.
"We stress there is no credible risk, which is why it's voluntary"
Hayes said. "We're just preparing."
Edwards said she had no thoughts of skipping her appointment. It's an
uncertain world, she said, so it's in her best interest to be prepared for
anything.
"We went through a lot of training. We went through a lot of
techniques," she said. "We did everything we could do to be ready to make
our own decisions."
Smallpox was eradicated worldwide in 1980, but fears that leftover
stockpiles of the virus could pose a bioterrorism risk led to a push for
renewed vaccinations. After exposure to the virus, it takes one to two
weeks for symptoms, usually flu-like at first, to appear. The disease is
often accompanied by an outbreak of tiny open sores, which remain
contagious until they scab over and fall off. Smallpox kills as many as 30
percent of the people it infects.
Edwards, 54, said her decision to volunteer for the vaccination was
easy. The majority of her peers nationwide, though, are having a decidedly
different response.
Medical professionals nationwide are concerned about compensation
should they develop an adverse reaction to the vaccine or if they infect
others, including family members and patients. Some medical experts
question the need for the vaccinations, since no one knows of any credible
threat of a smallpox attack.
"I embrace the debate and I am encouraging the discussion," said Dr.
John Agwunobi, secretary of the Florida Department of Health. "It comforts
me to know that people are really thinking this through before they
commit."
Many of Florida's hospitals have not decided if they will participate
in the voluntary inoculation program, which stemmed from President Bush's
urging last year that the nation become better prepared for the threat of
biological attacks. Bush also ordered vaccinations for all military
personnel in high-risk areas.
"In essence, the health care workers in our country have been asked to
step up and be a line of defense," said Martha Baker, a registered nurse
at Miami's Jackson Memorial Hospital and president of Service Employees
International Union Local 1991. "We're hoping health care workers proceed
with caution."
Edwards awoke on the morning of the vaccination at 6 a.m., her usual
time, but was so anxious to receive the inoculation that she skipped her
second cup of coffee.
Her drive to the vaccination location was a short one, only seven or
eight miles. She completed the pre-inoculation paperwork shortly after
arriving, and when her number was called she knocked on a small examining
room door. At 9:27 a.m., she entered and sat down.
"Ready? Just rest your elbow right here, please," said the nurse who
will give Edwards the vaccine.
Edwards sighed softly as her left elbow found a spot at the edge of the
green table. The woman administering the inoculation dipped a tiny
two-prong needle into the small vial containing the smallpox vaccine, then
quickly jabs Edwards' arm 15 times. The process lasted about five seconds.
Edwards, her hands folded in her lap, smiled when she felt the first
prick. Moments later, droplets of blood formed at the spot where she was
vaccinated. Gauze and a large rectangular bandage were applied to the
area. The procedure was over at 9:29 a.m.
"You are officially vaccinated," the nurse told Edwards.
Edwards walked into a post-interview room, where she was given a box of
waterproof bandages and a clear plastic bag containing fresh dressings.
She spent the rest of her day going about her usual work, feeling fine, as
she did the following day.
"When you volunteer to do something and you're not obligated, there's a
whole different perspective on how you approach it," Edwards said. "You
look forward to doing it because it's something you truly want to do."
As an administrator in Broward's health department, Edwards handles
everything from overseeing certain programs to actually treating patients
when need arises. She will be used as a vaccinator throughout the rest of
Florida's smallpox inoculation program.
Her 24-year-old son Jason lives at home, meaning Edwards will have to
take precautions to ensure she and her son do not share towels or have
their laundry mixed in with the other's for about three weeks, when the
chance of infecting others has passed. The virus is live; direct contact
with it could cause problems, including blindness.
Edwards' other children, a 26-year-old daughter and 20-year-old
daughter, had no reservations about their mother becoming vaccinated,
although experts say one or two people per million inoculated will die
because of complications related to the shots.
"You do what you have to do," she said. "I think they're kind of
excited about the idea of their mom really stepping forward. ... The best
thing I can do is be ready."
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On the Net:
Florida Department of Health smallpox site: doh.state.fl.us/php/smallpox/index.html