By Bayne Hughes
DAILY Staff Writer
hughes@decaturdaily.com
340-2432

The Alabama Department of Public Health expects to administer smallpox vaccinations to about 750 first-contact hospital employees in seven local counties after Jan. 24.

The department is waiting for vaccine delivery to vaccinate emergency room doctors and nurses, infectious-disease specialists, X-ray technicians and others who would likely come into contact with any smallpox patients.

The 750 workers are in the department's Area 2 — Morgan, Lawrence, Limestone, Cullman, Madison, Marshall and Jackson counties.

As many as 12,000 people statewide are expected to voluntarily get the vaccine when the state begins the first round, which should be completed in 30 days.

Bush's national plan

President Bush announced recently a national plan of vaccinating about 500,000 health-care workers and about 500,000 members of the military as part of defense measures in the war on terrorism.

According to Area 2 Administrator Ronald Grantland, county health departments will set up temporary clinics with about eight workers, including a social worker, a clerk and nurses, at each hospital.

Officials from Decatur General Hospital, Parkway Medical Center, Athens-Limestone Hospital, Hartselle Medical Center, Lawrence Baptist Medical Center in Moulton, Cullman Regional Medical Center, and Woodland Medical Center in Cullman confirmed they are participating in the program.

Grantland said vaccines also will be available for about 400 Area 2 health department staff members.

Dr. Scott Harris, director of infection control for Decatur General Hospital, said approximately 150 employees were identified for the first wave of vaccinations. He will start employee education sessions this week.

Employee education vital

Employee education is important because the vaccine can have serious and even life-threatening side effects. Reactions also can be mild, including a sore arm, fever and body aches, according to the Centers for Disease Control and Prevention.

Developed in 1795-96 by English physician Edward Jenner using cowpox, the vaccine is administered using a two-pronged needle that is dipped into the solution and then pricks the skin a number of times in a few seconds.

If a vaccination is successful, a red, itchy bump develops in three or four days. The bump becomes a blister in the first week and then scabs in the second week. The scab falls off in the third week, leaving a small scar.

The CDC said about 1,000 people for every 1 million vaccinated for the first time experienced mild to serious reactions in the past.

Between 14 and 52 people out of every 1 million experienced potentially life-threatening reactions, and two out of a million died from taking the vaccine.

"We'll give them all the information we can and a checklist, and let them decide whether they want to be vaccinated," Dr. Harris said.

While the health department will be administering the vaccine, the hospitals must provide the follow-up care because of the complications.

Dr. Harris said vaccinations will be staggered among Decatur General personnel because of the possible side effects and concerns about department understaffing. The hospital also wants to make sure personnel vaccinated aren't in contact with patients with low immunity.

Some will not, however, be able to take the vaccination, including:

• People who have had skin conditions (especially eczema and atopic dermatitis).
• People with weakened immune systems, such as transplant patients, cancer patients, those infected with HIV, and those taking medications (like steroids) to suppress the immune system.
• Women who are pregnant or breastfeeding.

The last known smallpox case in the United States was in 1949. The federal government administered the vaccinations until the early 1970s.

Some critics question the need for the vaccination program, especially since chances of infection are remote and administering it within three days will prevent or significantly lessen the severity of smallpox symptoms.

But Dr. Harris said it is important that first-line medical personnel be prepared, and he plans to have the vaccination.

"Smallpox is so highly contagious that the attack ratio is 50 percent of the people who come in contact with it are infected, and a third will die because there's no treatment," Dr. Harris said. "The potential is so deadly we like to be prepared."