Health officials have questions about mass inoculations; hospitals look at safety issues

By CLAIRE HUGHES, Staff writer
First published: Friday, January 24, 2003

Health officials across New York appear to be at least a month away from mass vaccinations against smallpox, amid lingering questions and concerns over the controversial federal inoculation program, which officially begins today.

While the U.S. Centers for Disease Control and Prevention began shipping vaccine to some states this week, New York is not ready to administer shots. State health officials still are awaiting answers to a variety of questions about the program and are sorting through other information that became available as recently as Thursday.

"New York state has not yet placed an order for smallpox vaccine," said state Health Department spokeswoman Kristine Smith. "We do expect to do so shortly, but we don't have a specific date that I can discuss right now."

In addition, some hospitals, including at least two in the region, are having second thoughts about encouraging employees to get the live vaccine, which carries more risks than most immunizations.

Officials at both Ellis Hospital in Schenectady and St. Mary's Hospital in Troy said they have been swayed by a growing number of reports from medical groups that question administering a risky vaccine for a disease last seen in the world in 1977. "We have a lot of reservations still and concerns and questions about the vaccine, so I guess we haven't yet made a commitment to implement" the program, said Pamela Rehak, a spokeswoman at St. Mary's.

State officials' questions include liability issues. As of today, U.S. government becomes immune to legal liability for injury or death due to the vaccine, under the Homeland Security Act. But the act doesn't address such questions as who is responsible if someone is infected through exposure to a family member's vaccination site, Smith said.

State health officials also are poring over educational materials released Thursday by the CDC, Smith said. Among the questions that arose Thursday, she said, were discrepancies between the consent forms the CDC issued, which must be signed by those who volunteer to get the vaccine, and the CDC's own data collection procedures.

The state will not order the estimated 16,000 doses of vaccine it needs until health officials are sure they are ready to administer it, Smith said.

"Once we take delivery of the vaccine, we're responsible for its security," she said. "So why have it if we're not going to use it right away? That doesn't logistically make sense."

The state has planned two training sessions next month in which inoculators will be taught how to administer the shot, according to county health officials. Unlike other vaccines, the smallpox inoculation is given with a two-pronged needle.

Albany County has scheduled its initial clinic to inoculate the first round of hospital workers to receive the vaccine for Feb. 25-28, said county spokesman Jim Plastiras. Hospital officials in Schenectady said they expect such clinics won't be held there until March or April.

Though world health officials declared smallpox eradicated in 1980, the virus re-emerged as a potential public health threat after Sept. 11, 2001, when it was placed on the federal government's short list of biological agents that could be used by terrorists.

Under the voluntary federal vaccination program, announced by President Bush last month, the vaccine will be administered first to special "smallpox response teams" -- hospital employees who would be in contact with patients exposed to smallpox in the event of a bioterrorist attack. The plan calls for the federal government's release later this year of enough vaccine for all health workers who want it, perhaps 10 million doses.

County officials remain concerned over the time and personnel needed to make the program work, which will draw resources from other public health programs, said Dr. Lloyd F. Novick, Onondaga County Health Commissioner who also is president of the New York State Association of County Health Officials.

Managers at Capital Region hospitals do not yet know how many of their employees will volunteer to be on the special response teams slated to receive the first wave of inoculations. That's because the CDC did not release final educational materials until Thursday. Because the smallpox vaccine is live and carries health risks unlike most vaccines administered these days, volunteers must receive information and counseling, and sign a consent form before rolling up their sleeves.

Hospital and county health officials said the state has imposed an end-of-month deadline for a volunteer count.

Based on preliminary surveys of their employees, Albany Medical Center has more than 60 workers potentially interested in volunteering, Ellis Hospital in Schenectady has about 50, and St. Peter's Hospital in Albany has 50 to 100, officials at the hospitals said.

Spokespeople at other hospitals would not reveal the level of interest in the vaccine program at their institutions.