By April Yee
Post contributor

Elizabeth Setser, the first volunteer to receive a smallpox vaccine at Children's Hospital Medical Center, admitted to being a bit nervous -- not because of the procedure, but because of the attention it received.

"It was because the television people were there," the hospital research assistant said.

"I'm more scared about the commute to work every day."

Setser's smallpox vaccination is part of a special study being conducted at Children's.

The vaccine was routinely given until 1972, when the U.S. was declared smallpox-free. Since the September 2001 terrorist attacks on New York City and Washington, D.C., however, medical officials have had to re-evaluate the potential risks.

"With all the events of 9/11, there is some risk of a bioterrorism attack," said Dr. Rebecca Brady, who heads the study.

That's why Setser chose to take the vaccine.

"If there's a chance that a couple years down the line (the vaccine is required), I'd prefer to be getting it now," she said.

Children's Hospital, along with Vanderbilt University and the University of Iowa, want to know whether a diluted vaccine will still be effective in preventing the disease while stretching current supplies. If the vaccine were distributed nationwide, the amount  currently stored would not be sufficient for a full-concentration vaccine for everyone.

The study is meant "to help us determine how to use the supplies that we have," said Dr. David Bernstein, director of the Division of Infectious Diseases at Children's Hospital.

In the double-blind study, nurses dip a two-pronged needle into a vaccine covered with tin foil so that neither volunteers nor nurses know the dosage being administered. Full dosages and one-to-10 and one-to-five dilutions are being used in the study.

The droplet captured on the needle is place on the arm. The needle pokes the skin a few times.

The vaccine procedure is technically a "scarrification," Brady said. In what the Centers for Disease Control call a "success," a red and itchy bump forms at the site of the application, which then blisters, scabs, and finally forms a scar.

The scab usually takes about 20 days from the time of the vaccination to heal.

Volunteers keep a personal health diary and take their temperatures daily. They come to the hospital every three to five days for monitoring.

Because a live virus vaccine is used, there is a small danger to recipients, Brady said. Severe reactions, which occur in only 20 out of one million cases, include the flu and the pox spreading to other parts of the body.

The risk of death is probably one in a million," Brady said. "That's why we go through a careful screening."

There is no risk of actually contracting smallpox itself, because the vaccine is made from "vaccinia," a pox-type virus.

"About thirty percent of people have fever and have to miss work," Brady said.

Most people also experience a low fever and swelling of the glands under the armpits.

About 10 Children's Hospital staff have been vaccinated so far. The emergency preparedness team, which is part of a nationwide effort to prepare for a possible smallpox epidemic, also will be vaccinated.

The hospital needs 150 healthy volunteers between ages 18 and 32 for the study.

To volunteer to take the vaccine, call (513) 636-7699.

For more information, visit www.cdc.org.