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July 2003 • Volume 37 • Number 7

 

News

Myocarditis/pericarditis cited
ACIP Against Expansion of Smallpox Vaccinations

Miriam E. Tucker
Senior Writer

ATLANTA — The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention has advised the federal government not to expand the current pre-event smallpox vaccination recommendations.

The decision, made at an ACIP meeting, was based largely on the fact that 37 unanticipated cases of myocarditis/pericarditis arising among military vaccinees appear to be linked to the vaccine. Because the long-term extent and severity of such unanticipated events is unknown, ACIP's draft resolution said it would be “unwise” to broaden the program to include emergency medical staff, security staff, and private health care providers.

At press time, it was unclear whether the CDC would adopt ACIP's guidance. At a press briefing, CDC director Julie Gerberding remarked, “With smallpox … we are balancing the public health issues and the safety and indications for vaccination with a homeland security issue. … When we get advice from the ACIP, we will be respectfully considering it and I'm sure the [Health and Human Services] secretary will be weighing that advice in conjunction with other input he receives.”

Thus far, uptake of the vaccine among designated first responders has been far less than the Bush administration had hoped for. Earlier this year, the president signed a bill establishing a “no-fault” program that would provide benefits and/or compensation to persons injured as a result of receiving the vaccine, but it has not yet been implemented, said Dr. Raymond A. Strikas of the CDC's National Immunization Program, Atlanta.

As of early June, just over 37,000 civilians had been vaccinated against smallpox. About 100 are now being immunized each week, compared with a peak of more than 5,000 at the end of February.

Dr. Gerberding discouraged the focus on numbers. “The number of people vaccinated really depends on how the plan in a given location is going to work to be able to immunize the public [in the event of an outbreak]. … The exercise of getting the 40,000 people vaccinated over the last year certainly has improved the efficiency and the capability of all of these jurisdictions to more quickly vaccinate larger numbers of people.”