http://www.cnn.com/2003/HEALTH/06/20/smallpox/index.html

CDC panel: Don't expand smallpox vaccine program

Friday, June 20, 2003 Posted: 9:29 AM EDT (1329 GMT)

ATLANTA, Georgia (CNN) -- Citing possible health risks to people with heart conditions, the national smallpox vaccination program should not be expanded, a Centers for Disease Control and Prevention advisory committee recommended.

The panel said Thursday that health-care workers and public health officials should continue to receive the vaccine but that the program should not be extended to other groups.

They cited the unanticipated concerns over the possible risk to people with heart conditions.

More than 37,000 health-care workers and public health officials have received the vaccine on a voluntary basis since January, when the program went into effect.

At least two health-care workers with heart problems died after being inoculated, and six others had heart attacks. Several other cases of heart problems have been reported among people shortly after they were inoculated.

The advisory committee's recommendation is not binding on the Department of Health and Human Services, which will make the final decision about whether to expand the program.

The advisory panel recommended to department officials that the vaccine only be administered to those who fit the government's criteria.

"In the context of such plans and activities, smallpox vaccination should continue to establish and maintain health-care and public health response teams necessary for state and local preparedness," the panel said in a draft statement provided to CNN.

Under the vaccine program, health-care workers were given priority to the vaccines and were to be followed by police, firefighters and others who respond first in emergencies. Members of the military have been receiving the inoculations under a separate program.

The push to vaccinate some sectors of the population against smallpox began due to fears of a terrorist attack using some form of biological weapons.

The deaths of the health-care workers forced officials to reconsider who should be allowed to receive the vaccine. In March, the CDC said anyone with known heart disease and people with three or more known major cardiac risk factors -- high blood pressure, diabetes, high cholesterol or smoking -- should not receive the vaccine.

The CDC recommends many others -- including pregnant women and those with weakened immune systems, such as HIV and some cancer patients and people with certain skin conditions such as eczema -- not be inoculated with the vaccine.

Cardiac side effects were not considered a risk during the years when smallpox was routinely administered to Americans before its eradication worldwide more than 20 years ago.

At that time, health officials estimated that the vaccine killed one or two of every 1 million recipients.