(AP) A second health care worker died of a heart attack after receiving the smallpox vaccine, and federal officials continue to investigate whether the vaccine is to blame for cardiac problems.

The vaccine has never been associated with heart trouble before, but as a precaution, the federal government says people with a history of heart disease should not be vaccinated until further investigation is complete.

The 57-year-old Florida woman died Wednesday from a heart attack about two weeks after receiving the smallpox vaccine, said Walter Orenstein, director of the National Immunization Program at the Centers for Disease Control and Prevention. She collapsed and was not resuscitated for 20 minutes and later died, he said Thursday.

Robert Jorgensen identified the victim as his wife, Virginia.

Like other vaccine recipients who have had heart trouble, Jorgensen had a history of high blood pressure and other factors that put her at risk for heart attack, Orenstein said.

"She's been having heart problems for almost a year," Robert Jorgensen said in an interview. "It just seems odd the way it came up."

After the vaccination, he said, "within a few days she was feeling like she had a cold coming on and then it got bad."

CDC officials are investigating a total of seven cases of heart trouble in people who received the vaccine.

A total of three women, all in their 50s, suffered heart attacks, including two who died.

Two others developed angina, or chest pain.

And two patients suffered heart inflammation. Additionally, 10 people vaccinated through the military program also suffered heart inflammation.

Orenstein said the evidence is "somewhat suggestive" that the vaccine is playing a role in the inflammation cases. He said there were reports from decades ago in Europe of similar problems with another strain of smallpox vaccine.

But officials are less convinced that the heart attacks and angina cases are related, saying that there aren't necessarily more cases that would be expected without the vaccine.

"This very well could be coincidental," Orenstein said.

The vaccine carries well-documented side effects, but they have never included heart problems. Still, the data were gathered during a time when most people being vaccinated were young children not likely to have heart trouble.

The CDC was consulting with cardiac experts on to consider whether something in the vaccine might be triggering heart problems in people who already have risk factors.

Existing guidelines already screen out people with conditions that are known to increase the chances of side effects, including people with HIV, pregnant women, organ transplant recipients and people with a history of skin disorders.

As of March 21, states had vaccinated just over 25,000 civilians, mostly in public health departments and hospitals. Concerns about the vaccine's risk have helped keep the numbers well below the 450,000 initially expected.

Under the mandatory military program, several hundred thousand people have been vaccinated, the CDC said.

Based on studies in the late 1960s, experts estimate that one or two people out of every million being vaccinated for the first time will die. The death rate for those being revaccinated was lower: Two people died out of 8.5 million who were revaccinated in a 1968 study.

Additionally, 14 to 52 people out of every million being vaccinated for the first time are expected to suffer life-threatening side effects.

That's because the smallpox vaccine is made with a live virus called vaccinia, a cousin to smallpox which can cause illness if it escapes the inoculation site and infects another part of the body. Vaccinia can also infect those who touch someone else's vaccination site.

Also Thursday, the Institute of Medicine issued a report on the smallpox vaccination program, saying the federal government must provide money to the states and compensation to people injured by the vaccine in order to run a successful program.

Congress is working toward plugging the compensation hole. Legislation is pending in both the House and Senate to aid people injured by the vaccine, which carries rare but serious side effects. But Democrats and Republicans are at odds over how generous the package should be.

The Institute of Medicine panel, a group of experts advising the federal government on the program, said that without a compensation program, "the nation's preparedness to respond to a smallpox attack could be hindered."

The Bush administration put forth a plan that would pay about $262,000 for people who are killed or permanently injured. Injured workers could also get two-thirds of lost wages, up to a maximum of $50,000.

The House had planned to consider a similar, GOP-sponsored package on Thursday, but the legislation was pulled from the schedule amid partisan disagreement.

Democrats are promoting a more generous package. They want a higher cap for lost wages and guaranteed funding for the program; the Republican plan would force this program to compete with others during the appropriations process.

In its report, the Institute of Medicine also said lack offederal dollars to run the vaccination program is producing "significant financial worries" among states, local health departments and hospitals. Local departments appear to have shifted money from other important tasks, including areas related to bioterrorism and to other disease prevention, to focus on this one, the report said.

 

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