WASHINGTON (Reuters) Mar 27 - Two women vaccinated against smallpox died from myocardial infarctions soon afterward, the U.S. Centers for Disease Control and Prevention reported Thursday in its Morbidity and Mortality Weekly Report for March 28.

As previously announced, a 50-year-old nurse died in Virginia after a heart attack on March 22. Yesterday, March 26, a 57-year-old woman died, the CDC said, and local officials in Florida said she lived in St. Petersburg.

The CDC said it was not likely the two deaths were directly caused by the vaccine, as the women had a history of heart disease. But just to be cautious, the agency told states not to vaccinate people with serious heart disease against smallpox.

"We have recommended that persons with histories of heart disease be temporarily excluded from vaccination," reiterated Dr. Walter Orenstein, head of the CDC's vaccination program.

Three other people recently vaccinated have experienced chest pain, and two more have myopericarditis that is more likely to be related to the vaccine, Dr. Orenstein told a telephone briefing.

In a astatement, the American Heart Association said it supported the recommendation from the CDC that people with heart disease not be vaccinated against smallpox until more information is available.

"This is a prudent step for the CDC to take because safety of the individual is always the foremost concern," said Dr. Robert Bonow, AHA president. "The association will be in close contact with the CDC as they assess the situation."

The vaccination program, aimed at protecting the country against a biological attack, has been plagued by criticism. Only 25,000 of the 450,000 women and men scheduled to get the shots have signed up, in part because of concerns about side effects and the lack of a federal program to compensate them (See today's related Reuters Health report, "Smallpox compensation bill stalls in U.S. House").

Smallpox was eradicated in 1979 but the U.S. government is worried that Iraq and other countries have developed smallpox virus as a weapon and that Iraq may use it in the current war.

MMWR 2003;52248-250.

Smallpox Vaccination Campaign: Benefits, Risks, Implications

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