Hospital Corpsman 2nd Class Jeremy West gives the smallpox
vaccine to a member of a military emergency response team on
Friday.
1-in-3 troops ineligible for
smallpox shots
Soldiers exempted due
to health conditions
NBC NEWS AND NEWS SERVICES
Dec. 19 — A
week after a smallpox vaccination program for military troops began,
one in three soldiers has been exempted from the mandatory shots
because of medical complications. The situation underscores the
importance of careful screening and public education about smallpox,
yet a new poll finds that a majority of Americans still knows little
about the disease or the vaccine.
The most common medical exemptions were for skin conditions, such as
eczema.
IN THE
first five days of the smallpox vaccination program, 276 people have
been screened for the vaccine, with 102 — 37 percent — exempted for
medical conditions, said Dr. William Winkenwerder Jr., assistant
secretary of defense for health affairs. The others received the
inoculation.
Nearly half of those exempted live with someone who would be
at risk for a side effect. The vaccine is made with a live virus,
and it can escape the inoculation site and infect people who come
into close contact with the person vaccinated.
The most common medical exemptions were for skin conditions,
such as eczema. People with skin conditions are at increased risk
for serious side effects from the vaccine.
NO SERIOUS
COMPLICATIONS
So far, there have been no serious complications among those
inoculated, and Winkenwerder is hoping that careful screening will
mean far fewer problems than were found in the smallpox program in
the 1960s. During that time, there were one or two deaths for every
million people vaccinated and at least 15 life-threatening
complications per million.
“We’re paying a whole lot more attention to screening,” he
said.
The vaccinations began last Friday, targeting about 500
people who would serve on smallpox response teams. In the next
stage, beginning in January, the Pentagon will vaccinate about
25,000 medical teams in hospitals and large clinics across the
country, and up to 500,000 overseas troops in high-risk areas,
particularly southwest Asia.
The study, which was
published in the New England Journal of Medicine and sponsored by
the RAND Center for Domestic and International Health Security, said
smallpox could be spread by terrorists in various ways, resulting in
widely divergent numbers of deaths.
One scenario would be to let three smallpox-infected
terrorists ride mass transit in a large city. The researchers
estimated that fewer than 20 people would die before the disease was
contained through a vaccination campaign.
The worst scenario imagined was turning 40 terrorists loose
on a busy day in 10 large airports with portable nebulizers spraying
smallpox into the air. Unless most of the population had already
been vaccinated, between about 40,000 and 55,000 people would die.
The study also found that while mass vaccinations ahead of an
actual bioterror attack may not be warranted, it is important for
health workers to be vaccinated, as President Bush’s policy has
ordered.
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For
instance, if 60 percent of all 288 million Americans were
vaccinated, the result would be nearly 500 deaths from the vaccine,
even if smallpox never reappears. However, in an outbreak, health
care workers are the ones most likely to catch the virus. They make
up 3 percent of the population but would account for 20 percent to
60 percent of all smallpox cases, depending on which scenario of
disease spread is used.
“We show there would be a net benefit to vaccinating health
workers, even if there is a low probability of an attack, because
health workers are at greatly increased risk,” said the study’s
director, Dr. Samuel Bozzette of the Veterans Affairs San Diego
Healthcare System.
Jim Bentley, a senior vice president of the American Hospital
Association, said most hospitals seem willing to participate in the
effort to vaccinate health care workers, others are deliberating,
and a few have indicated they do not want their staff vaccinated.
Among the reluctant facilities are Grady Memorial Hospital in
Atlanta and Virginia Commonwealth University’s health center in
Richmond, Va.
The American Medical Association has endorsed the concept of
voluntary vaccinations for health care workers but says it will
monitor the program for possible complications.
HHS has launched a Web site
for people with questions about smallpox and the president’s
vaccination plan to visit for information.
ALL INFORMATION, DATA, AND
MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION
PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS
OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR
LEGAL ADVICE. THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND
COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH
YOUR HEALTH CARE PROVIDER.
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30 percent of Americans believe there has been a smallpox case in
the United States in the past five years, and 63 percent think there
has been one somewhere in the world. Actually the last U.S. case was
in 1949, and the last in the world was in 1977.
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