Public urged to forgo smallpox vaccination

Most still unaware of risks, officials say

By TODD ACKERMAN
Copyright 2002 Houston Chronicle Medical Writer

Saying many people still have no idea just how risky the smallpox vaccine is, leading U.S. health officials stressed Saturday that the federal government isn't recommending it for the general public.

Leaders from the Department of Health and Human Services, the National Institutes of Health and the Centers for Disease Control and Prevention defended President Bush's plan to make the vaccine available to the public but said they hope few seek it.

"The federal government is not recommending vaccination (beyond military personnel and emergency health workers)," said HHS Secretary Tommy Thompson. "It will just accommodate members of the public who insist on being vaccinated."

However, children will not be eligible to receive the vaccination unless there's a bioterrorist attack with smallpox, the leaders said. Because ethical and safety concerns disqualify children from clinical trials being conducted with the vaccine, it cannot be licensed for them.

The health leaders warned of the vaccine's dangers during a conference call with the media a day after Bush announced a long-awaited plan in the event of a smallpox attack. Although smallpox was eradicated in the 1970s, experts fear terrorists or hostile nations could use it on the battlefield or against civilians.

The plan calls for the vaccination of 500,000 military personnel, which began Friday, and of 450,000 to 500,000 smallpox response teams and hospital workers, which is scheduled to begin Jan. 24. A second round of vaccinations for health care workers and emergency personnel, scheduled for the spring, could bring the civilian medical and response team total to 10.5 million people.

States initially were told they'd have 30 days to carry out the inoculation of their teams, chafing some that worried about finishing in time. But Thompson said Saturday it is fine if some states take longer.

It was Bush's decision to offer the vaccine to the general public in 2004 that is causing health officials to mount an aggressive educational campaign. Polls show that most people would get the vaccine if given the chance. But the health leaders said people's minds change when they find out about the side effects.

Tony Fauci, director of the NIH's National Institute for Allergy and Infectious Diseases, said that when he speaks at public meetings, about 60 percent of people initially say they want the vaccine. After he shows slides of its side effects -- such as a nasty rash -- the number of those who say they want the shot drops to 15 percent to 20 percent.

In the past, between 14 and 52 of every 1 million people who were vaccinated experienced potentially life-threatening reactions, and one to two died. In a recent study, one-third of participants taking the vaccine missed at least one day of work or school, typically from fever.

Thompson said the vaccine will be available only through public health agencies and that it won't be handed out "willy-nilly to doctors in America."