Dec. 12
— By Maggie Fox, Health and Science Correspondent
WASHINGTON (Reuters) - When health-care workers start inoculating
500,000 Americans against the smallpox virus next year, they will see
side-effects not seen in 30 years -- sore, swollen arms, scary-looking
scabs and perhaps even illness serious enough to hospitalize a few
people.
President Bush said on Wednesday he was going ahead with widely
expected plan under which 500,000 military troops would be vaccinated
right away, and another 500,000 health-care workers a few weeks later.
These health-care workers would then be protected against smallpox in
case of a biological attack, and could be available to vaccinate others.
Smallpox was eradicated in 1978, but experts believe Iraq has at
least tried to develop smallpox into a biological weapon that it may use
if attacked by the United States.
Bush was forced to balance the risks of the vaccine against the
theoretical risk of a biological attack.
"We stopped using this vaccine when this disease was eradicated
because it was dangerous," Dr. Julie Gerberding, head of the U.S.
Centers for Disease Control and Prevention, told reporters in a recent
briefing.
The United States stopped vaccinating the public in 1972, but there
is a small group of people who have been vaccinated recently under
studies aimed at seeing if 30-year-old stocks of the vaccine could be
diluted and stretched out.
Doctors conducting those trials said they have seen startling
side-effects -- reactions not seen with today's improved vaccine
technology.
"We did have a lot of people calling us in a panic," said Dr. John
Treanor, who has tested the vaccine on volunteers at the University of
Rochester in New York. "They are only scary because people are
unfamiliar with using the vaccine."
About one in five people get a big red lump at the vaccination site.
The vaccine is a solution containing a live virus, called vaccinia,
which is related to smallpox. This is scratched into the skin using a
two-pronged needle.
OOZING BLISTERS
If the vaccine is successful, the patient develops an oozing blister
that shows the vaccinia has infected the body. If all goes well the body
responds with a targeted attack that leaves it primed to also attack and
eliminate smallpox virus.
"Those relatively large reactions can be associated with swelling of
the lymph nodes in the armpit, which can be painful," Treanor said. "You
can get malaise. Ten percent or so may have missed a couple of days from
work because they didn't feel up to coming in."
"This is just what the vaccine is doing in the process of making you
immune to smallpox, but it is not very comfortable."
People can also develop a more serious rash over parts or all of
their bodies. "We don't understand why people get that rash," Treanor
said. "It does look kind of alarming."
Like a cold sore, the blister "sheds" a virus that can be passed from
person to person, or spread to other parts of the body. "If you get
vaccinia in your eye, you can become blind," Gerberding said.
Out of every million people who got the vaccine in the 1960s, two
died of serious complications such as encephalitis and another 14 were
sick enough to go the hospital.
Experts are not sure what to expect today. "Although the vaccine may
be the same, we are different," Washington state Secretary of Health
Mary Selecky told a recent conference.
"How many people do you know who have gone through chemotherapy
today, and how many did you know, or did your parents know, in 1954?"
Former cancer patients, people infected with the AIDS virus,
transplant recipients and others with suppressed immune systems are all
more susceptible to severe side-effects from a live virus vaccine. So
are people with eczema, which for some reason is more common than it was
30 years ago.
Copyright 2002 Reuters News Service. All rights reserved. This
material may not be published, broadcast, rewritten, or redistributed.
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