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State officials cautious about smallpox shots

Nena Baker
The Arizona Republic
Dec. 19, 2002 12:00 AM

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Arizona health officials Wednesday cautioned against widespread smallpox vaccinations for the public but said the state will begin a voluntary program for as many as 7,700 front-line health care workers.

"Using the vaccine safely is a paramount concern," said Dr. Peter C. Kelly, infectious disease specialist, who warned of side effects, some of them life-threatening, associated with the vaccine. "All prospective recipients will be screened very carefully."

The health care workers to be vaccinated would be on the front line of any bioterrorism assault. Their shots would begin as early as next month and are part of a national plan announced last week by President Bush, who also ordered vaccinations for military personnel.

No clear plan has emerged for widespread public vaccinations. A newer vaccine is being developed that reportedly has fewer side effects.

Currently, however, pregnant and nursing women should avoid the smallpox vaccine, health officials said.

So should anyone with HIV or AIDS, the skin condition eczema, or an immune system compromised by cancer, organ transplants or the use of immunosuppressive drugs.

Those conditions, some of them unknown or not as prevalent when the vaccine was given routinely before 1972, can contribute to serious adverse reactions.

"It could end up doing more harm than benefit," Kelly said.

In addition, those in contact with anyone at high risk for an adverse reaction should avoid the vaccine, Kelly said. The vaccine contains a live virus that can be spread by contact with the inoculation site.

As frightening as smallpox is - it kills 30 percent of those infected - an outbreak could be contained without widespread vaccinations, said Dr. Bob England, state epidemiologist.

A vaccine can be administered a few days after contact with smallpox and still be effective, England said.

"If you vaccinate the contacts of the contacts, you can create a ring of vaccinations and prevent spreading," he said.

Baby boomers and older Americans who bear a telltale round, uneven scar from a smallpox vaccination are still at risk in an outbreak, England said.

"You may not die or get as sick," he said. "But the vaccination really is good for only about 10 years."

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