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Dec. 14

— By Maggie Fox, Health and Science Correspondent

WASHINGTON (Reuters) - Defending a plan to vaccinate a million Americans against smallpox, a disease not seen in 30 years, top U.S. health officials said on Saturday they would watch carefully for any side-effects from what they acknowledge is a crude and relatively dangerous vaccine.

Unions representing health care workers have condemned a decision by President Bush to vaccinate close to a million Americans against the smallpox virus, saying the plan does not adequately protect them.

Bush said on Friday that after thinking for months about what to do he would go ahead and order 500,000 troops and ask more than 400,000 health workers to get the vaccine so that they are protected in case of a biological attack.

"Our government has no information that a smallpox attack is imminent, yet it is prudent to prepare for the possibility that terrorists who kill indiscriminately would use diseases as a weapon," Bush said in announcing the plan.

Groups such as the American Medical Association have accepted the decision, under which any member of the public who really wants the vaccine can get it. They will have to apply to take part in a clinical trial, however, which is not an easy process and involves close monitoring and extensive briefing.

Both health and union officials want the government to move slowly to ensure that serious side-effects are as limited as possible.

In the past, one or two people out of every million vaccinated died, and up to 52 per million had severe side-effects, such as encephalitis. One in five felt ill, perhaps missing a few days of work.

Officials said they would watch closely for such reactions and would take them into account when deciding how to handle any wider offering of the vaccine.

"We expect that monitoring of the safety of this vaccine will be exemplary," Dr. Julie Gerberding, head of the Centers for Disease Control and Prevention, told reporters in a telephone briefing.

Sandra Feldman, president of the American Federation of Teachers, whose health care division represents 65,000 nurses and other health care workers, said she understood the need to prepare for an attack.

'HASTY' PREPARATIONS

"However the rushed pace with which the Bush administration wants to implement its plan -- to vaccinate more than 500,000 healthcare workers within 30 days of the executive order -- seems hasty, especially if there is no, as President Bush said, imminent danger of a smallpox attack," Feldman said.

"This approach could lead to unnecessary loss or risk of life," she added in a statement.

The 1.5 million-member Service Employees International Union agreed. "President Bush's smallpox plan puts hospital workers and their patients at unnecessary risk," SEIU president Andrew Stern said in a statement.

"No one should get this vaccine without getting screened and understanding the risk for themselves and their family. But under this plan, only people who can afford to pay for the tests or whose insurance might cover it will be protected."

Health and Human Services Secretary Tommy Thompson said he had tried, without success, to speak to Stern about the plan. He noted that Homeland Security legislation passed in November ensured the workers could not be sued by patients who may develop side-effects from the vaccine.

Their own health insurance plans will pay for any needed treatment from side-effects, he told reporters in a telephone briefing.

Thompson admitted all the kinks had not been worked out and said he hoped Congress would provide more funds to hospitals to deal with such problems.

The vaccine to be used is DryVax -- coming from 30-year-old stocks last used to immunize the public in 1972. It is the most dangerous vaccine existing, posing a threat not only to those vaccinated, but to people they come into contact with.

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