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http://thestar.com.my/news/archives/story.asp?ppath=\2002\12\22&file=/2002/12/22/world/poxrisk&sec=world

US debates risk of smallpox jabs

WASHINGTON: The decision by US authorities to vaccinate military and medical personnel against the smallpox virus has sparked a debate about the risks being run by recipients. 

At least two major US hospitals have already refused to inoculate some of the 11 million candidates for the vaccine, even on a voluntary basis, saying the risks from complications outweigh any from a terrorist-inspired smallpox outbreak. 

Several leading medical experts have questioned the wisdom of the programme in an issue of the New England Journal of Medicine dedicated exclusively to the subject of smallpox. 

“A terrorist introduction of smallpox could produce a short outbreak of cases and deaths,” acknowledged Thomas Mack, a professor of preventive medicine at the University of Southern California’s Keck School of Medicine. 

“But the current vaccination policy will provide little protection and the cost in deaths from vaccine complications will outweigh any benefit,” he wrote. 

“Only if evidence suggests that a massive attack or sustained biologic warfare is probable can such a vaccination policy be justified.” 

The US government plan, announced last week, calls for phased vaccination of key personnel, beginning in January with the military, and followed by thousands of public health officials who would be on the frontline in the event that terrorists were to attack America with smallpox. 

President George W. Bush said he would also have a vaccination. 

After that, “first responders” – police, fire and emergency medical technicians – will be inoculated on a voluntary basis with ordinary Americans allowed to get their own jabs – if they insist – by spring. 

The problem is that the vaccine carries real and potentially fatal risks. 

Officials are treading cautiously, phasing in the vaccination programme in order to monitor individuals who get the jab for adverse reactions and any unexpected side effects. 

But, medical experts are also concerned about the possibility that medical personnel could infect vulnerable hospital patients, especially those with AIDS, with the live virus during the contagious phase in the days immediately after inoculation. – AFP  

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