SMALLPOX VACCINATION
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[1]
Date: 10 Jun 2002
From: ProMED-mail <promed@promedmail.org>
Source: Agence France Presse English 29 May 2002


Smallpox immunity from childhood jabs has died out, says study
---------------------------------------------
Only a tiny fraction of people who were vaccinated against smallpox 
before the disease was declared eradicated more than 2 decades ago 
have still retained their immunity, according to a U.S. study. The 
figures are bad news to those who believe that they will be protected 
against a smallpox bioterror weapon thanks to a jab in their 
childhood.

Of 621 microbiologists in Maryland who received fresh vaccinations 
against smallpox between 1994 and 2001 to protect them in their daily 
work of handling dangerous viruses, only 6 percent were still immune 
from their early vaccination.

The U.S. government is planning to buy 286 million of doses of 
smallpox vaccine by the year (sic), enough to protect every American 
from the disease.  However, health professionals are divided as to 
whether it is best to vaccinate everyone immediately, in a 
pre-emptive campaign, or wait until there is any clear threat. A 
pre-emptive campaign would make it far easier to contain any outbreak.

However, many people would die -- at least 180 in the US population 
-- because of health complications arising from the vaccine, says the 
British weekly New Scientist, which reports on the Maryland research 
in next Saturday's issue.

Smallpox was declared eradicated by the World Health Organization in 
1980, prompting countries around the world to stop routine 
vaccinations. The virus is highly transmissible from person to person 
and has a 33 percent mortality rate.

--
ProMED-mail
<promed@promedmail.org>

[Residual immunity, even if unmeasurable, may still make the 
difference between surviving rather than dying from a smallpox 
infection. - Mod.JW]

******
[2]
Date: 10 Jun 2002
From: ProMED <promed@promedmail.org>
Source: AScribe - The Public Interest Newswire 5 Jun 2002 [edited]
<http://www.ascribe.org>


As Experts Debate Need for Voluntary Smallpox Vaccination, 3 in 5 Say 
They Want It
--------------------------
Although not a single case of smallpox has been reported in the 
United States, 3 in 5 Americans (59 percent) surveyed by the Harvard 
School of Public Health and Robert Wood Johnson Foundation say they 
would get vaccinated as a precaution against a bioterrorist attack 
using smallpox if a vaccine were made available to them.

This is the case even though people were told that the vaccination 
may produce serious side effects in a small number of cases. If cases 
of smallpox were reported in their own community, more than 3/4 (81 
percent) of Americans say they would get vaccinated. This includes 
the 59 percent who had already said they wanted to get vaccinated in 
the near future, even without cases having been reported, as well as 
an additional 22 percent who became interested in vaccination once 
local cases were mentioned. One in 10 (9 percent) would not get 
vaccinated even if an outbreak of smallpox occurred in their 
community.

These findings, based on interviews with 2000 Americans nationwide, 
come at a time when 2 federal government advisory committees of 
experts, the Advisory Committee on Immunization Practices and the 
National Vaccine Advisory Committee, are debating whether or not 
voluntary smallpox vaccinations should be offered to the public.

Also starting on Thu 6 Jun 2002, in New York City and San Francisco, 
the Centers for Disease Control and Prevention is conducting a series 
of public forums on the use of the smallpox  vaccine.
<http://www.cdc.gov/nip/smallpox/News.htm#Forums>

"The survey results also raise the question of whether or not the 
country should move ahead with voluntary vaccination of frontline 
workers, such as doctors, nurses, and emergency personnel," said 
Robert J. Blendon, professor of Health Policy and Political Analysis 
at the Harvard School of Public Health. "If there were a bioterrorist 
attack using smallpox, millions of Americans would want to find 
health professionals to vaccinate them. If the professionals 
themselves have not been vaccinated, it could lead to serious delays 
and public panic."

The substantial public interest today in receiving a smallpox 
vaccination grows in part from continuing fears about a future 
bioterrorist attack. Now, 9 months after the September 11th attacks, 
more than 4 in 10 (43 percent) report being worried about a future 
attack using smallpox, down from 53 percent in November 2001. About 
half (49 percent) of women, compared with 36 percent of men, are 
currently worried about such an attack.

The interest in vaccination may also reflect Americans' familiarity 
with the smallpox vaccine. Nearly 3 in 5 Americans (56 percent) 
report having been vaccinated earlier in their lives. In the near 
run, the public sees little risk that they or a family member will 
get smallpox. Only 1 in 12 Americans (8 percent) believes that they 
or someone in their immediate family is likely to contract smallpox 
during the next 12 months. This compares with [1 in 5] 20 percent who 
believe they or a family member are likely to be injured in some 
other type of terrorist attack.

Most Americans (74 percent) are at least mildly optimistic that they 
would survive if they contracted smallpox and received immediate 
medical care, 44 percent see it as very likely that they would 
survive, while 30 percent thought it somewhat likely.

The public is also somewhat optimistic that adequate planning, 
preparation, and professional education have taken place in their 
community in regards to a possible smallpox attack. Most Americans 
(84 percent) report confidence that their own doctor can recognize 
the symptoms of smallpox. Almost half (45 percent) are very 
confident. [Really! - Mod.JW]

About 2/3 of Americans (70 percent) believe that their local hospital 
emergency room is prepared to diagnose and treat people who have 
smallpox. However, this includes only 23 percent who think their 
local ER is very prepared. Similarly, 2/3 (66 percent) are confident 
that their local health department is prepared to prevent smallpox 
from spreading if there were an outbreak of the disease, but this 
includes only 19 percent who think the local health department is 
very prepared. If they had symptoms of what they thought might be 
smallpox, most Americans would seek help from the traditional health 
care system. The most common place to turn for diagnosis or treatment 
would be their own doctor or medical clinic (83 percent), followed by 
a hospital emergency room (62 percent) or outpatient department (52 
percent). Very few Americans (27 percent) would seek assistance from 
a public health department clinic.

The survey finds that there is no single spokesperson the public most 
trusts on these issues. When asked, in the event of an outbreak of 
disease caused by bioterrorism, which of 6 public officials they 
trusted most to provide correct information about how to protect 
themselves and their families from the disease, 43 percent said a 
senior scientist from the Centers for Disease Control.

No other official was chosen by more than 16 percent. The other 
choices were the heads of the Department of Health and Human 
Services, Office of Homeland Security, and FBI, the U.S. Surgeon 
General, and the city or state health commissioner. Asked whom they 
trusted most to provide correct information about where to go if they 
were exposed to a disease caused by bioterrorism, Americans were 
nearly evenly split between the CDC (28 percent) and their city or 
state health commissioner (26 percent); 19 percent chose the head of 
the Department of Health and Human Services.

Americans' knowledge about smallpox is mixed. More than 3/4 (85 
percent) know that smallpox is contagious. Many believe that smallpox 
is easily spread. For instance, 90 percent know that if someone has 
contracted smallpox and has the symptoms, they should be kept 
isolated from uninfected people.

However, less than half (43 percent) of Americans know that if a 
person has been exposed to smallpox but does not have symptoms, 
getting a vaccination would prevent the person from coming down with 
the disease. Only about 1/3 (32 percent) know that once a person 
develops symptoms of smallpox, there is no cure. "This is the central 
issue for public health education," said Blendon. "Americans need to 
know that according to experts, if people are exposed to smallpox but 
do not yet have symptoms, an immediate vaccination will help protect 
them against the disease. The message is that you should not wait 
until you get sick. If you have been exposed, go get vaccinated right 
away, because once the symptoms start, there is no treatment to stop 
the course of the disease."

Since the Fall of  2001 there have been only a few changes in 
Americans' behavior in response to bioterrorist threats. Most 
Americans continue to believe that in the near run they or someone in 
their immediate family is unlikely to contract anthrax or smallpox.

Currently, 10 percent think they or a family member is likely to 
contract anthrax during the next 12 months, down slightly from 14 
percent in October 2001 shortly after anthrax-laden mail was first 
discovered, but nearly identical to the 9 percent figure in 
November-December 2001.

The proportion of Americans believing that they or a family member is 
likely to contract smallpox during the next year has remained 
virtually unchanged: 9 percent in October 2001, 8 percent in 
November-December 2001, and 8 percent currently.

Decreases have been seen in the proportion of Americans who:

- are taking mail precautions (from 37 percent in October 2001 to 24 
percent in May 2002)

- are avoiding public places and consulting a website for information 
about how to protect themselves in case of bioterrorism (from 12 
percent each in October 2001 to 7 percent and 8 percent, 
respectively, in May 2002).

Of note, there has been a significant rise, from 5 percent in October 
2001 to 15 percent in May 2002, in the proportion of Americans who 
report that they or someone in their family has gotten a prescription 
for or purchased antibiotics in response to concern about 
bioterrorism. This suggests that some Americans are stockpiling 
antibiotics in case of a future bioterrorist attack.

Methodology & survey data is available at:
<http://www.hsph.harvard.edu/press/releases/press652002.html>

--
ProMED
<promed@promedmail.org>
........................................jw/pg/lm
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