Smallpox immunity from childhood jabs has died out, says study

SMALLPOX VACCINATION ************************ A ProMED-mail post <http://www.promedmail.org> ProMED-mail is a program of the International Society for Infectious Diseases <http://www.isid.org> [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 *##########################################################* ProMED-mail makes every effort to verify the reports that are posted, but the accuracy and completeness of the information, and of any statements or opinions based thereon, are not guaranteed. The reader assumes all risks in using information posted or archived by ProMED-mail. ISID and its associated service providers shall not be held responsible for errors or omissions or held liable for any damages incurred as a result of use or reliance upon posted or archived material. ************************************************************ Visit ProMED-mail's web site at <http://www.promedmail.org>. Send all items for posting to: promed@promedmail.org (NOT to an individual moderator). If you do not give your full name and affiliation, it may not be posted. Send commands to subscribe/unsubscribe, get archives, help, etc. to: majordomo@promedmail.org. For assistance from a human being send mail to: owner-majordomo@promedmail.org. ############################################################ ############################################################