By LAWRENCE K. ALTMAN

TLANTA, Oct. 17 — Federal health officials said today that a network of experts would be made available for consultation at any hour in case of bad reactions to smallpox vaccine, which may be given soon to a half-million hospital workers.

The network would be part of the most comprehensive system ever to monitor the safety of a vaccine, officials of the federal Centers for Disease Control and Prevention here said.

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It would also be the first formal program in which doctors treating a patient with a vaccination complication could immediately consult with designated experts at selected medical centers around the country. Such consultations have been done informally, with the disease centers relying on reports from doctors that were not collected in a standard way.

"We are responding to criticism that we have not had comprehensive, standard clinical evaluations" of adverse reactions to vaccines, Dr. Walter Orenstein, an official at the disease centers, said.

The monitoring system will help determine the frequency of complications caused by the smallpox vaccine, the riskiest of all vaccines.

The network will also be used to determine who will get the scarce and dangerous drugs needed to treat complications of the smallpox vaccine, and when, said Dr. Gina Mootrey, another official at the centers, in announcing the monitoring plan to a panel advising the government on smallpox vaccinations.

On Wednesday, the advisory panel recommended offering the immunization to an estimated half-million emergency room and other hospital workers because of the possibility of a bioterrorist attack.

Today, the panel recommended that anyone with either of two common skin conditions — eczema and atopic dermatitis — not receive a smallpox vaccination. The exclusion also applies to anyone who has had either condition in the past, even a mild case.

Such individuals are at increased risk of developing a severe and potentially fatal illness known as eczema vaccinatum.

The panel also recommended not giving smallpox vaccine to anyone who has a family or household member with either skin condition because the virus in the vaccine could be transmitted to them.

The panel's chairman, Dr. John F. Modlin of Dartmouth Medical School, said the criteria might exclude an estimated 7 percent to 17 percent of Americans from receiving the vaccine.

Individuals infected by the AIDS virus and women who are pregnant, or who are trying to become pregnant, should also not be given the vaccine, the panel said.

Modern knowledge about the safety of the vaccine is limited because the government stopped standard use of smallpox vaccine in 1972 as the disease was being eradicated from the world.

Earlier this year, researchers reported that 36.4 percent of volunteers in a study missed school, work or recreation or had difficulty sleeping after receiving a dose of the smallpox vaccine that was used before smallpox was declared eradicated in 1980.

Individuals with severe reactions might be treated with either of two drugs. One is vaccinia immune globulin, a drug that is derived from the blood of individuals who have been immunized against smallpox and that is now in short supply. The government owns the only stores.

The other is cidofovir, a drug that experts hope might be effective against vaccinia, the virus in the vaccine that protects against smallpox. Cidofovir must be injected, is dangerous and its only approved use is for a different virus.

Another reason for instituting the monitoring system is to maintain credibility and public confidence, Dr. Mootrey said. Last year during the anthrax attacks, the centers were widely criticized for failing to communicate pertinent information about anthrax in a timely manner to health officials, doctors and the public.

The monitoring system will require extensive cooperation from state and local health departments and hospitals to resolve a number of issues, including liability for the health professionals involved. The centers plan to start discussions with state and territorial health officials on Friday.

Most experts at the meeting were cautiously optimistic about the plan.

Dr. Guthrie S. Birkhead , an official of the New York State Health Department, called the plan comprehensive but underscored the need for health officials and hospitals to immediately talk through the issues.

Dr. Kent Sepkowitz, an infectious disease expert at Memorial Sloan-Kettering Cancer Center in Manhattan, complimented the center for developing "a good system," but added that "it will take months for it to go right and that is a reason to go slowly at first."

Under the monitoring system, each hospital worker will be given a personal identification number at the time of vaccination.

The recipients will also receive a telephone hotline number to report any possible adverse effect like fever, a spreading rash or altered mental status caused by encephalitis.

An estimated 35 percent, or 175,000, of the recipients are expected to call the hotline, where the staff will provide advice and refer those needing immediate care to their doctors.

Of these, about 17,500 are expected to need care from a designated local specialist in dermatology, allergy, neurology and infectious diseases. In turn, about 30 percent of this group will need referrals for more extensive consultation with experts at designated hospitals around the country.

The experts are at Columbia-New York Presbyterian Hospital in Manhattan; Boston University; Johns Hopkins; the University of Maryland; the Northern California Kaiser Permanente hospital; Stanford University and Vanderbilt University.

About 100 recipients are expected to need treatment with vaccinia immune globulin, cidofovir or both.

The disease centers plan to conduct a telephone survey involving 15,000 to 20,000 vaccine recipients on the tenth and twenty-first days after vaccination.