Panel Recommends Against Smallpox Shots
Panel Recommends Against Smallpox Vaccinations for General Public Over
Concerns on Side Effects
The Associated Press
http://abcnews.go.com/wire/US/ap20030812_1194.html
WASHINGTON Aug. 12 —
A scientific panel recommended against smallpox vaccinations for the
general public Tuesday because of concerns about side effects both for
those receiving the shots and others in contact with them.
The focus of smallpox preparedness should move away from the number of
people vaccinated to concentrate on who needs to be prepared for a
possible smallpox attack by terrorists and how communities should
respond, the panel said.
The efforts of the Centers for Disease Control and Prevention to ready
the nation for bioterrorism won praise from Brian Strom of the
University of Pennsylvania, chairman of the Institute of Medicine
committee that prepared the report.
"That said, we need to begin to shift the focus away from vaccination
toward preparedness in general," Strom said in a telephone briefing on
the new report.
Dr. Ray Strikas, CDC's director of smallpox preparedness response,
said the agency had no detailed response to the report because it is
still under study. He said the CDC looks forward to working with panel
members in setting performance standards for response programs.
The Bush administration launched a program last year requiring
smallpox vaccination for about 500,000 military personnel and offering
a voluntary program to immunize several million medical and emergency
personnel who would be in immediate danger in a biological attack.
The civilian program has been lagging, however, with 38,004 people
vaccinated as of July 25. Many health care workers have resisted
getting the shots out of concern over side effects.
That concern was expressed by the committee in urging that the vaccine
not be offered to the general public except in clinical trials because
it can cause illness in some people.
Someone might be willing to take the risk of vaccination to counter
the unlikely event there would be a smallpox attack, the unlikely
event it would be in their neighborhood and the unlikely event CDC
would be unable to protect them, Strom said.
"But the problem with the smallpox vaccine is it's a live virus, so
when you take on that risk you are taking it on not only for yourself,
but for the people around you and those you come in contact with," who
haven't had the opportunity to say if they want to take the risk,
Strom said.
The vaccine is not currently available to the public, but President
Bush has urged that health departments try to accommodate individuals
who insist on it. Before the 1970s smallpox vaccine was commonly given
to children, but how long that protection lasts is in question and
studies are underway to determine whether vaccinated people are still
protected.
Strom said that turning attention more toward general preparedness
involves such things as determining who in a community will be first
to respond to any attack and making sure they are trained. Other
considerations, he said, might include making sure physicians who
cross state lines to assist are licensed in the state they visit.
Further committee meetings are planned hear other preparedness
proposals, he added.
As part of the preparation for a bioterror attack, the committee said,
CDC should help create registries of health care workers and others
who have been vaccinated, including former members of the military and
reservists.
Trained and vaccinated military personnel will be returning to
civilian life, and health workers change jobs and move to new
communities, Strom said. Having a registry of these people would be
vital in organizing a response to an attack, he said.
The committee was organized by the Institute of Medicine, a sister
agency of the National Academy of Sciences, which is chartered to
provide advice to the government on medical policy matters.
"Smallpox is not the only threat to the nation's health, and
vaccination is not the only tool for preparedness," Strom said. "The
focus should continue to be on defining preparedness in each state or
region and determining what else is needed to be fully ready."
The committee added that vaccinating the general public could strain
health agencies' budgets and staff. It urged that CDC do surveys to
determine public demand for the vaccine and find out what resources
are available to meet that need.