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Last Updated

14 Feb 2003

Source: Atlanta Journal-Constitution, February 14, 2003

CDC says smallpox vaccinations will increase

By NORA ACHRATI, The Atlanta Journal-Constitution

WASHINGTON -- Officials from the Centers for Disease Control and Prevention predicted Thursday that the civilian smallpox vaccination program will take off next month.

But state health officials said they are unwilling to expand the program right away and health care workers appear reluctant to participate.

As of Tuesday, 1,043 health care workers in 19 states had been inoculated against the virus.

Nearly 270,000 doses of smallpox vaccine have been distributed nationally since January.

Speaking before a panel at the Institute of Medicine, Joe Henderson, CDC's associate director for terrorism and preparedness, said he expected 45 states to be vaccinating workers by Feb. 21.

He predicts that by the end of March there will be enough data to support vaccinating a wider pool of people.

The voluntary vaccination is scheduled to take place in four phases.

Phase one, now under way, involves the inoculation of state and local health care workers.

Subsequent phases will expand vaccinations to emergency responders such as police and firefighters and then to the public.

Georgia public health director Kathleen Toomey told the committee the first phase was still "a work in progress" that should be handled slowly and could not be done in the 30-day time frame the CDC had initially predicted.

As of Wednesday, 71 health care workers had been vaccinated in Georgia, Toomey said.

Georgia public health officials have launched a campaign to educate health care workers about the vaccination program, Toomey said, and are using a screening process to ensure health care workers at risk are not vaccinated.

Those who have immune deficiencies or who may be pregnant cannot receive the vaccine, which contains a live version of the smallpox virus.

Additionally, Toomey said, Georgia health administrators are evaluating the program, slowing the vaccination process but minimizing risks to workers.

There has been a wide discrepancy in the number of inoculated workers from state to state. Nebraska has immunized 137 health care workers. New York, which suffered an anthrax attack in 2001, has immunized 16.

CDC's Henderson said he was "not surprised" by the numbers.

"We knew this was going to be 'go slow, learn as you go,' " he said.

He cited the need for training vaccinators and educating health care workers about risks as reasons why vaccination counts were so low.

Henderson also acknowledged "there is no uniform compensation program as of yet," a cause for concern among many health care workers. They worry the vaccine may sicken workers or their families, who may not have adequate insurance or worker's compensation.

Media coverage and reaction to reports of illness also have affected the rate of vaccination, Henderson told the committee.

More than 100,000 members of the military have been vaccinated, Department of Defense vaccine specialist John Grabenstein said, and three who suffered serious reactions have recovered.

Overall, he said, the rate of severe reaction has been significantly lower than studies have predicted.

"Morale is good," he said.

No serious side effects have been reported among vaccinated non-military health care workers.

In December, President Bush announced a goal of vaccinating 450,000 health professionals and about 500,000 members of the military.