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Last Updated

26 Feb 2003

Source: Atlanta Journal-Constitution, February 27, 2003

CDC: Vaccine reactions seen at expected levels

By M.A.J. McKENNA, The Atlanta Journal-Constitution

Up to 25 recipients of the smallpox vaccination have experienced bad reactions, two serious and the rest relatively mild, the Centers for Disease Control and Prevention will announce today.

The two most serious reactions are a suspected case of generalized vaccinia, a rash that erupts on another part of the body after the virus in the vaccine spreads through the bloodstream, and a heart attack that followed a vaccination by four days. Both recipients, whom the agency would not identify, are recovering.

As of Friday, according to CDC records, 7,345 public health and hospital workers had been vaccinated. That makes the current reaction rate less than during the previous vaccination campaign, which ended in 1972.

"This is consistent with what we expected," said Dr. J. Michael Lane, the former chief of the CDC's smallpox eradication program and author of the side-effects research.

Details of the cases will be published today in the agency's weekly bulletin, officials said. The cases were disclosed Wednesday during an Atlanta meeting of a CDC vaccine advisory board.

CDC officials stressed Wednesday that links between the serious cases and the vaccinations have not been confirmed. The cases were described as possible vaccine reactions because the agency is receiving reports through a nationwide system that records any side effects in civilian volunteers who have been vaccinated.

The heart attack, officials said, occurred in a 60-year-old man with a personal and family history of heart disease who was playing tennis when he became ill. The patient with the rash, they said, could have either generalized vaccinia, or a less serious, more common reaction that is confined to the skin and does not involve the bloodstream. The diagnosis will not be completed until the CDC receives lab reports of viral cultures, which take several days to mature.

The 23 mild reactions, reported through the same nationwide system, include fever, fatigue and redness and swelling near the vaccination site, said Dr. Eric Mast of the CDC.

Fear of serious side effects has been one of the chief obstacles to public acceptance of the smallpox vaccination program, which seeks to enroll up to 500,000 public health and hospital workers.

Research done at the CDC in the 1960s recorded one to three deaths, 15 to 52 life-threatening reactions and about 900 serious ones for every 1 million vaccinations given. (Those numbers do not include mild reactions such as fever and swelling, which were considered common.)

The CDC also reported on Wednesday more serious complications among 250,000 military members vaccinated since December: four cases of myocarditis, an inflammation of heart muscle.

The disease, which has never been linked to smallpox vaccine, was diagnosed when the recruits complained of chest pain one to two weeks after vaccination. All four patients are recovering.