about Epidemiology & the department

Epidemiology academic information

Epidemiology faculty

Epidemilogy resources

sites of interest to Epidemiology professionals

Last Updated

21 Feb 2003

Source: Los Angeles Times, February 21, 2003

Hospitals split over smallpox vaccines

Officials say workers are concerned about side effects.

By Buck Wargo, Inland Valley Voice

As San Bernardino County prepares to start immunizing doctors, nurses and other public health workers for smallpox in the next two weeks, half of the county's hospitals have decided to stay on the sidelines as they mull health concerns related to the vaccine.

The San Bernardino County Department of Public Health received 400 doses of the smallpox vaccine Wednesday. It was the first round of vaccinations for emergency health staff who would identify and treat patients with the deadly virus, said Dr. Eric Frykman, chief of disease control and prevention for the county. Through Thursday, doctors and nurses at nine of 18 hospitals were signed up.

"So far the numbers have fluctuated, depending on the given day," said Frykman, who contends that warnings from professional unions about the dangers of the vaccine have prompted concerns. He said he isn't worried about the initial reluctance from doctors and nurses and expects the number of workers willing to be vaccinated to increase over time.

Smallpox was eradicated in 1972, but if an outbreak occurred, doctors and nurses could still be vaccinated even after they were exposed to the virus, Frykman said.

"At this point, we estimate we will have enough people vaccinated to take care of what we need," Frykman said.

What's happening in San Bernardino County has occurred elsewhere. There has been a reluctance by many hospitals across the country to participate in the voluntary effort, frustrating the nation's top health officials who said it will take weeks to resolve the concerns of emergency health workers.

The federal government prepared to vaccinate as many as 450,000 workers in the first phase of a plan to prepare for a potential bioterrorist attack using the smallpox virus.

The delays in vaccinating hospital workers could slow the next phase of the vaccination program for police officers, firefighters and paramedics and ultimately slow the delivery to the public, federal officials said.

Frykman said his department, using a model from the Centers for Disease Control, is developing a plan for the vaccination of all of San Bernardino County's residents in case of an outbreak.

As of Wednesday, 4,213 people have been immunized in the country, including 38 in Los Angeles County, which has had seven of 81 hospitals decline to participate in the program.

Among area hospitals on the sidelines is the Chino Valley Medical Center, but a final decision hasn't been made.

Karl Van Allen, a registered nurse and director of the emergency department, said few hospital workers who weren't at risk were willing to get the vaccine now.

Allen, whose wife has eczema, said he doesn't want the vaccine because he would have to stay away from her for several weeks to keep from exposing her to the vaccine's virus.

Other colleagues or their families have medical conditions that put them at risk from side effects, which can include fever and body aches, Allen said.

"If I didn't have to worry about my wife, I would get it," Allen said. "A lot of people have fallen out because of the screening process."

Those with skin conditions or weakened immune systems are at risk from the vaccine. Pregnant women shouldn't get vaccinated because of the risk to the fetus and children younger than 1 are also at risk, according to the CDC.

In the past, between 14 and 52 people out of every 1 million vaccinated for the first time suffered life-threatening illnesses. One or two people in 1 million died, according to the CDC.

So far, the Pentagon has reported that of the 100,000 troops it has vaccinated, three have had serious reactions

Frykman wouldn't say whether he will get the vaccine. Although he called the vaccine safe, he said he understands the concerns of health workers and that people need to be aware of the risks and benefits of it. He said health care workers would line up to be vaccinated if an outbreak occurred. Smallpox kills 30% of the population it affects.

There is no smallpox in the world now, Frykman said. Right now, people don't see any risks but, he said that would change with a diagnosis of a case.

Some hospital workers have expressed concerns about whether they would be paid if the vaccine made them sick or if they would have to use sick days to take time off.