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Last Updated

07 Mar 2003

Source: Washington Post, March 7, 2003

Smallpox Vaccination Campaign Bolstered

By Ceci Connolly, Washington Post Staff Writer

Several hundred federal health workers will be added to the national smallpox vaccination campaign as part of an effort to reinvigorate a key component of the Bush administration's bioterrorism preparations, officials announced yesterday.

The administration will also give states permission to speed up vaccinations for emergency responders "to make sure we have enough people prepared" for a smallpox attack, said Health and Human Services Secretary Tommy G. Thompson. Authorities had planned to vaccinate as many as 10 million emergency medical technicians, firefighters and police officers after inoculating 500,000 health care workers, but now will allow states to begin the second phase of the program immediately, Thompson said.

The administration's December call for volunteers has resulted in vaccinations for 12,404 medical professionals so far, forcing changes in the program. Most notably, the White House has agreed to support a proposed compensation fund for people who suffer serious complications from the live-virus vaccine.

Under the proposal outlined yesterday, immunized health workers and emergency responders who become seriously ill or die would be eligible for lost wages, medical treatment and a one-time $262,100 payment. People suffering minor illness from the vaccine could receive partial reimbursement for lost wages after missing at least five days of work. The same benefits would be provided to people accidentally exposed to the live-virus vaccine who suffer similar serious reactions.

The creation of a compensation fund, which must be approved by Congress, "removes the major barrier to this program," said Julie Gerberding, director of the Centers for Disease Control and Prevention.

But some health care unions and Democratic lawmakers said the administration proposal does not go far enough. "I am concerned that the $262,000 won't adequately compensate a family who loses its sole breadwinner either because he or she died or has been completely disabled," said Rep. Henry A. Waxman, (D-Calif.) who has drafted a broader compensation proposal. "It doesn't seem fair for a worker who we ask to take the vaccine to bear the cost of up to five days lost wages if they are injured by the vaccine, or to face this cap on wages."

When President Bush unveiled his vaccination policy, Thompson said he intended to have the 500,000 hospital and public health workers inoculated by March 1. "There is no question we wish there were more people willing to be vaccinated," he said yesterday. With that effort flagging, officials decided to immunize hundreds of CDC workers, members of the Public Health Service Commissioned Corps and rescue workers, Gerberding said.

But Patrick Libbey, head of the National Association of City and County Health Officers, said inoculating emergency responders does not help the CDC meet its top priority of having medical personnel available to treat initial cases and run mass vaccination clinics in the event of a smallpox outbreak. Accelerating the inoculation of police officers and firefighters, he said, "is fundamentally moving into a whole different purpose of vaccination."

Although the compensation issue has been a major stumbling block, the medical community has also voiced concern that the dangers of the vaccine outweigh the risk of a germ attack. For every 1 million people immunized, historical data suggest that about 1,000 people may suffer moderate complications such as fever and exhaustion and that one or two may die.

Yesterday, many of the same health leaders who previously played down worries about a smallpox attack ratcheted up their rhetoric. "Smallpox is a disease that our public health experts fear so much, because it is so contagious and it can spread so quickly and it is so deadly," Thompson said.

Federal officials have said that they fear terrorists or enemy nations could use the virus as a weapon, but that the only known stocks are in guarded labs in the United States and the former Soviet Union.