SMALLPOX VACCINATION REACTIONS REPORTED
13 Feb 2003
Source: Associated Press, February 13, 2003
Smallpox Vaccination Reactions Reported
By RANDOLPH E. SCHMID, Associated Press Writer
WASHINGTON - Three serious reactions have been reported out of more than 100,000 military vaccinations against smallpox, the Army's deputy director for military vaccines said Thursday.
Col. John D. Grabenstein told an Institute of Medicine panel there have been two cases of encephalitis and one heart infection associated with the vaccinations. All three people have recovered and returned to duty, he said.
"We're seeing a rash of rashes," Grabenstein said, but overall bad reactions are occurring at a lower rate than had been expected.
Off to a slower start is the civilian smallpox program, with just 1,043 people vaccinated as of Feb. 11, said Joe Henderson, associate director of terrorism preparedness and response at the Centers for Disease Control and Prevention.
He said no serious reactions have been reported in this group, mainly public health and safety personnel.
Henderson said he was not surprised by the low number of vaccinations and predicted substantial increases over the next few weeks as more states get involved.
Concerns about liability and compensation for people who suffer reactions have slowed the civilian program, but Henderson said only one state, Michigan, has declined to take part until that is resolved.
When the national smallpox vaccination program was announced, as preparation for a potential attack, the rate of serious reactions was estimated at about 40 per million people being vaccinated for the first time, with one or two deaths.
Routine smallpox vaccinations were discontinued in the 1970s. People born before that probably had a vaccination, while younger people will be vaccinated for the first time. The reaction rate is expected to be lower for people being revaccinated.
In the 1970s, the only remaining stocks of the variola virus that causes smallpox were kept in Russia and the United States. But concerns have risen in recent years that some of the virus may have fallen into the hands of terrorists or countries such as Iraq.
Grabenstein said 63 percent of those vaccinated in the military program are getting the vaccine for the first time.
In addition to the three cases classified as serious, Grabenstein said there have been seven cases of generalized vaccinia — a widespread rash — and a variety of minor complaints including fever, malaise, swollen lymph nodes and swelling at the site of the vaccination.
Overall, he said, 4 percent to 5 percent of people receiving a first vaccination have missed a day or more or work, compared with 1 percent to 2 percent of those being revaccinated.
Of the serious reactions reported, one encephalitis case and the heart infection were from new vaccinations, both involving people in this country. The other encephalitis case, treated in Germany, was a revaccination, he said.
Henderson characterized the civilian program as a success despite the low number vaccinated so far, noting that the main effort has been in providing vaccine to the states and setting up education programs and infrastructure for the work to proceed.
"We're much better prepared than we were even three weeks ago," he said.
The CDC is also working with state health departments to collect information about those receiving the vaccine and, if any refuse it, why, he said.
The vaccination uses the live vaccinia virus, a less potent cousin of smallpox, and people receiving it need to keep the site covered until it heals to avoid passing it along to others.
Noting that concern, Grabenstein said the most commonly asked question among the military receiving the vaccine is whether they can have sex afterward.
The answer? Sure, but "wear a T-shirt," he said.
The Institute of Medicine is a branch of the National Academies, an independent organization chartered by Congress to advise the government on scientific issues.