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Last Updated

21 Jun 2003

Source: Newsday, June 21, 2003

Smallpox Vaccine Called Risky

By Delthia Ricks, STAFF WRITER

Emergency workers and other civil servants should not be vaccinated in the nation's ongoing smallpox inoculation campaign because of possible cardiac risks, a government advisory panel recommended Friday.

The decision by the Advisory Committee on Immunization Practices could halt expansion of the campaign, which is the centerpiece in the Bush administration's bioterrorism preparedness plan. The vaccination campaign was supposed to move into its second, and larger round throughout summer. Volunteers among firefighters, ambulance drivers and other emergency workers were expected to line up for the inoculation. Federal health officials had estimated that nearly 10 million volunteers would participate.

The committee, which advises the Centers for Disease Control and Prevention on a wide range of immunization issues, including smallpox vaccinations, nevertheless commended the CDC on its handling of the massive program, which got under way in January. In an early draft of the recommendation released Friday, panelists said critical smallpox preparedness activities must continue, such as training health care teams in the event of a terrorist attack.

But the advisory panel decided that certain heart conditions developed among a fraction of vaccine recipients posed too great a risk to expand the campaign. Committee members cited myocarditis, an inflammation of the heart's muscle; pericarditis, an inflammatory condition of the sac surrounding the heart; and myopericarditis, a combination of the two conditions, as reasons not to expand. The heart conditions first surfaced in March in civilian and military inoculation programs. Reports of the disorders have occurred sporadically ever since.

To date 37,600 health care workers have been vaccinated, far fewer than the 400,000 federal officials had expected by spring. CDC spokesman Curtis Allen said details of the recommendations are to be published next week in the agency's Morbidity and Mortality Weekly Report.

But Dr. Julie Gerberding, the CDC's director, said the vaccination program, announced by President George W. Bush in December, is not dead. A separate military arm of the campaign has already inoculated 350,000 members of the armed forces. Inflammatory heart ailments have surfaced in the military as well. Military doctors counted 15 cases among soldiers. None of the conditions was life-threatening, but were worrisome, military medical experts said.

"CDC has been very aggressive in achieving smallpox preparedness," she said. "We have no information to say that the risk of smallpox has changed since that time. There is no evidence of an imminent threat, but the the risk is not zero. We are not finished in this effort, working with state and local health departments."