IOM, NYCOSH against Bush’s smallpox policy
Both the Institute of Medicine (IOM) and the New York Committee for Occupational Safety and Health (NYCOSH) have recently issued concerns about the government’s plans for smallpox vaccinations.
A committee of the IOM, established to advise the Centers for Disease Control and Prevention (CDC) on its implementation of a smallpox immunization program, urged the CDC to proceed cautiously with the program. The committee’s report advised that CDC take the time necessary to analyze outstanding issues and concerns to ensure that the campaign is carried out as safely as possible.
William F. Henning Jr., chairman of the board of directors of NYCOSH, was even more direct:
"The nation needs a smallpox vaccination plan that doesn’t make the threat worse. I’m sorry to say that the president’s plan doesn’t meet that standard," he says. "Under the president’s plan, half a million civilians are going to be in the first wave of people vaccinated. Every one of them is a worker, and they must get at least as much protection from the vaccination process as they get from any other on-the-job hazard."
The IOM panel said the CDC needs to address how people who are vaccinated are compensated for medical expenses and other losses incurred through vaccination.
"While we recognize that CDC has been asked to initiate the immunization campaign rapidly, it’s important to remember that recipients of the vaccine are voluntarily assuming its risks for the greater good," says Brian Strom, MD, MPH, University of Pennsylvania School of Medicine and chairman of the committee. He says learning from experience, making midcourse corrections and maintaining communication with the public are integral to developing the program.
In the Jan. 16, 2003, New York Times, reporter Denise Grady cited portions of a confidential draft of the panel’s report that indicated panel members felt the government’s plan was too hastily written and did not have adequate safeguards. Concerns about the program, she wrote, centered on risks from the vaccine, which has more dangerous side effects than other vaccines and caused one or two deaths per million vaccinations when it was in routine use. The panel urged that there be enough time allowed between the two phases to evaluate the first phase and apply any lessons learned.
The panel also recommended that the CDC identify specific criteria, such as adverse effects from the vaccine, which would lead it to reconsider its guidelines for who should be vaccinated and how potential recipients should be screened.
Henning agrees. "Before the inoculations begin, the government needs to answer some tough questions about the vaccine’s side effects and their costs," he says.
NYCOSH says that by the government’s estimates, one-third of the people vaccinated are likely to be made sick enough to miss a day or two of work. All that lost time should be charged to the government, not to the sick leave of the individual who misses work, says NYCOSH. Workers who do not have sick leave should be paid for the time missed.
"The government’s plan is completely silent on this question," asserts NYCOSH.
Also, by the government’s estimates, between seven and 26 of the health care workers vaccinated in the first wave are likely to develop life-threatening side effects, and one of them is likely to die.
"The federal government should agree, in advance, to cover the cost of medical care for side effects and lost work-time," NYCOSH says.
Finally, according to NYCOSH, the government acknowledges that the vaccine is so dangerous that people with compromised immune systems should not take it at all.
"That includes people with HIV/AIDS, because the vaccine could kill them," says NYCOSH. "How is the federal government going to protect the estimated 500 health care workers in the first wave who are scheduled for the inoculation and who are HIV-positive, but don’t know it?"
"Heath care workers are going to be on the front line of any smallpox vaccination program, whenever it is implemented," says Henning. "Anyone who is enlisted in this patriotic effort should get every medical, social, and financial protection they deserve. The president’s program doesn’t even come close."
Both the Institute of Medicine (IOM) and the New York Committee for Occupational Safety and Health (NYCOSH) have recently issued concerns about the governments plans for smallpox vaccinations.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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