If you haven’t seriously considered how you would handle administration of smallpox vaccine to your staff, now’s a good time to start. The Washington, DC-based Department of Health and Human Services (HHS) has recommended that smallpox vaccinations be given to 250,000 to 500,000 individuals, including hospital and emergency workers. This new plan conflicts with a June 2002 recommendation from the Atlanta-based Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices for only 10,000 to 20,000 vaccinations because of concerns about the vaccine’s side effects.
At press time, the HHS plan had been sent to the White House for approval, with a final decision on the number of vaccinations expected shortly. State health officials will determine who will be offered the vaccine.
Eric Lavonas, MD, FACEP, emergency physician and toxicologist at Carolinas Medical Center in Charlotte, NC, says that the complications of a mass vaccination campaign are predictable. Lavonas points to statistics that indicate the vaccine causes serious illness in one out of every 1,000 adults who receives the vaccine for the first time, and one out of every 10,000 adults who is revaccinated.
About half of all health care workers were born after routine smallpox vaccination stopped in 1971, he adds. "We can predict that vaccination of 500,000 health care workers would cause about 2,800 of them to become seriously ill," he says. Still, Lavonas predicts that most ED staff will choose a voluntarily chosen risk such as vaccination over the unknown risk of exposure to smallpox from a terrorist attack.
Resource
For updated information on smallpox vaccination plans, go to the Centers for Disease Control and Prevention's National Immunization Program's home page on smallpox at http://www.bt.cdc.gov/agent/smallpox/index.asp.
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