Some ICPs, epidemiologists likely will be on smallpox response teams
Bioterror fears drive decision to break out vaccine
|
Infection control professionals — particularly those already working with public health or in hospitals designated for smallpox patients — may be asked to join a smallpox response team in the coming months. If you join, you will be among a new wave of people receiving vaccine for smallpox, a disease that has been completely eradicated in the wild. But in a historic concession to the new age of bioterrorism, the Centers for Disease Control and Prevention (CDC) on June 20 recommended that state-based teams of health care workers and public health officials be immunized against smallpox. However, the vaccine will not be offered to the public or health care workers in general, as the potential side effects of the vaccine outweigh the risk of exposure. The landmark decision, coming three decades after broad-scale smallpox immunizations were discontinued in the United States, was made in a unanimous vote by the CDC’s Advisory Committee on Immunization Practices (ACIP).
ACIP recommended smallpox vaccination "for people predesignated by the appropriate bioterrorism and public health authorities to conduct investigation and follow-up of initial smallpox cases that would necessitate direct patient contact."
The smallpox response teams might include medical team leaders, public health advisors, medical epidemiologists, disease investigators, diagnostic laboratory scientists, nurses and other trained vaccinators, and security/law enforcement personnel, ACIP recommended. "Such teams may also include medical personnel who would assist in the evaluation of suspected smallpox cases." In that regard, the panel voted to vaccinate "selected personnel in facilities predesignated to serve as referral centers [so-called type C’ hospitals] to provide care for the initial cases of smallpox. These facilities would be predesignated by the appropriate bioterrorism and public health authorities, and personnel within these facilities would be designated by the hospital."
ACIP’s decision essentially delegates the formation of the teams to bioterrorism planners in individual states. The total number nationwide who will opt for the voluntary vaccine is estimated at 10,000 to 20,000. In making the decision, ACIP emphasized that much planning and implementation remains to be done at national and state levels. The recommendations should "catalyze" the public health and clinical response to bioterrorism, said William Schaffner, MD, a nonvoting liaison member of the committee. Either extreme — offering vaccine to all or holding it back until an attack — was a flawed strategy, said Schaffner, chairman of the Department of Preventive Medicine at Vander-bilt University in Nashville, TN.
"This is the direction I was hoping the committee would go," he said. "It knits together the public health response and clinical care. That is very important. This will oblige the public health network and the major hospitals to collaborate, to have conversations. And that’s a great thing."
The committee recommended that each state establish and maintain at least one smallpox response team. Consideration for additional teams should take into account population and geographic factors. The recommendations await final approval by the Dept. of Health and Human Services. The vote came after a workshop meeting, where the CDC solicited advice and opinion.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content