-Caveat Lector-
http://www.newsmax.com/archives/articles/2002/9/23/153652.shtml
Feds Reveal Plans to Inoculate 1 Million for Smallpox
NewsMax.com Wires
Tuesday, Sept. 24, 2002
WASHINGTON � The federal government issued guidelines Monday to state and
local governments detailing how to set up mass-vaccination clinics to
inoculate 1 million people in 10 days in response to a bioterrorist attack
using smallpox.
Although the federal government maintains the national stockpile of the
smallpox vaccine, state and local governments will be responsible for
setting up clinics and vaccinating people if an attack occurs. The Centers
for Disease Control and Prevention in Atlanta is capable of shipping the
vaccine anywhere in the country in a matter of hours.
The guidelines are designed to enable state and local officials to
"effectively and rapidly respond to a smallpox attack," Joseph Henderson,
CDC's associate director for terrorism preparedness and response, said
during a teleconference.
"This guide describes how to set up and run large-scale voluntary smallpox
vaccination clinics," the CDC said in a written statement. "It provides
details on all aspects of immunization clinic operations and staffing and
includes an example of a model smallpox vaccination clinic."
Because smallpox has been globally eradicated, a single case of the disease
in the United States would be enough to trigger the new mass vaccination
guidelines, said David Fleming, the CDC's deputy director for science and
public health. "We would act as if the nation was under attack and
immediately implement this response plan."
Although the guidelines used 10 days as a general timeframe for vaccinating
1 million people, Fleming said the "exact timeframe would depend on the
nature of the circumstances" and could be scaled up or scaled down depending
on the urgency of the outbreak.
Generally, the vaccine needs to be given within three to five days of
exposure to effectively prevent people from contracting the disease.
Dangerous Side Effects for Some
The smallpox vaccine can cause severe side effects, including death, in
people with certain medical conditions such as AIDS and eczema skin rashes.
The new guidelines say these people should not be vaccinated if it is
unlikely they have been exposed.
Walter Orenstein, director of CDC's National Immunization Program, said the
rate of unintentional death due to the vaccine was expected to be about 1
for each million people vaccinated. He noted it could be higher because that
rate is based on vaccination efforts in the 1960s, and there now are "more
people with immune problems and skin rashes that put them at risk of severe
complications."
Smallpox Could Kill 300,000 of Each Million Infected
Even so, that still pales in comparison to the expected rate of death in a
smallpox outbreak, which Orenstein said could be 300,000 fatalities per 1
million people infected.
A product called vaccinia immune globulin can help reduce the severity of
certain side effects, but the CDC has only a limited supply. Officials said
they have contracted with a company to produce more and have asked the
company to speed production so a substantial amount is available by the end
of the year.
Charles Pena, senior defense policy analyst at the think tank Cato
Institute, told United Press International the guidelines were unfeasible.
"I don't know how they think they can vaccinate large numbers of people in a
short period of time." He said an outbreak would cause "panic and chaos"
that would prevent orderly vaccination lines.
"What will they do with the people at risk of developing severe
complications from the vaccine?" he asked.
Vaccinate Now?
The government should pre-vaccinate the entire country now before an attack
has occurred, Pena said.
"For those people who can't be vaccinated, pre-vaccinating creates a
firebreak that could forestall the virus from spreading to that at-risk
population.
"Pre-vaccination is like a win-win-win scenario for everybody involved,
including those who do not get vaccinated," Pena said. "Waiting is a
lose-lose-lose scenario for everybody but the first responders."
Although the government has not finalized its plan for a pre-attack
vaccination, it appears to involve vaccinating thousands of emergency and
health care personnel who would be the first to respond to an attack and
treat victims.
The government has been scrambling to produce enough vaccine to inoculate
the entire country if necessary and it appears it now has just enough to do
so.
Henderson said although all the doses under contract are not ready, there is
enough to vaccinate everyone in the country, if emergency supplies are
tapped.
Copyright 2002 by United Press International.
All rights reserved.
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