MONDAY, Sept. 23, 2002 (HealthDayNews) -- The government today sent to states its template for how to implement voluntary mass smallpox vaccinations in the event of a bioterrorism attack with the killer virus.
Officials at a news conference today said the document doesn't represent a departure from current smallpox policy to contain the virus through widening "rings" of vaccination around contacts of infected patients. Nor does it affect the pre-attack strategy of vaccinating those considered most vulnerable in a smallpox attack, like hospital workers and emergency response crews. The Bush administration has yet to announce its policy regarding pre-attack inoculations and who should get them.
Joseph Henderson, associate director for terrorism preparedness
and response at the CDC, said the government now has 155 million doses of smallpox vaccine it could release tomorrow if necessary. By the end of the year, it hopes to have the rest it needs to cover each of the more than 288 million Americans.
The United States abandoned routine immunization against the virus in 1972, and the World Health Organization declared the infection eradicated in 1980. However, the United States and Russia have preserved samples of the virus, and intelligence experts fear that terrorists or renegade states like Iraq and North Korea may have obtained supplies of it to use as a bio-weapon.
So, if a single case of smallpox were to appear, officials said a bioterror strike would have to be presumed. Smallpox can kill as many as 30 percent of those it infects.
The plan, which has been in the works since last November, calls for states to get their mass vaccination programs up and running with 10 days of the detection of a smallpox case. But that number is a loose guide and might be too generous for some scenarios, said Dr. David Fleming, the CDC's deputy director for science and public health. "The exact time is not going to be predicted in advance," he said.
Dr. Walter Orenstein, director of the CDC's National Immunization Program, said the decision to launch mass vaccinations would be made at the federal level after consultation with state and local authorities. It would depend on the scope of the attack, its duration, and the way the virus was introduced into the environment.
Although states would play a role in the decision to implement mass vaccination, the goal of the plan is coordination, officials said today. As a result, Fleming said the decision to opt for widespread inoculations in one area would trigger full coverage nationwide.
The plan offers guidance on how states should set up dedicated smallpox clinics, including details like layout, disposal of needles, staffing and training, and vaccine storage. It also has tips on how state officials should communicate with the public and health workers during an outbreak.
Fleming said a "back-of-the-envelope" figure for the cost of mass vaccinations might be $5 to $10 a dose, not including the cost to states of building the necessary infrastructure to provide the immunizations.
Evidence from the 1960s showed that side effects of the smallpox vaccine caused about one death per 1 million recipients. However, officials said that number could be higher today because of the greater number of people with weakened immune systems, such as AIDS patients, in the population.
The drug vaccinia immune globulin (VIG) can treat serious reactions to the vaccine, but the government has only about 600 doses on hand. Dr. Lisa Rotz, a CDC bioterrorism expert, said the agency recently arranged with a company to obtain "a substantial number" of additional doses of the substance in intravenous form.
What To Do
For more on the government's terrorism preparedness efforts, check out the Centers for Disease Control and Prevention. You can also try the U.S. Department of Health and Human Services.
