1 in 3 Soldiers Exempt From Vaccination
"Nearly half of those exempted live with someone who is at risk for a side effect. The vaccine is made with a live virus, and it can escape the inoculation site and infect people who come into close contact with the
person vaccinated. "
1 in 3 Soldiers Exempt From Vaccination
By LAURA MECKLER
Associated Press Writer
http://www.newsday.com/news/health/wire/sns-ap-smallpox-vaccine1220dec19,0,7148248.story?coll=sns-ap-health-headlines
December 19, 2002, 7:06 PM EST
WASHINGTON -- The U.S. military has inoculated more than 150 people in the past week against smallpox, but about 100 others were exempted because of medical complications, officials said Thursday, underscoring the importance of careful screening to minimize dangerous side effects.
In Israel, more than half of 42,000 health and emergency workers offered the vaccine have declined for medical and other reasons, with doctors among
the most reluctant, the chief of Israel's program told an expert panel reviewing U.S. plans to resume vaccinations among civilians beginning in early January.
In the first five days of the U.S. military program, 276 people have been screened for the vaccine, with 102 -- 37 percent -- exempted for medical conditions, said Dr. William Winkenwerder Jr., assistant secretary of defense for health affairs. The others got the inoculation.
Nearly half of those exempted live with someone who is at risk for a side effect. The vaccine is made with a live virus, and it can escape the inoculation site and infect people who come into close contact with the
person vaccinated.
The most common medical condition were skin conditions, such as eczema.
So far, there have been no serious complications, and Winkenwerder is hoping that careful screening will mean far fewer problems than were found in the U.S. smallpox program in the 1960s. During that time, there were one or two deaths for every million people vaccinated and at least 15 life-threatening complications.
"We're paying a whole lot more attention to screening," he said.
The vaccinations began last Friday, targeting about 500 people who would serve on smallpox response teams. In the next stage, beginning in January, the Pentagon will vaccinate about 25,000 medical teams in hospitals and large clinics, and up to a half-million troops in high-risk areas, particularly southwest Asia.
In Israel, a total of 17,500 people have been vaccinated so far, with about 20,000 expected before the program is complete, said Dr. Yehuda L. Danon, a
pediatrician at Tel Aviv University and the first to get the smallpox shot in Israel.
"The medical personnel (are) the most difficult to educate. The ignorance is really unbelievable," Danon told the panel convened by the Institute of Medicine. "You hear all kinds of rumors."
He estimated that half of doctors have been vaccinated; nurses are more willing, with about 65 percent saying yes.
So far, Danon said, four Israelis have been hospitalized with conditions that may have been related to the smallpox vaccination, though only two of
them were clearly reactions to the vaccine.
Less serious reactions have been common. Nearly one in three experienced fatigue or weakness, 28 percent had headaches and 18 percent, muscle pain. About one in 10 were nauseous.
The data from Israel and the early experience in the military are helping U.S. health officials prepare for civilian vaccinations to resume after three decades.
First up will be hospital and health care response teams, and to help educate them, officials are busy preparing detailed information about the smallpox vaccine and its risks, including graphic photographs.
"I think, realistically, a picture is worth a thousand words," said Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention.
But she added that people will also be told that the risk of these complications is quite low, particularly for people who do not have skin conditions, compromised immune systems or other risk factors.
CDC officials plan to distribute detailed information outlining risks and benefits and let people know if they should take tests for HIV and pregnancy before taking the vaccine. On Friday, they plan a satellite
broadcast of a video for those considering the vaccine.
CDC officials have asked the Institute of Medicine panel for advice on their education and screening plans, as well as their plans to train doctors about smallpox and to educate the general public.
The panel was asked to work quickly so their advice can be used in the first stage of vaccinations, beginning next month.
Plans for the first stage have been submitted by all 50 states and four cities that get direct funding, and states hope to vaccinate about 440,000 people. A total of 3,600 hospitals -- out of about 5,000 nationwide -- are expected to participate, officials said Thursday.
In the second stage, the inoculation will be offered to about 10 million health care workers and emergency responders, and officials have estimated that about half of them will be vaccinated.
For the military, where inoculations are mandatory, some half-million troops are likely to be vaccinated, although those at risk for side effects are exempted.
