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Smallpox Vaccine Guidelines Readied

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    NHNE News List Current Members: 690 Subscribe/unsubscribe/archive info at the bottom of this message. ... EDITOR S COMMENT: If there is an outbreak of
    Message 1 of 1 , Sep 23, 2002
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      NHNE News List
      Current Members: 690
      Subscribe/unsubscribe/archive info at the bottom of this message.

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      EDITOR'S COMMENT:

      If there is an outbreak of smallpox, and if the policy outlined in the story
      below is set in motion, then it will be important for all of us to be as
      informed as possible. I have, therefore, included a list of links along with
      this article to balance the often panicky and poorly researched smallpox
      policies trumpeted in the mainstream press. In particular, I would encourage
      all of you to read this post:

      SMALLPOX OUTBREAK: WHAT TO DO (8/20/2002):
      http://groups.yahoo.com/group/nhnenews/message/3592

      I also encourage you to keep a copy of all the information included in these
      articles for future reference -- just in case...

      --- David Sunfellow

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      SMALLPOX VACCINE GUIDELINES READIED
      EMERGENCY PLAN TO COVER ALL OF U.S.
      By Ceci Connolly
      Washington Post
      Monday, September 23, 2002; Page A01

      http://www.washingtonpost.com/wp-dyn/articles/A52992-2002Sep22.html

      Federal health officials will issue detailed guidelines today for
      vaccinating the entire U.S. population against smallpox within five days of
      an outbreak of the dreaded disease.

      Intended as a blueprint for state and local health officials nationwide, the
      unprecedented move reveals a growing belief within the Bush administration
      that even one case of smallpox anywhere in the Western Hemisphere would
      signify a terrorist assault and should therefore trigger a far more massive
      response than officials had previously suggested, said two experts involved
      in the planning.

      The manual being sent to health commissioners in the 50 states and the
      District of Columbia offers advice on how to operate mass vaccination
      clinics -- from logistical issues such as parking to the medical challenge
      of treating severe side effects. It offers suggestions on utilizing the
      National Guard, recruiting translators, building intricate data systems and
      contending with extreme weather conditions.

      For now, the Bush administration does not anticipate inoculating the
      nation's 288 million residents -- partly because the threat of an attack is
      unknown and partly because the vaccine can cause severe, sometimes fatal,
      side effects. The vaccination plan would be activated only if an outbreak of
      the deadly disease occurred, an event administration officials characterize
      as unlikely but not impossible.

      "This is a very detailed, thoughtful recipe for response" to a bioterror
      incident, said Michael Osterholm, a public health expert at the University
      of Minnesota who is advising the federal government. Using the template,
      states and cities should be able to devise plans "for vaccinating the
      largest amount of people in the shortest time possible," he said.

      Smallpox has not been seen in the United States for decades, and the disease
      was declared eradicated worldwide in 1980. Still, it is perhaps the most
      feared biological weapon because it is contagious, often incurable and can
      kill at least one-third of its victims. Since routine vaccination was halted
      in this country in 1971, there is little immunity left in the population and
      little expertise in dealing with the disease or vaccine.

      Only the United States and Russia are known to possess stocks of the virus,
      but security experts fear a hostile nation such as Iraq may have acquired a
      cache of the virus. Vice President Cheney has contended the risk of attack
      may necessitate inoculating every American as a protective measure.

      "One of the real concerns about Saddam Hussein, as well, is his biological
      weapons capability," he said recently on NBC's "Meet the Press." "The fact
      that he may, at some point, try to use smallpox, anthrax, plague, some other
      kind of biological agent against other nations, possibly including even the
      United States."

      Ten months ago, Health and Human Services Secretary Tommy G. Thompson signed
      a $428 million contract to buy a dose of vaccine for every American.
      Production is under way, and the United States already has stockpiled nearly
      100 million doses.

      Federal experts since have been working furiously on two tracks: a
      vaccination program for the emergency medical workers most likely to see an
      initial case of smallpox, and a mass vaccination plan if an attack occurs,
      said Julie L. Gerberding, director of the federal Centers for Disease
      Control and Prevention.

      "We have to be able to do both," she said in a recent interview.

      Pre-vaccination, as it is known in public health, would be targeted to
      medical personnel, who could respond to an attack knowing they are
      protected. Plans are underway to begin vaccinating tens of thousands of
      "first responders," perhaps by the end of this year.

      There have been no plans to make the vaccine available to the public in the
      absence of any cases. But officials have been debating what would be the
      best response to an outbreak. Last winter, the CDC released a blueprint for
      containing a smallpox outbreak based on the "ring vaccination" strategy used
      during the campaign to eradicate the disease. Ring vaccination involves
      starting with the people closest to an exposure and working out in
      concentric circles.

      There is growing recognition, however, that although that approach worked
      well for a naturally occurring outbreak during a time when air travel was
      rare, it would be no match for a terrorist with the ability to release the
      virus in several locations simultaneously, said Jerome M. Hauer, acting
      assistant secretary for HHS's Public Health Emergency Preparedness.

      "You begin with ring vaccination, but in a big outbreak obviously mass
      vaccination would be part of the plan," he said. Federal officials are
      requiring states to develop plans for vaccination within five days, he said,
      because it is widely believed that even if a person has been exposed to the
      virus, a vaccine given in that time frame will provide immunity.

      Administration officials refused to release the manual until state health
      commissioners receive it. But in interviews with The Washington Post,
      several described the scenario for responding to a smallpox attack.

      At the first hint of a smallpox case, the CDC in Atlanta would begin
      dispatching emergency teams to the area to confirm the outbreak and begin
      vaccination.

      Yet the suspicion that terrorists would strike more than one location "would
      require us to be in many, many places simultaneously," one federal planner
      said. "That would completely deplete our assets."

      Instead of sending its staff to every corner of the country, the CDC plans
      to ship the vaccine and let states handle inoculation, Osterholm said. The
      National Pharmaceutical Stockpile, he said, "can be at any hamlet in this
      country in 12 hours." Officials have not said how much it would cost or how
      it would be paid for.

      HHS has received assurance that even if air traffic were halted, as it was
      immediately after the Sept. 11 attacks, planes transporting vaccine would
      have clearance. Vaccine would be delivered in waves much the way a grocery
      store receives its weekly shipment of milk in batches.

      The manual, which is almost 100 pages, was developed in consultation with
      local health officers, medical societies, the military and businesses such
      as UPS and Federal Express that have logistical expertise, said an adviser
      to Thompson. Much of its contents were based on previous large-scale
      vaccination programs, such as the 1995 meningitis outbreak in Mankato,
      Minn., in which 26,000 people were inoculated in four days.

      Each state must determine where vaccination clinics would be located, who
      would staff them, how to counsel people on the potential risks of
      vaccination and most importantly, how to move hundreds of thousands of
      people through the process calmly and quickly. Some communities might select
      large shopping malls or sports arenas because of parking availability;
      metropolitan centers might rely on buses and subways to bring people to
      clinics.

      Every state will need provisions for everything from inclement weather to
      the person who faints at the sight of a needle, Osterholm said. "Are you
      going to have a line stretching 21/2 blocks in the snow or blistering heat?"
      he said, describing one challenge.

      The guidelines urge states to address the need for bathrooms,
      transportation, a media strategy and a medical questionnaire, as well as how
      to separate and treat any potential smallpox cases. They also include sample
      consent forms if states must administer an unlicensed vaccine. Two
      administration sources said they hope the vaccine soon will be re-licensed.

      Although bioterrorism is a new challenge, large vaccination campaigns are
      not, Osterholm said. "The public health system delivers vaccine to our
      nation's children every day, overcoming language, transportation and
      financial hurdles," he noted.

      Aside from an assumption that some health care workers will be vaccinated
      before an attack, the document does not resolve enormous questions
      surrounding that issue.

      Last month, Thompson sent recommendations to the White House on how many
      people should be inoculated in advance. Although a CDC advisory panel has
      recommended vaccinating about 20,000 medical personnel, several
      administration sources said President Bush is weighing a proposal on the
      order of 500,000 people.

      "Until a decision is made on pre-vaccination," Hauer said, "our efforts
      continue to focus on bioterrorism detection and response."

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      PREVIOUS NHNE NEWS LIST ARTICLES:

      SMALLPOX OUTBREAK: WHAT TO DO (8/20/2002):
      http://groups.yahoo.com/group/nhnenews/message/3592

      DOUBTS OVER SMALLPOX VACCINES EMERGE (7/30/2002):
      http://groups.yahoo.com/group/nhnenews/message/3497

      TWO ARTICLES: MMR VACCINATIONS CONNECTED TO AUTISM (8/10/2002):
      http://groups.yahoo.com/group/nhnenews/message/3559

      CONGRESSMAN CALLS FOR CRIMINAL PENALTIES AT VACCINE MERCURY HEARINGS
      (7/20/2002):
      http://groups.yahoo.com/group/nhnenews/message/3443

      U.S. TO VACCINATE 500,000 WORKERS AGAINST SMALLPOX (7/7/2002):
      http://groups.yahoo.com/group/nhnenews/message/3371

      LIVING WITHOUT VACCINATIONS (12/8/2001):
      http://groups.yahoo.com/group/nhnenews/message/2371

      LEADING DOCTORS' GROUP OPPOSE MANDATORY VACCINATIONS (11/4/2001):
      http://groups.yahoo.com/group/nhnenews/message/793

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      RELATED WEBSITES:

      NATIONAL VACCINE INFORMATION CENTER (NVIC):
      http://www.909shot.com

      DR. CLASSEN'S VACCINE SITE:
      http://www.vaccines.net/%c2%a0

      IMMUNIZATIONS:
      http://www.pcslink.com/~klove/immunize.htm

      VACCINE INFORMATION AND AWARENESS (VIA) WEB SITE:
      http://www.access1.net/via/

      CONCERNED PARENTS FOR VACCINE SAFETY:
      http://home.sprynet.com/~gyrene/index.htm

      ANTHRAX VACCINE INFORMATION:
      http://www.anthraxvaccine.org

      VACCINATION NEWS:
      http://www.vaccinationnews.com

      VACCINEWEBSITE.COM:
      http://www.vaccinewebsite.com

      DR. TIM O'SHEA'S THEDOCTORWITHIN.COM:
      http://www.thedoctorwithin.com/index1.html

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