Panel Urges Smallpox Vaccine Warnings
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PANEL: SMALLPOX VACCINE WARNINGS NEEDED
WHITE HOUSE ADVISED TO TELL HEALTH WORKERS OF VACCINATION RISKS
Friday, January 17, 2003
WASHINGTON (AP) -- The Bush administration should tell health workers being
offered the voluntary smallpox vaccine that it carries real risks and they
are likely to receive only minimal compensation if they are injured,
scientific experts said Friday.
"The committee suggests explicitly stating that the benefit of the
vaccination program is to increase the nation's public health preparedness,
but that the benefit of vaccination to any one individual might be very
low," the panel reported to the Centers for Disease Control and Prevention.
The panel, convened by the Institute of Medicine, also urged the White House
to analyze the first round of inoculations -- set to begin next week --
before offering the vaccine to millions of other health care workers and
The last case of smallpox in the United States was more than 50 years ago.
Routine vaccinations here ceased in 1972, but experts fear the disease could
return in an act of bioterror.
Still, the risk of such an attack is unknown, the Institute of Medicine
noted, while the risks of the vaccine are well documented. Based on
historical information, as many as 40 people out of every million being
vaccinated for the first time will face life-threatening reactions, and one
or two will die.
President Bush's plan calls for a quick, voluntary vaccination of nearly a
half million people working in hospital emergency rooms and those on special
smallpox response teams. The panel emphasized that information about risks
and benefits must be clearly communicated to them.
The experts also recommended that people be told that they may not receive
any compensation if they are injured by the vaccine.
Congress acted to protect people and institutions delivering the vaccine
from most lawsuits that could be filed by those injured by the inoculation,
leaving such patients with little recourse. Under the policy, injured people
may have access to state workers' compensation programs, but those programs
are not likely to cover all medical expenses and time lost from work.
An existing compensation fund helps people injured by other vaccines, but it
does not cover smallpox. So far, the administration has not proposed any
similar fund for smallpox.
The panel advised the Bush administration to look for "bold and creative"
solutions to provide compensation to people who are injured.
Without a way to reimburse people for their lost work time and medical
expenses, the panel said, "some, perhaps many" people may decline to get
vaccinated, thus "undermining the effectiveness" of the program.
The report also recommends that federal officials move slowly from the
program's first phase, set to begin next week. In the second phase, the
vaccine would be offered to some 10 million people, including other health
care workers and emergency responders such as police and firefighters.
Friday's report recommended that the CDC evaluate the rate of serious
reactions, the effectiveness of its educational material and the variation
in vaccination policies from round one before moving to the second group of
The CDC also should name a "single voice" to communicate with the public --
someone with a strong scientific background and widely recognized
credibility, the panel said.
"To safeguard the separation between political and public health
communications, the key spokesperson should not be a politician," the report
During the 2001 anthrax attacks, the administration was roundly criticized
for inaccurate information given by politicians, particularly in the early
days of the crisis.
Friday's report comes a day after a pair of large health care unions argued
that a delay in the program is needed to address many of the same issues
spotlighted by the Institute of Medicine. The White House responded Thursday
that the program would move forward as planned.
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