- The Washington Times - Sunday, December 1, 2002

LAS VEGAS (AP) In a town known for high-stakes gambling, Suzanne Lau is ready to risk a small chance of injury and even death to be vaccinated against smallpox.
A nurse at one of the city's busiest emergency rooms, she probably will be among the first Americans in three decades to be offered the vaccine. She does not betray any of the angst that has consumed federal officials completing vaccination plans for the nation.
"It's what you do. It's part of the risk of the job," said Mrs. Lau, whose hospital ID hangs on a red, white and blue cord stamped USA around her neck. "We're here to take care of the patients. That's the bottom line."
The government is preparing for the possibility of a bioterror attack that would use smallpox, a deadly and incurable virus, but President Bush has yet to say who will be offered the vaccine.
The plan being considered would offer the inoculation first to those most likely to come in contact with a contagious smallpox patient: people assigned to special smallpox response teams in each state and those who work in hospital emergency rooms. About a half-million vaccinations are expected during this first stage.
It will put emergency rooms such as University Medical Center's at the forefront of that readiness effort. If there were to be an attack, doctors at the Las Vegas facility would also be responsible for spotting smallpox, a particular challenge given that the disease has not been seen in this country for half a century.
For now, the issue is vaccination.
The government will soon undertake an education campaign to ensure that people understand the risks of the vaccine, which is more dangerous than any other.
In the 1960s, 15 out of every million people being vaccinated for the first time faced life-threatening complications, and one or two died. Side effects included horrible rashes and brain-destroying diseases.
Some people who came into close contact with those vaccinated also got sick when the live virus used in the shot escaped and touched them.
But most workers at the University Medical Center emergency room voice little concern and say smallpox is much more to be feared than the vaccine.
"The odds are with you," nurse Tom Erichsen said. Nurse Beth Leoni added, "I've seen pictures of smallpox, and it scared the hell out of me."
Mrs. Lau says she would send her 6-year-old son to live with his grandparents during the days after her inoculation, just to be sure he is not exposed.
Hearing the statistics about side effects, Dr. Tom Higgins is nonchalant. "That's probably safer than most drugs we use on a daily basis," he said.
This instinctive willingness to be vaccinated has some worried. Health care workers need to understand the vaccine's dangers, said Cheryl Peterson, senior policy analyst for the American Nurses Association.
"Most of us got the vaccine when we were a child, and we never heard about any problems. We just went and got it," she said.
But that was a time when the disease was still prevalent. The last smallpox case was in 1977.
There is some nervousness about the vaccine in the Las Vegas emergency room.
Secretary Patti McGill said she does not trust the government enough to get an annual flu shot, much less be vaccinated for smallpox.

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