- The Washington Times - Thursday, October 17, 2002

ATLANTA (AP) A federal committee voted yesterday to recommend vaccinating about 510,000 hospital workers against smallpox, bringing its earlier proposal closer to the Bush administration's suggestion.

The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices voted 8-1 for the plan, which amounts to vaccinating about 100 workers at every hospital in the nation that could handle smallpox patients.

Those receiving shots at the hospitals with "negative pressure rooms" would include emergency room doctors, nurses, radiology technicians, and selected security and housekeeping workers.

The vaccine can cause dangerous side effects, even death, in a fraction of patients. Smallpox has been declared eradicated from the globe, but some experts fear that terrorists have samples of the virus and could use it as a devastating biological weapon.

The recommendation is not binding, and the final decision on vaccines will be made by the CDC, the Department of Health and Human Services and the White House.

Under the recommendation, the 510,000 hospital employees would get the shots first. The vaccine would then be made available to other health care and emergency workers, and finally to the public.

The committee chose the plan over two other proposals:

•Its original recommendation, which was to establish regional hospitals that would handle all smallpox cases and vaccinate emergency workers and select staff about 20,000 people.

•Vaccinating all of the nation's first responders firefighters, paramedics and police officers who could come in contact with smallpox cases. That would involve inoculating up to 10 million people. This plan is similar to one suggested by Bush administration officials earlier this month.

Committee members said that they changed their earlier recommendation after more study and feedback, not political pressure.

"Many hospitals, particularly those with negative pressure rooms, need to be prepared, because you can't say where smallpox patients will arrive," said Dr. Guthrie Birkhead.

Dr. Birkhead said that the regional plan had some weaknesses, including hospitals not wanting the stigma of being the "regional smallpox hospital."

Dr. Paul Offit of the Children's Hospital of Philadelphia was the only dissenting board member.

"We're thinking about immunizing 500,000 people in a country for a disease that is still theoretical. We haven't seen a case of smallpox on this planet for 25 years," he said. "If there's not a case of smallpox, we will be doing more harm than good."

Dr. Offit suggested not vaccinating anyone until a case of smallpox is found.

Routine smallpox vaccinations in the United States ended in 1972 when health officials noticed that complications from the vaccine, rather than the virus, were hurting more people. Experts say 15 out of every million vaccinated for the first time will face life-threatening complications, and one or two will die. Reactions are less common for those being revaccinated.

Some experts say that the virus which can kill about 30 percent of non-vaccinated, infected people can cause much more harm today than the vaccine can, especially if used as a weapon by terrorists. But others fear that the smallpox shot may be useless if terrorists alter the virus.

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