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Smallpox
vaccinations
to start

3,500 due for shots here

Public availability set for 2004


Star-Bulletin staff

The state plan to vaccinate up to 3,500 Hawaii public-health and health-care workers against smallpox has been filed with the Centers for Disease Control and Prevention.

"The probability of an intentional release of smallpox virus is low, but because the outcome is so serious, as with any infectious disease, we must be ready to respond," said Dr. Paul Effler, chief of the Department of Health Communicable Disease Division.

He said vaccinating the response teams enables them to move quickly to protect the public by identifying those needing vaccination to control an outbreak and establishing vaccination clinics.

Vaccination of response teams could begin next month, pending CDC's approval of Hawaii's plan and release of vaccine, according to the Health Department.

Participation in the vaccination program will be voluntary, with eligibility based upon the roles public-health and health-care providers may have in an outbreak.

Those with a history of eczema or other skin conditions, pregnancy or HIV infection will not be considered for the first vaccinations.

Meanwhile, representatives of the various military services here say they have not been directed to implement any plan to inoculate their personnel against smallpox.

A Pacific Fleet spokesman would only say "the Navy is currently reviewing its procedures so it would be able to implement such a program once directed, but as yet it has not received any such direction."

Hawaii's Health Department is working with state hospitals through the Healthcare Association of Hawaii and the medical community to identify and inform potential health-care response team members. The agency also will draw response team members from its own employees.

Smallpox was declared eradicated from the world in 1980, but experts fear that it could be used by hostile nations or terrorist groups in an attack.

President Bush plans to make the smallpox vaccine available to all Americans on a voluntary basis to guard against a bioterrorist attack, senior administration officials said yesterday. The president will order military personnel to begin getting smallpox vaccinations and launch a plan to offer the vaccine to emergency medical workers and response teams within weeks, the officials said.

States have been asked to submit plans for a National Smallpox Vaccination Program.

Hawaii's plan includes establishment of readiness teams for each county with a basic core of professionals.

They would include a medical epidemiologist or physician, an epidemiology specialist, mcirobiologist or laboratory specialist, a public health nurse or immunization specialist and a paramedical assistant.

The Health Department said an estimated 4,500 doses of vaccine are needed to cover 3,500 people. Vaccination clinics are planned for each county, with vaccine administered by public health nurses.

The department submitted a separate plan to CDC Dec. 1 describing how the state would response to a case of smallpox.

The department received $9 million from the federal center in May to conduct a Bioterroism Preparedness Program, which now has nearly 35 staff members working with local and national institutions.

For more smallpox information, see the DOH Web site, www.state.hi.us/doh, or the CDC Web site, www.cdc.gov.


Star-Bulletin reporters Helen Altonn and Gregg Kakesako and the Associated Press contributed to this report.


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The president will
announce plan to make
vaccine available to all


Associated Press

WASHINGTON >> President Bush has decided to make a risky but effective smallpox vaccine available to all Americans, beginning with the military and health workers who would be front-line defenders against a bioterror attack.

Bush will announce the program tomorrow, and shots are to begin in January, senior administration officials said.

The shots will be mandatory for about 500,000 military personnel and recommended for the 500,000 people who work in hospital emergency rooms and on smallpox response teams.

The public will be offered the vaccine on a voluntary basis as soon as large stockpiles are licensed, probably early in 2004.

Bush had to weigh the risks of the often-deadly disease against the dangers of the vaccine, which produces more serious side effects than any other vaccine used in America.

Bush has emphasized his concerns about the vaccine and said yesterday that people have to consider its dangers.

"It's going to be very important for us to make sure there's ample information for people to make a wise decision," Bush said yesterday on ABC's "World News Tonight" program.

Federal health officials are preparing a massive public education campaign about both the disease and the vaccine. Polls show most people would choose to receive the vaccine if given the chance. But health officials fear that many do not understand the risks.

Based on studies from the 1960s, about 15 out of every 1 million people vaccinated for the first time will face life-threatening complications, and one or two will die. Reactions are less common for those being revaccinated. "The success of a vaccination program is going to depend on our success in communicating with people accurately and openly," Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention, said yesterday.

Smallpox killed hundreds of millions of people in past centuries, but it hasn't been seen in this country since 1949 and was declared eradicated worldwide in 1980. But experts fear that it could be used by hostile nations or terrorist groups.

Dr. D.A. Henderson, a federal bioterrorism adviser who led the global campaign to wipe out the disease, said he hopes the administration will evaluate the results of early vaccinations before actually offering the shot to the public. "I must confess, I thought we'd seen the very last of smallpox vaccine," he said yesterday. "It troubles me every time I think about this."



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