Smallpox vaccine to be ready ahead of schedule

WASHINGTON — A federal health agency said yesterday that it had arranged for the maker of a smallpox vaccine to deliver millions of doses next year — two to three years ahead of schedule — as a hedge against one of the most feared forms of potential biological attack.

The action by the Department of Health and Human Services comes as rising fears of bioterrorism are putting a renewed focus on vaccines as a method to protect citizens and soldiers.

The Biotechnology Industry Association last week issued an "urgent" inquiry to more than 1,000 companies asking, among other things, for their ideas on how to draw more companies into the vaccine business.

And Defense Department officials are sorting through how to boost their program to vaccinate the armed forces against anthrax.

Terrorism experts say it is unlikely that the United States would face a biological attack. But more than a dozen nations and terrorist groups are believed to have tried to develop biological weapons, with various degrees of effort and success.

Anthrax is considered one of the most likely lethal agents to be turned into a weapon, and smallpox, while less likely, is feared because it is highly contagious.

The federal government last year contracted with Acambis — a British company with operations in Cambridge, Mass. — to produce 40 million doses of a new type of smallpox vaccine.

Yesterday, however, the Department of Health and Human Services said it had arranged for Acambis to deliver all 40 million doses by mid- to late 2002, well ahead of the previous delivery date of 2004 or 2005.

Federal officials have about 15 million doses of an older smallpox vaccine on hand. The government will stockpile both the old and new vaccines for use in an emergency, department spokesman Kevin Keane said. They will not be available to doctors for general preventive use, he said.

Similarly, there are no plans to make an anthrax vaccine available to the public.

Since the Sept. 11 attacks, more than 1,000 people have contacted the sole maker of a government-approved anthrax vaccine to ask about its availability.

The company, BioPort of Lansing, Mich., has received so many calls that it is directing people to a recorded message.

The company makes the vaccine only for the Defense Department. BioPort spokeswoman Kim Brennan Root said the company has held some internal discussions about how to make the vaccine available to the general public, but she could provide no timetable for when people might be able to obtain the vaccine.

In case of an anthrax outbreak, health officials would draw on a government antibiotics stockpile to treat citizens.

The Defense Department originally wanted to vaccinate all 2.4 million active and reserve troops against anthrax, but it has scaled back its plans because of a vaccine shortage.

Personally, I feel that smallpox is a bigger threat than Anthrax because it is highly contagious.

Recently there has been a big backlash against immunizations in general because of suspected health risks. Parents have protested school regulations that require immunizations for attendance. In some cases, especially with smallpox, the risks from the vaccine can be worse than the risks of exposure. Studies have shown that certain groups of people may contract fatal complications from the smallpox vaccine.

Would you be willing to get the vaccine, just in case it's used in biological warfare? Would you have your children immunized, knowing the possible complications? Little has been said in the media about the dangers to young children.

What about Anthrax?

I agree that small pox is the most worrisome potential threat. It is highly contagious and has a 30% mortality rate. No one in this country under the age of 30 has been immunized for small pox.

After small pox was eradicated in the late sixties and early seventies only the CDC in Atlanta and a Soviet lab in Moscow were allowed to keep live viruses. Did the F'ing Soviets screw around with this virus and have they had a security breech ? I wonder what classified information our government knows. I doubt they would be ordering tens of millions of vaccines if they knew the Moscow viruses were secure and unmolested.

Unfortunately, some vaccines have a tiny rate of significant/tragic complications. However, you can't live life worrying about the one in a million tragedy when you are trying to prevent known pestilence such as polio, pertussis, small pox, etc. I am a physician and have had all my children vaccinated and also get my flu shot every year. Influenza kills thousands every year (mostly the elderly and debilated). Could my family or I have a tragic idiosyncratic reaction to a vaccine ? Sure, but I'll take those odds.

We used to get small pox vaccines when I was a kid,what's the big deal?

AIDS made people stop caring about 'mere Herpes.' Do you want people to stop caring about 'mere AIDS?'

Smallpox vaccination, unlike smallpox itself, doesn't give lifetime immunity, only 10-15 years. Virtually everyone is at risk. It's very contagious. Prior to Jenner's vaccine it was like chickenpox; everyone got it as a child. You either survived or became a statistic. Historical mortality rates with the more severe variola major strain averaged 30-40% and some historical outbreaks hit 90%. If you want to kill billions the easiest way known to man is to infect a bunch of suicide volunteers and spread them around the world before they become symptomatic.

Strict quarantine and mass vaccination of everyone around outbreaks is the only defense. You'd have to shut down the economy in affected areas for a couple weeks. These 40M units of vaccine may not be enough, but at least we have a production line again and can make more. The vaccine itself can make you seriously ill or even dead, especially if you have atopic dermatitis (eczema.) Other than injection of stored immunoglobulin from smallpox survivors or effectively vaccinated persons, very little of which exists, there is no proven treatment. It's possible some of the newer antivirals may work. There is anecdotal evidence that Cidofivir works against at least one pox virus, molluscom contagiosum (which causes only minor skin infections.) Unfortunately Cidofivir seriously nephrotoxic and requires IV administration. We should be developing better drugs.

As a Dermatologist I probably could diagnose smallpox. I pray I never do.

We used to get small pox vaccines when I was a kid,what's the big deal?

AIDS made people stop caring about 'mere Herpes.' Do you want people to stop caring about 'mere AIDS?'

As a Dermatologist I probably could diagnose smallpox. I pray I never do.

Nasty stuff- one of the early forms of warfare here in America was smallpox-ridden blankets. Brits used them on the colonials, colonials used them on the French, later Americans used them on the natives. It would be ironic to see that return.

still, I wonder if having passed through such outbreaks in the past, if a lot of Americans still carry resistance to it? Or were descended from people who showed natural immunity and might be resistant? Historically, not everyone in a village would succumb.

Which disease was the one (or more) they used to inject you in the shoulder for... and you would usually get a rised scar on the shoulder as a result? That wasn't for smallpox was it? They gave me that one but for some reason it didn't scar, but it's been so long I don't remember what the shots were for.

The vaccine itself can make you seriously ill or even dead, especially if you have atopic dermatitis (eczema.)

I would love to find a statistic on how many people have eczema. My 3 yo son has it. My husband has it (is it hereditary? He also has rosacea.) I've had anecdotal evidence that it's caused by allergies or sensitivities to various foods/chemicals, so I wonder what would the mortality rate be now, in a world where we're exposed to many more potential allergens/chemicals that cause eczema?

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