Smallpox vaccinations urged (MSNBC) - Offer to general population represents a shift in policy

http://www.msnbc.com/news/817382.asp ^ | 10-5-02 | MSNBC

[bonesmccoy]

WASHINGTON, Oct. 5 — The Bush administration’s top bioterrorism advisers said yesterday they support a voluntary smallpox vaccination program that would begin with 500,000 health care workers, expand to 10 million emergency responders and extend to the rest of the population as early as 2004.

IT WAS THE first time high-ranking administration officials acknowledged they are considering offering the risky vaccine to the public prior to an attack and it represented a profound shift in thinking from the June recommendations of a government advisory panel to inoculate about 20,000 medical personnel.

“We live in a society that values individual choice,” said Julie L. Gerberding, director of the Centers for Disease Control and Prevention. “If we have vaccine and we have data to accurately assess the safety, one school of thought is that informed people may want to have the choice of getting vaccine or not.”

In a 90-minute briefing at the Department of Health and Human Services, the group of officials responsible for implementing a bioterror response plan laid out the options before President Bush, stressing that he has yet to make a decision on who could be vaccinated and when. If a smallpox case were detected, officials would assume the nation was under attack and would quickly move to nationwide vaccination.

Developing a “pre-attack” vaccination policy, however, has proven to be “extremely difficult” because of the challenge in balancing the possible risks of the vaccine against the risks of an attack, said Jerome M. Hauer, assistant secretary for emergency health preparedness.

THREAT OVERCOMES CONCERNS

Although they have no way of knowing the likelihood of a smallpox attack, health experts fear such an attack because the virus is so contagious and so deadly. About one-third of people who get the disease die, yet the vaccine itself can cause serious, sometimes fatal, complications.

Concerns that Iraq or another hostile nation may have acquired the virus have added urgency to the vaccination debate. “We need to be mindful that the context of this decision has changed a bit” since the far more conservative June recommendations, Gerberding said.

Vice President Cheney has speculated that the threat from Iraqi President Saddam Hussein may necessitate mass vaccination. Privately, sources said Cheney has vigorously advocated a broad vaccination policy. White House spokesman Scott McClellan said last night the policy “is under review” but he could not elaborate on a timetable or factors involved in the decision.

Since last fall’s anthrax attacks, federal health officials have moved swiftly to build up the nation’s smallpox vaccine stockpile. If an attack occurred today, they said they could safely dilute the existing supply to inoculate every American. By the end of next year, they expect to have 209 million doses of new vaccine on hand. None of the vaccine has been licensed by the Food and Drug Administration, but officials expect the first batches will be approved by November.

MILITARY FIRST IN LINE

At the request of the Department of Defense, Hauer said HHS will provide the first 1 million doses of licensed smallpox vaccine to the military within the month. Pentagon spokesman James Turner refused to comment.

For civilians, the HHS team favors a policy of “ever-expanding access to vaccine” that could be phased in as more vaccine is licensed and scientists have time to monitor early reactions to it. Using licensed vaccine would be much easier logistically than administering it as an experimental treatment that involves tricky liability issues.

The approach envisions vaccinating the people considered to be at greatest risk if an outbreak occurs. That would include public health investigators, emergency room workers and even janitors and security guards at local hospitals.

The goal in the early stages, Gerberding said, “is to maximize our ability to respond to an attack should one occur.”

In the second phase, as many as 7.5 million medical workers would be offered vaccine, along with the nation’s 3 million firefighters, police officers and rescue workers, Hauer said. Inoculating that many emergency personnel “would make it even easier to respond” to an attack, Gerberding explained. It is possible Bush would combine the first two phases and opt to inoculate the majority of first responders immediately.

At some later date, perhaps in early 2004, vaccine could be offered to every American. “Right now, our thinking is in favor of making vaccine available to the general public,” Gerberding said.

Federal health officials rejected the advice of its advisory panel to designate certain smallpox hospitals because Hauer said it was unrealistic to think patients would follow those guidelines.

America stopped routine vaccination in 1972, which means about 45 percent of the population has never been inoculated. It is unclear how much immunity remains from vaccines given 30 or 40 years ago.

Between 30 million and 50 million Americans should not be given the vaccine because they have weak immune systems, said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases. That includes people who have received chemotherapy, have eczema or are infected with the AIDS virus. For every 1 million vaccinated, 15 people are likely to suffer life-threatening complications and one or two would die.

Because there is limited scientific data, it is difficult to predict the risks of a person spreading the virus in the vaccine to others. Administration aides are still grappling with the liability issues of reviving a vaccination program.

State health officials have until Dec. 1 to file plans for mass vaccination within five to 10 days of an attack, Hauer said. In the event of an attack, he observed, “Five days might be a luxury.”

[bonesmccoy]

Any Freepers involved in state wide races... HAS the incumbent governor's office TURNED IN their HOMEWORK TO THE WHITE HOUSE????

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[Robert_Paulson2]

for small pox? five days too late?
hmnn.... tests show that vaccines over thirty years old are plenty effective... and half of us have them... this "plan" covers more than distribution of small pox I would guess.

I wonder if this is about small pox, or OTHER attacks? Say what do they give you for radiation sickness? Iodine tabs? or injections? What about Anthrax, botulism, or ricin? plague?

What else makes sense?

[bonesmccoy]

I take this report at face value...it's about small pox vaccination and I'm pleased that more rational heads in the Administration are beginning to prevail. Even if Saddam is contained and regime change occurs, it will be sometime before physicians and citizenry are confident that "The Base" doesn't have small pox weapons.

[Robert_Paulson2]

I don't take it at face value.. I have questions, and am not alone buddie. For example:

http://reese.king-online.com/Reese_20021004/index.php

The Smallpox Hoax

I'm curious why the United States government is trying to frighten the American people with the possibility of a biological attack that uses smallpox.

The U.S. government is well-aware that smallpox was pronounced eradicated from the world and that only two governments possess smallpox viruses — the United States and Russia.

Not even in its wildest accusations has the Bush administration suggested that Iraq or any other member of its "axis of evil" has access to the smallpox virus. Yet it has made a big deal about buying vaccines and talked much about plans to vaccinate the entire population if an attack occurs.

Well, there is only one way an attack can occur, and that is if someone in the United States or Russia makes the virus available to terrorists. I would think that is highly unlikely. But, by the by, it is known that Russia has developed a super-virulent form of smallpox against which vaccination would offer no protection. The U.S. government has paid the Russians for samples of this super-bug, yet Russia has found one excuse after another to avoid delivering the sample we paid for.

Since Mr. Bush has stared into Russian President Vladimir Putin's eyes and pronounced him a trustworthy friend, I wonder why President Bush hasn't picked up the phone and asked his pal, Putin, to hand over what we've already paid for.

This is just another example of why I believe the United States should be focusing its diplomatic and intelligence resources on Russia and China instead of diddling around with Third World countries. When you are in bear country, it pays to watch the bears and not be distracted by foxes and squirrels.

Unfortunately, biological agents are easy to produce, though the methods of distribution are much more complicated. It is probably only a matter of time before there is a biological attack. Yet you should know that one country stands in the way of a worldwide treaty, backed up by inspections, to ban biological-weapons research and production. That country, of course, is the United States. It seems that drug companies object to the idea of international inspections.

The outbreak of what was called Spanish flu in 1918 is a reminder of what biological warfare could do. This was, apparently, a natural disease. It appeared in the spring of 1918 and disappeared in the spring of 1919, but during that short duration it killed 20 million people, mostly children and young adults. In France, 166,000 people died; in Germany, 225,000; in Great Britain, 228,900; and in the United States, 550,000. In India, the death toll was 16 million.

At the time, nobody knew what it was or where it had originated. It was certainly not like any flu we are familiar with. About 25 percent of its victims were 15 and younger, and another 45 percent were between 15 and 35. It was said that people would develop symptoms in the morning and often be dead by the afternoon. Since viruses mutate all the time, the possibility of another such pandemic can never be ruled out. Of course, at the time, nobody knew anything about viruses.

When I was boy, smallpox vaccinations were mandatory, and comparing scars was one of those silly things that occupy the minds of elementary-school children. I cannot recall any cases of fatal reactions, though naturally children at the age of 6 are not the best-informed human beings.

But nevertheless, there are far more immediate threats than a possible smallpox outbreak, and one has to wonder why the government has put so much attention on it. I suspect it is just part of the administration's ongoing campaign to scare people into supporting its endless war against terrorism.

---

© 2002 by King Features Syndicate, Inc.

[Robert_Paulson2]

I suspect it is just part of the administration's ongoing campaign to scare people into supporting its endless war against terrorism.

I don't agree with reese on this point... I happen to think we are facing more than just a simple anthrax or smallpox outbreak...

[Tree of Liberty]

Potassium iodine and potassium iodate only protect against thyroid irradiation. It's not a wholesale vaccine against radioactive material.

[Robert_Paulson2]

What was that stuff in AFRICA that was so deadly?
touch a sick person and you start bleeding internally in 48 hours or less?

You better believe that sadaam tried to get some of that stuff... "hemmoraghic fever" or some kind of "e-coli?"

[Miss Marple]

Saddam has smallpox. That has been documented by defectors from his bio-weapons program. The government has been concerned about smallpox since shortly after 9/11. Eli Lilly's CEO has met with Senator Frist several times, and the Indianapolis paper carried a story about Lilly testing to see if one of their anti-cancer drugs would be effective against smallpox.

Personally, I take this seriously, I want my family vaccinated, I will be re-vaccinated (since no one knows for sure how long immunity lasts after 30 years) and I suggest that second-guessing and looking for hidden motives in every operation of the government can be counter-productive. At some point you have to have a little trust, and this administration is trustwowrthy.

[Cicero]

This is still a lot of big-brother-knows-best cr*p. Read the details. There is enough vaccine available to start using it now, but they will not release it to the American public for voluntary vaccinations by their doctors until 2004.

Are they planning to tell Saddam and al Qaeda that they mustn't try to start a smallpox epidemic until 2004?

This is still a typically clintonoid approach, reluctantly backing away from bureaucratic control one step at a time, just as slowly as possible.

We are very likely to be going to war with Iraq in a month or two. Why the big wait? Can't Bush weed some of these left-wing bureaucrats out of the health bureaucracy?

[Miss Marple]

Ebola. A variety of ebola was the biological agent in Tom Clancy' book Executive Orders. The method of dispersal was aerosol cans set off in trade shos and airport terminals. The Jack Ryan character as president used an executive order to institute a national quarantine.

I have stockpiled canned goods and other supplies just in case. Even with smallpox I would imagine there will be some sort of quarantine until vaccinations are available.

[ValerieUSA]

ebola

[Robert_Paulson2]

tests show any residual is plenty effective... even up to 45 years I read last week...

over half of the adult population is safe.

I trust...

... but want to verify.

the portland terrorist, arrested yesterday, had worked in the mayor's office and had access to infrastructure data and personnell... these folks are no doubt planning on something bigger than spot "small pox" outbreaks.

small pox, only half of us could catch, and half of the people we contact could catch that... It could be easily caught, and a quarantined area vaccinated en masse to stop the spread of the disease... pretty quickly.

"small pox" is a big enough demon to get us thinking... but I wonder if there might not be something else they are not telling us. It doesn't hurt to ask, speculate and consider... it's what we do here. You know that.

[stndngathwrthistry]

Not even in its wildest accusations has the Bush administration suggested that Iraq or any other member of its "axis of evil" has access to the smallpox virus.

http://cns.miis.edu/pubs/other/vacc.htm

"What most troubles U.S officials today, however, is the fear that the Soviet Union may have shared with Iraq smallpox that it weaponized by the ton in the 1970s and 1980s." (from the International Herald Tribune)

http://www.newsmax.com/archives/articles/2002/8/17/165828.shtml

"This week the Israeli government announced that it has begun vaccinating some 1,500 health workers against an outbreak of smallpox launched by Saddam." (NewsMax.com)

http://www.intelmessages.org/Messages/National_Security/Archives/Archive_07/wwwboard/messages/79.html

"TONY BLAIR rushed through an order for 16 million doses of the smallpox vaccine after Dick Cheney, the American Vice-President, warned him that a military attack on Iraq would be met by a biological terror onslaught on Britain." (from the Telegraph)

http://commdocs.house.gov/committees/intlrel/hfa76481.000/hfa76481_0.htm

"The agents of concern with Iraq have to be the organisms that cause anthrax, tularemia, brucellosis, and smallpox." (Richard O. Spertzel, head of bioweapons inspections from UNSCOM, 1994-98, at a hearing before the House Committee on International Relations)

But of course, Charley Reese knows better, though the use of an internet search engine seems to be beyond his capabilities.

[Robert_Paulson2]

that was some scary stuff.
no vaccine for it either.

any prophylactic antibiotic that is effective? Is it something a five day regimen of antibiotics would possibly prevent the spread of?

[Robert_Paulson2]

I don't agree with reese...
I just dont think smallpox is all they have in view with this "plan".

We need to consider our "stored goods" in case of something more diabolic is envisioned... without panicking., of course.

[stndngathwrthistry]

My point was that the assertion upon which Reese's entire column was based ("Not even in its wildest accusations has the Bush administration suggested that Iraq or any other member of its 'axis of evil' has access to the smallpox virus") is demonstrably untrue.

I knew it was untrue as soon as I read it, and a single Google search on "Iraq smallpox" (without the quotes) was enough to confirm that, in fact, the US, British, and Israeli governments, as well as the former bioweapons guy from UNSCOM, think that Iraq may have smallpox.

Either Reese is a liar who hopes no one will check up on him, or he's badly out of touch with reality. Either way, using his column as part of your argument is counterproductive.

[concerned about politics]

The U.S. government is well-aware that smallpox was pronounced eradicated from the world and that only two governments possess smallpox viruses — the United States and Russia.

Russia lost some of it's very heavy nukes. Who knows what else. One small vile is all it takes.

[Miss Marple]

Robert, I guess most of my argument is with Mr. Reese, and I think you chose a poor article to use to make your point, as stndatwrthistry says (by the way, stnd...get a new screen name...LOL!).

It is quite possible that you are correct and that they have something worse. It is also possible that they have a mutated variety of smallpox, in which case we will ALL need to be vaccinated, regardless of whether we were in the past. I am not a medical professional, so I can only go on lay readings and common sense as a mother and grandmother.

The government has a good idea of what SOME of the biological agents are. They cannot possibly know ALL of them. Therefore, it is wise to have a plan and whether it is used for smallpox or something else, or hopefully nothing at all, I am glad they are moving towards general vaccination.